Information from the abstract
Background: Intensive care unit (ICU)-acquired weakness is a significant complication affecting approximately 34.1% of ICU patients, leading to muscle atrophy, prolonged hospitalization, and increased mortality. Early mobilization (EM) is a critical nursing practice to mitigate these effects. Despite its benefits, standardized guidelines are often underutilized due to safety concerns and the limited availability of clinical protocols. Objective: To compare muscle strength and mobility levels in critically ill patients before and after the implementation of a structured EM nursing practice guideline. Methods: This retrospective descriptive study analyzed 35 critically ill patients at Ramathibodi Hospital’s medical ICU (January-December 2024) who received an established EM nursing practice guideline comprising a standardized EM protocol, staff training, and educational media. Outcomes were measured by the Medical Research Council (MRC) sum score and the ICU Mobility Scale (IMS), analyzed via paired t tests and Wilcoxon signed rank tests. Results: Most participants were aged 70-79 years, with acute respiratory distress syndrome (ARDS) and septic shock as primary diagnoses. Following the 5-day EM protocol, muscle strength significantly improved, with mean (SD) MRC scores increasing from 38.77 (12.46) to 47.26 (11.76) (P < .001). Functional mobility also showed significant gains (P < .001), with 54.3% of patients achieving higher mobility levels and 45.7% remaining stable. Importantly, no decline in mobility level was observed. Conclusions: This study demonstrated that a structured EM nursing practice guideline is feasible and effective in improving muscle strength and mobility among critically ill patients, supporting its integration into routine ICU nursing care.
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Related topics: Intensive Care Unit Cognitive Disorders · Clinical Nutrition and Gastroenterology · Nosocomial Infections in ICU
Thai researcher and institutional participation
Metta Kheiawsawang · Onsuda Sopaporm · Siwakon Sriwicha · Ramathibodi Hospital
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