scholarly journals Early Mobilization: Changing the Mindset

2015 ◽  
Vol 35 (4) ◽  
pp. e1-e6 ◽  
Author(s):  
Emily Castro ◽  
Michael Turcinovic ◽  
John Platz ◽  
Isabel Law
Keyword(s):  
Mechanical Ventilation ◽  
Interdisciplinary Collaboration ◽  
Early Mobilization ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Team Collaboration ◽  
Vein Thrombosis ◽  
Implementation Evaluation ◽  
Skin Breakdown ◽  
Deep Vein

BACKGROUND Staff in the surgical intensive care unit (SICU) had several concerns about mobilizing patients receiving mechanical ventilation. OBJECTIVE To assess and improve the mindset of SICU staff toward early mobilization of patients receiving mechanical ventilation before, 6 months after, and 1 year after implementation of early mobilization. METHODS The Plan-Do-Study-Act model was used to guide the planning, implementation, evaluation, and interventions to change the mindset and practice of SICU staff in mobilizing patients receiving mechanical ventilation. Interventions to overcome barriers to early mobilization included interdisciplinary collaboration, multimodal education, and operational changes. The mindset of the SICU staff toward early mobilization of patients receiving mechanical ventilation was assessed by using a survey questionnaire distributed 2 weeks before, 6 months after, and 1 year after implementation of early mobilization. RESULTS The median score on 6 of 7 survey questions changed significantly from before, to 6 months after, to 1 year after implementation, indicating a change in the mindset of SICU staff toward early mobilization of patients receiving mechanical ventilation. The SICU staff agreed that most patients receiving mechanical ventilation are able to get out of bed safely with coordination among personnel and that early mobilization of intubated patients decreases length of stay and decreases occurrence of ventilator-associated pneumonia, deep vein thrombosis, and skin breakdown. CONCLUSIONS SICU interdisciplinary team collaboration, multimodal education, and operational support contribute to removing staff bias against mobilizing patients receiving mechanical ventilation.

scholarly journals Prevalence of deep vein thrombosis in acutely admitted ambulatory non-surgical intensive care unit patients

2014 ◽  
Vol 7 (1) ◽  
Author(s):  
Holger Lawall ◽  
Ralph Oberacker ◽  
Claudia Zemmrich ◽  
Peter Bramlage ◽  
Curt Diehm ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Deep Vein Thrombosis ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Vein Thrombosis ◽  
Deep Vein

scholarly journals Tracheostomy in Postoperative Pediatric Cardiac Surgical Patients—The Earlier, the Better

2021 ◽  
Author(s):  
Chalattil Bipin ◽  
Manoj K. Sahu ◽  
Sarvesh P. Singh ◽  
Velayoudam Devagourou ◽  
Palleti Rajashekar ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
Hospital Stay ◽  
Pediatric Patients ◽  
Tertiary Care ◽  
Surgical Patients ◽  
Surgical Intensive Care Unit ◽  
Care Hospital ◽  
Surgical Intensive Care ◽  
Nutrition Supplementation

Abstract Objectives This study was aimed to assess the benefits of early tracheostomy (ET) compared with late tracheostomy (LT) on postoperative outcomes in pediatric cardiac surgical patients. Design Present one is a prospective, observational study. Setting The study was conducted at a cardiac surgical intensive care unit (ICU) of a tertiary care hospital. Participants All pediatric patients below 10 years of age, who underwent tracheostomy after cardiac surgery from January2019 to december2019, were subdivided into two groups according to the timing of tracheostomy: “early” if done before 7 days or “late” if done after 7 days postcardiac surgery. Interventions ET versus LT was measured in the study. Results Out of all 1,084 pediatric patients who underwent cardiac surgery over the study period, 41 (3.7%) received tracheostomy. Sixteen (39%) patients underwent ET and 25 (61%) underwent LT. ET had advantages by having reduced risk associations with the following variables: preoperative hospital stay (p = 0.0016), sepsis (p = 0.03), high risk surgery (p = 0.04), postoperative sepsis (p = 0.001), C-reactive protein (p = 0.04), ventilator-associated pneumonia (VAP; p = 0.006), antibiotic escalation (p = 0.006), and antifungal therapy (p = 0.01) requirement. Furthermore, ET was associated with lesser duration of mechanical ventilation (p = 0.0027), length of ICU stay (LOICUS; p = 0.01), length of hospital stay (LOHS; p = 0.001), lesser days of feed interruption (p = 0.0017), and tracheostomy tube change (p = 0.02). ET group of children, who had higher total ventilation-free days (p = 0.02), were decannulated earlier (p = 0.03) and discharged earlier (p = 0.0089). Conclusion ET had significant benefits in reduction of postoperative morbidities with overall shorter mechanical ventilation, LOICUS, and LOHS, better nutrition supplementation, lesser infection, etc. These benefits may promote faster patient convalescence and rehabilitation with reduced hospital costs.

scholarly journals Trombosis venosa profunda en cirugías de tobillo y pie. Algoritmo de profilaxis [A prophylaxis algorithm for deep vein thrombosis in ankle and foot surgery]

2019 ◽  
Vol 84 (3) ◽  
pp. 252-259
Author(s):  
Héctor Masaragian ◽  
Fernando Perin ◽  
Hernán Coria ◽  
Luciano Mizdraji ◽  
Nicolás Ameriso ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Rare Complication ◽  
Major Complication ◽  
Early Mobilization ◽  
Foot And Ankle ◽  
Vein Thrombosis ◽  
Ankle Surgery ◽  
Preventive Drug ◽  
Deep Vein ◽  
Trombosis Venosa Profunda

