Implementing Early Rehabilitation in the ICU to Improve Patient Outcomes

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Resident’s Handbook of Medical Quality and Safety

Abstract

Bed rest and immobility are associated with negative outcomes in survivors of critical illness. Use of a structured quality improvement model to improve early mobilization in the intensive care unit has multiple steps, including engaging and educating a multidisciplinary team, and identifying barriers that need to be addressed in designing the project.

The original version of this chapter was revised. An erratum to this chapter can be found at DOI 10.1007/978-3-319-24190-6_35

An erratum to this chapter can be found at http://dx.doi.org/10.1007/978-3-319-24190-6_35

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References

  1. Clavet H, Hebert PC, Fergusson D, Doucette S, Trudel G. Joint contracture following prolonged stay in the intensive care unit. CMAJ. 2008;178:691–7.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Truong AD, Fan E, Brower RG, Needham DM. Bench-to-bedside review: mobilizing patients in the intensive care unit – from pathophysiology to clinical trials. Crit Care. 2009;13:216.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Berney SC, Harrold M, Webb SA, et al. Intensive care unit mobility practices in Australia and New Zealand: a point prevalence study. Crit Care Resusc. 2013;15:260–5.

    PubMed  Google Scholar 

  4. Nydahl P, Ruhl AP, Bartoszek G, et al. Early mobilization of mechanically ventilated patients: a 1-day point-prevalence study in Germany. Crit Care Med. 2014;42:1178–86.

    Article  PubMed  Google Scholar 

  5. Winkelman C, Higgins PA, Chen YJ. Activity in the chronically critically ill. Dimens Crit Care Nurs. 2005;24:281–90.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Pronovost PJ, Berenholtz SM, Needham DM. Translating evidence into practice: a model for large scale knowledge translation. BMJ. 2008;337:a1714.

    Article  PubMed  Google Scholar 

  7. Parker A, Sricharoenchai T, Needham DM. Early Rehabilitation in the Intensive Care Unit: Preventing Physical and Mental Health Impairments. Curr Phys Med Rehabil Rep. 2013;1:307–14.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Stevens RD, Dowdy DW, Michaels RK, Mendez-Tellez PA, Pronovost PJ, Needham DM. Neuromuscular dysfunction acquired in critical illness: a systematic review. Intensive Care Med. 2007;33:1876–91.

    Article  PubMed  Google Scholar 

  9. Desai SV, Law TJ, Needham DM. Long-term complications of critical care. Crit Care Med. 2011;39:371–9.

    Article  PubMed  Google Scholar 

  10. Needham DM. Mobilizing patients in the intensive care unit: improving neuromuscular weakness and physical function. JAMA. 2008;300:1685–90.

    Article  CAS  PubMed  Google Scholar 

  11. Korupolu R, Gifford J, Needham DM. Early mobilization of critically ill patients: reducing neuromuscular complications after intensive care. Contem Crit Care. 2009;6:1–12.

    Google Scholar 

  12. Zanni JM, Korupolu R, Fan E, et al. Rehabilitation therapy and outcomes in acute respiratory failure: an observational pilot project. J Crit Care. 2010;25:254–62.

    Article  PubMed  Google Scholar 

  13. Hager DN, Dinglas VD, Subhas S, et al. Reducing deep sedation and delirium in acute lung injury patients: a quality improvement project. Crit Care Med. 2013;41:1435–42.

    Article  PubMed  Google Scholar 

  14. Needham DM, Korupolu R. Rehabilitation quality improvement in an intensive care unit setting: implementation of a quality improvement model. Top Stroke Rehabil. 2010;17:271–81.

    Article  PubMed  Google Scholar 

  15. Hopkins RO, Spuhler VJ, Thomsen GE. Transforming ICU culture to facilitate early mobility. Crit Care Clin. 2007;23:81–96.

    Article  PubMed  Google Scholar 

  16. Needham DM, Korupolu R, Zanni JM, et al. Early physical medicine and rehabilitation for patients with acute respiratory failure: a quality improvement project. Arch Phys Med Rehabil. 2010;91:536–42.

    Article  PubMed  Google Scholar 

  17. Dinglas VD, Parker AM, Reddy DR, et al. A quality improvement project sustainably decreased time to onset of active physical therapy intervention in acute lung injury patients. Ann Am Thorac Soc. 2014;11(8):1230–8.

    Article  PubMed  Google Scholar 

  18. Gina Kolata. New idea to cut ICU trauma: get patients up, tubes and all. The New York Times, January 11, 2009. A2.

    Google Scholar 

  19. Damluji A, Zanni JM, Mantheiy E, Colantuoni E, Kho ME, Needham DM. Safety and feasibility of femoral catheters during physical rehabilitation in the intensive care unit. J Crit Care. 2013;28(4):535.

    Article  PubMed  Google Scholar 

  20. Kamdar BB, Yang J, King LM et al. Develo**, implementing, and evaluating a multifaceted quality improvement intervention to promote sleep in an ICU. Am J Med Qual. 2013;29(6):546–554.

    Google Scholar 

  21. Sricharoenchai T, Parker AM, Zanni JM, Nelliot A, Dinglas VD, Needham DM. Safety of physical therapy interventions in critically ill patients: a single-center prospective evaluation of 1110 intensive care unit admissions. J Crit Care. 2014;29:395–400.

    Article  PubMed  Google Scholar 

  22. Kamdar BB, King LM, Collop NA, et al. The effect of a quality improvement intervention on perceived sleep quality and cognition in a medical ICU. Crit Care Med. 2013;41:800–9.

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Ibtehal Kimawi .

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If you have any questions about the information covered in this chapter or other medical safety and quality improvement-related topics, please contact us at http://www.medicalqualityandsafetyforum.com. The website will also provide a forum where you can ask specific questions about your safety and medical quality improvement projects or mentor upcoming medical quality leaders.

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Kimawi, I., Needham, D.M. (2016). Implementing Early Rehabilitation in the ICU to Improve Patient Outcomes. In: Atanelov, L. (eds) Resident’s Handbook of Medical Quality and Safety. Springer, Cham. https://doi.org/10.1007/978-3-319-24190-6_14

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  • DOI: https://doi.org/10.1007/978-3-319-24190-6_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-24188-3

  • Online ISBN: 978-3-319-24190-6

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