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. 2025 Jan 7;10(1):e783.
doi: 10.1097/pq9.0000000000000783. eCollection 2025 Jan-Feb.

Keep Moving: Sustainability of an Early Mobility Protocol in an Academic Pediatric ICU

Jenna E Domann  1 , Lindsay E Davies  1 , Elizabeth E Zivick  2 , Laken Johnson  3 , Everette P Keller  4 , Alice A Walz  2
Affiliations

Keep Moving: Sustainability of an Early Mobility Protocol in an Academic Pediatric ICU

Jenna E Domann et al. Pediatr Qual Saf. .

Abstract

Introduction: Mobilization protocols are safe and feasible for critically ill pediatric patients in the intensive care unit (ICU), but barriers exist to sustainability. This study described a focused early mobility protocol, sustained over 5 years, which is on time for therapy consults and patient mobilization at a single institution.

Methods: A formal ICU mobility protocol was implemented as part of a unit-wide ICU liberation bundle. As part of the ongoing program assessment, over a specific 3-month timeframe annually from 2017 to 2023, the number of physical and occupational therapy (PT/OT) consults, mobilization rate, and time to PT/OT consult were analyzed. In addition, in 2023, we assessed specific barriers to early PT/OT consultation.

Results: Annually, for each study timeframe, there was a sustained decrease in time to therapy consult from a mean of 3.8 days for PT and 7 days for OT in 2017 to 1.9 and 1.6 days, respectively, in 2023. Similarly, the mobilization rate increased from 20.3 sessions per 100 patient days in 2017 to 48.2 in 2023. There was a trend toward missed or delayed therapy consults at times of higher ICU census. No adverse events were associated with mobilization.

Conclusions: An ICU early mobility protocol leads to a sustained decrease in the time to therapy consultation, an increase in the number of therapy consults, and an increase in the mobilization rate. Future interventions should focus on mitigating barriers to timely consultation, specifically at times of higher ICU census.

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Figures

Fig. 1.
Fig. 1.
Phases of program development.
Fig. 2.
Fig. 2.
Chart depicting the increase in several PT and OT consults during the 3-month study time frame for each year of data collection.
Fig. 3.
Fig. 3.
Chart depicting the median number of days from PICU admission to physical and occupational therapy order placement during each established 3-month study time frame.
Fig. 4.
Fig. 4.
Mobilization rate for each collection period.
See this image and copyright information in PMC

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