Introducción: La enfermedad tromboembólica es una de las complicaciones serias en la cirugía ortopédica. La tromboprofilaxis para las cirugías de tobillo y pie no está estandarizada, porque la incidencia es baja, según la bibliografía. El objetivo de este estudio es aportar un algoritmo de prevención para la trombosis venosa profunda y una revisión de la bibliografía.Materiales y Métodos: Se llevó a cabo una revisión de las historias clínicas de los pacientes operados entre 2011 y 2017. La muestra estaba integrada por 696 hombres (28,98%) y 1706 mujeres (71,02%), con un promedio de edad de 51 años (rango 20-82). Se realizaron 2402 procedimientos, 575 (23,94%) fueron por patologías traumáticas y 1827 (76,06%), por patologías ortopédicas.Resultados: Nueve pacientes (0,37%) presentaron trombosis venosa profunda y solo dos, tromboembolismo pulmonar (0,08%). Los procedimientos en los que ocurrieron fueron: artroscopia, reparación aguda del tendón de Aquiles, hallux valgus y fractura del 5.° metatarsiano.Conclusiones: Se recomienda un enfoque multimodal para la profilaxis de la trombosis venosa profunda. Esto incluye abordar los factores de riesgo modificables, mediante la profilaxis mecánica, la movilización temprana y la profilaxis química. La heparina de bajo peso molecular es eficaz para reducir la tasa de trombosis venosa profunda y tromboembolismo pulmonar. AbstractIntroduction: Deep vein thrombosis (DVT) is a major complication in orthopedic surgery. According to the literature, thromboprophylaxis in foot and ankle surgery is not a standardized practice due to the low incidence of DVT.Materials and Methods: We reviewed the medical records of surgical patients. Between 2011 and 2017, 1591 surgeries were performed, 6 of them due to symptomatic DVT.Results: The incidence of DVT in major orthopedic surgeries, such as knee and hip, is well documented, but there are only a few reports about its incidence in foot and ankle surgery. It is considered a relatively rare complication in many published studies; thus, preventive drug therapy is not routine practice.Conclusions: A multimodal approach to DVT prophylaxis for high-risk patients is recommended. All risk factors should be addressed, such as mechanical prophylaxis, early mobilization, and the use of chemoprophylaxis. Low molecular weight heparin is effective in reducing the rate of clinically significant DVT and is also likely to reduce the rate of pulmonary embolism.

scholarly journals Effect of Early Mobilization on Hip and Lower Extremity Postoperative: A Literature Review

2021 ◽  
Author(s):  
Aprisunadi Aprisunadi ◽  
Moses Glorino Rumambo Pandin
Keyword(s):  
Literature Review ◽  
Lower Extremity ◽  
Health Workers ◽  
Lower Extremities ◽  
Early Mobilization ◽  
Bed Rest ◽  
Vein Thrombosis ◽  
Hospitalization Costs ◽  
Tract Infections ◽  
Deep Vein

Background: The incidence of fracture and surgery of the hip and lower extremities is still high. Long postoperative bed rest has the potential to increase the incidence of various complications that may increase the morbidity and mortality rate of patients after hip and lower extremities surgery. Aim: This literature review aimed to identify the effects of early mobilization in hip and lower extremity postoperative. Method: Search for articles on several databases such as ProQuest, ScienceDirect, CINAHL, Medline, Wiley Online and Scopus, using the Boolean operator by combining several keywords according to the literature review topic, with inclusion criteria are published in the last 3 years (2019-2021), used a quantitative design, written in English and full text articles. A total of 435 articles were obtained, then screened and reviewed, so that there were 16 (sixteen) eligible articles.Result: There were 11 (eleven) effects of early mobilization, i.e. reducing length of stay, reducing the risk of deep vein thrombosis (DVT), reducing pulmonary infections (pneumonia), reducing urinary tract infections, reducing the risk of wound infection, improving extremity function and ability to walk, reducing postoperative pain, reducing the risk of pressure sores, reducing postoperative delirium, reducing readmission and lowering hospitalization costs. Conclusion: This literature review showed that early mobilization is safe and effective in postoperative patients to reduce the risk of complications and adverse events. Nurses and health workers who care for patients could implement early mobilization and motivate patients to be cooperative in undergoing early mobilization.

scholarly journals Deep Vein Thrombosis in Patients with Amyotrophic Lateral Sclerosis Undergone-mechanical Ventilation

2016 ◽  
Vol 27 (3) ◽  
pp. 349-354
Author(s):  
Hiromasa Fukuba ◽  
Hiromitsu Ohmori ◽  
Masami Yamasaki ◽  
Hirofumi Maruyama ◽  
Takafumi Miyachi ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Amyotrophic Lateral Sclerosis ◽  
Deep Vein Thrombosis ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Lateral Sclerosis

scholarly journals Early mobilization versus bed rest for deep vein thrombosis

Medwave ◽  
2016 ◽  
Vol 16 (Suppl2) ◽  
pp. e6478-e6478 ◽  
Author(s):  
Ariel Izcovich ◽  
Federico Popoff ◽  
Gabriel Rada
Keyword(s):  
Deep Vein Thrombosis ◽  
Early Mobilization ◽  
Bed Rest ◽  
Vein Thrombosis ◽  
Deep Vein
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