Corona Update: SURGE CAPACITY SOLUTIONS – The mobi is a mobile headwall (equipment consolidator) that can be set up in any space that has an electrical outlet: next to a chair, a bed, a cot in a hallway, a cafeteria, or anywhere patients need to be located. Click here for more information.

Tag: Neurological Benefits of mobility

Known Benefits to Early Patient Mobility

Posted on by Steve Villanueva

Neurological Benefits with Patient Ambulation

There are many known neurological benefits of early patient mobility. The fact that immobility causes muscle stiffness and weakness is familiar to anyone who sits in a chair for too long, but can immobility actually cause permanent nerve damage? Recent studies reveal that immobility during hospital stays can cause damage to the peripheral nervous system, increase the likelihood and severity of delirium, and slow recovery for patients with neurological problems. To resolve this, neurological intensive care units have been developing specialized early mobility protocols that make it safe to mobilize patients with severe conditions like stroke, aneurysm, and severe acquired brain injury.

Key Facts:

  • Patients who experience in-hospital immobilization are at high risk for intensive care unit-acquired weakness (ICUAW), which contributes to long-term disability, including permanent damage to the peripheral nervous system. (Kramer 2017)
  • Patients who have experienced treatment for critical illness often acquire secondary, long-term neuropsychiatric problems like delirium. Exercise is associated with increased cerebral blood flow, normal nerve repair, and nerve health, and early mobilization may reduce delirium and improve neuropsychiatric outcomes. (Hopkins 2012)
  • Specialized early mobility activities have been developed specifically for patients admitted to the neurological intensive care unit (NICU) to maximize safety and minimize complications from immobility, even for patients with complications like an external ventricular drain. (Yataco 2019, Shah 2018, Olkowski 2017, Moyer 2017)
  • Movement is so important to nerve health that new nursing guidelines call for patients undergoing spinal surgery to be mobilized on the day of surgery, within six hours of arrival at the medical-surgical unit. (Rupich 2018)
  • Early mobilization assists in the clinical and functional recovery of patients who have severe acquired brain injuries. (Bartolo 2017)

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Emotional Benefits of Early Patient Mobility

Posted on by Steve Villanueva

Emotion & Early PATIENT MOBILITY

There are many emotional benefits of early patient mobility. One critical factor in determining a patient’s capacity for early mobility is their mental state, which nurses judge on a case-by-case basis. But it turns out that early mobility can actually stimulate patients’ mental well-being and improve their emotional well-being, which immediately improves the patients’ quality of life, while reducing the serious risk of delirium and decreasing overall recovery time.    

Physical & Mental Benefits Linked

Key Facts:

ABCDEF Protocol

To improve patient outcomes and reduce hospital costs, the Society of Critical Care Medicine officially recommends that all intensive care units adopt the “ABCDEF” Protocol:

  • Assess, Prevent, and Manage Pain
  • Both Spontaneous Awakening Trials & Spontaneous Breathing Trials
  • Choice of Painkillers and Sedatives
  • Delirium: Assess, Prevent, and Manage
  • Early Mobility & Exercise
  • Family Engagement and Empowerment

Reducing Delirium in Patients

  • To decrease the incidence and duration of delirium, it is recommended that intensive care unit (ICU) staff perform early mobilization of adult patients whenever it is feasible. (Barr 2013)
  • To limit the incidence of physical, cognitive, and psychological disabilities that can result from critical illness, the Agency for Healthcare Research and Quality strongly endorses early mobilization for all patients, whenever it is feasible.
  • Early mobility decreases the occurrence, severity, and duration of delirium in patients. (Dirkes 2019, Krupp 2019, Taito 2016, Banerjee 2011, Schweickert 2009)
  • There is a very strong correlation between delirium, increased length of hospital stay, and increased chance of death in adult ICU patients. Delirium is also associated with a development of cognitive impairment after discharge from the ICU. (Barr 2013)
  • For patients who have experienced an acute stroke, early mobilization decreases the risk of depression and anxiety. (Cumming 2008)
  • While early mobility studies in pediatric units are still new, pediatrician Kristina Betters M.D. has gone on record to say: “Anecdotally, medical staff members are seeing their patients improve. Patients are less sedated and more interactive, and families are also engaging more with their children. Oftentimes parents feel helpless in the ICU, and this is one way they can help their child get better.”

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ICU Physical Therapy

Posted on by Philip Crumpton

ICU Physical Therapy

Benefits of Physical Therapy in the ICU

Benefits of physical therapy in the ICU. You might ask yourself what a physical therapist does in the ICU. That is a great question. The role of a P.T. in the ICU will vary from facility to facility. Some facilities have a dedicated P.T. who spends the day mobilizing patients, doing progressive resistance exercises and acting as the expert for positioning and prevention of contractions. Other facilities order a P.T. consult only when a patient is extubated and active.

