Overcoming Barriers to Early Mobilization in ICU: The Effect of Teaching Guidelines on Nurses' Knowledge, Practices and Anxiety

Document Type : Original Article

Authors

1 Assistant Professor of Emergency and Critical Care Nursing, Faculty of Nursing, Mansoura University and Assistant Professor of Emergency and Critical Care Nursing, Faculty of Nursing, King Abdulaziz University

2 Pediatric Nursing, Faculty of Nursing, Sohag University, Egypt

3 Professor of Medical Surgical Nursing, Al Rayan National Colleges, College of Health Sciences and Nursing, Madinah, KSA

4 Assistant professor of Medical-Surgical Nursing, Faculty of Nursing, Port-Said University

5 Lecturer at Critical Care and Emergency Nursing, Faculty of Nursing, Sohag University, Egypt

6 Assistant Professor in Psychiatric Nursing, Faculty of Nursing, Modern University for Technology and Information

7 Lecturer of Medical Surgical Nursing / Faculty of Nursing / Beni- Suef University

Abstract

Background: Early mobilization is a safe and effective approach, with a potential of influencing functional outcomes and avoiding immobility complications. Even the ideal of early onset of mobilization of critically ill patients as part of standard of care can be difficult to implement. The clinical practice of early mobilization is though less adopted in the intensive care unit. Aim : This study aimed to evaluate the effect of  teaching guidelines on nurses' knowledge, practices, and anxiety to overcome barriers of early mobilization among patients in intensive care unit. Design: To fulfill the aim of the study a  quasi-experimental design was used in this study. Setting: The study was applied in the intensive care unit affiliated to Sohag University Hospital. Subjects: A convenience sample of 50 nurses working at the previously mentioned setting who were recruited in this study. Tools: Tool (I):  Nurses’ knowledge  about early mobilization,  Tool (II):  Nurses' practice Observation Checklist about early mobilization, and Tool III: Zung’s self-rating anxiety questionnaire. Results: The study findings revealed that nurses’ had a higher knowledge score and practice post-teaching guidelines implementation than pre-teaching guidelines implementation regarding early mobilization. There was a reduction in the studied nurses' anxiety levels post-the teaching guidelines implementation. There was a positive correlation between nurses' total knowledge, practice, and anxiety post-teaching guidelines implementation. Conclusion : Teaching guidelines has a positive effects on improving nurses' knowledge,  practice, and anxiety reduction to overcome barriers of early mobilization among patients in intensive care unit.  Recommendations: Regular efforts to alter intensive care unit culture toward early mobilization with a multidisciplinary approach and several interventions are also essential to early mobility success in clinical practice. It is recommended that nurses receive regular up-to-date refresher training with continuous follow up to the uptake early mobilization into daily nursing practice in the intensive care unit. The barriers to implementation of early mobilisation need to be addressed by the organisation.

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