There are some important things that a P.T. needs to be knowledgeable about when working in the ICU. I would recommend brushing up on the following; cardiopulmonary physiology, ventilator and respiratory equipment, medications commonly used in the ICU, exclusion criteria for mobility, clinical implications of lab values, and monitoring systems. It is also beneficial to take 2-4 hours to shadow an ICU nurse and a respiratory therapist if your facility allows for this.

There are many P.T. activities that can be done while the patient is sitting edge of bed such as; PREs for lower extremities, therapeutic exercises, deep breathing, ADLs, trunk control and seated balance activities.

The ultimate goal of ICU P.T. is to get patients mobile which will inevitably help them wean off of a ventilator, become more independent and eventually transfer out of the ICU.

As a P.T. who has worked in the ICU I can tell you that it is rewarding, exciting and important. The evidence for early mobility is strong and it is “Best Practice” for ICU patients. I encourage you to get trained, get involved and get your patients moving.

Beneficial Reading

Implementation of an Early Mobility Program

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What Customers Say

Testimonials

“6 months ago we implemented 12 mobis into our early mobility program. We have a very diverse population on our ICU and having the option of mobilizing them in a way that is helpful and assistive to staff while instilling confidence in the patient and family is great. We’re still working to figure out our ideal workflow but it’s given us concrete examples of how even our sicker vented patients can get mobilized safely and efficiently.”

Mark Rohlfing
RN, BSN Clinical Operations Manager Intensive Care Unit
Indiana University Health Ball Memorial Hospital - Muncie, IN

“After completing a research study with the LIVENGOOD mobi on our post trauma/surgical floor, I realized its potential to decrease length of stay, help with staff efficiency and empower patients to be independent.”

Lorrie Henecke
MS, APRN, ACNS-BC, CNRN Clinical Nurse Specialist
Medical Center of the Rockies, Loveland, CO

“We are so excited that the mobi helped us ambulate our very first vented patient.”

Esther Vandermeulen
R.N.
University Health System - San Antonio, TX

“The LIVENGOOD mobi is very user friendly, safe and a great solution to use minimal staff and be able to contain all of the patient’s equipment.”

Michael Saccone
P.T.
Saint Joseph's Hospital - Syracuse, NY

“I think the LIVENGOOD mobi will revolutionize the way we mobilize patients in the ICU. I saw patients mobilize sooner and with less anxiety with the mobi. One young patient was even able to walk outside with the mobi and her portable vent. Having the mobi made mobility a real team effort, not just a P.T. activity.”

Terra Terwilliger
PT, DPT - Adult Inpatient Physical Therapist
Rehab Services University of Minnesota Medical Center, Fairview Health System

“The LIVENGOOD platform allows my patients to be active and independent without attention being diverted to multiple lines, an oxygen tank, and other medically necessary devices. It allows patients to have hope and a sense of “normalcy”, which so often is lost after trauma or surgery.”

Jessica Gilbert
DPT
Staff Physical Therapist - Medical Center of The Rockies -Loveland, CO

“Six years ago I was introduced to the LIVENGOOD mobi. This piece of equipment has been life changing for my patients. I am now able to consolidate all of the patient’s medical devices onto an easy to push mobile platform, therefore freeing up both of my hands to safely assist my patient.”

Tanya Kensley
P.T.
Poudre Valley Hospital -Fort Collins, CO

“Mobility is Life, the mobi platform will help patients move again.”

Blas Villa
CCRN
University Health System - San Antonio, TX

“I was at NTI in Boston (2013) and, during the exhibit portion, I wandered across the LIVENGOOD booth. At that moment, I knew our hospital needed this mobi for our open heart recovery program. I worked with a Clinical Nurse Specialist to write a grant for this product. I am so excited to bring the mobi to our program.”

Celina Adams
RN, MSN, CCRN (CVICU)
John C. Lincoln - Phoenix, AZ

“We walked a vented patient with the mobi and it was awesome! This helped her physically and emotionally.”

Natalie Hariel
R.N.
Tulane Medical Center - New Orleans, LA

“I am a nurse in a cardiovascular ICU… Our goal for patients is to ambulate to the chair 2 hours after extubation, often the evening of surgery day. Our patients are up and walking with central venous catheters, swan ganz catheters, chest tubes, foley catheters, and with IV medications infusing. The ambulation of these patients would not be possible without the mobi walker. Every bit of equipment that these patients need can be carried on the walker while providing the stability of a standard walker… It is an essential piece of equipment for us and we couldn’t provide the care and therapies we do without it.”

Katherine Whitfield
RN CCRN
Athens Regional Medical Center - Athens, GA

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