PICU in Motion: Constructing an Evidence Based Protocol for Early Mobility in a Pediatric Intensive Care Unit

Problem: Patients enter the intensive care unit when they need close monitoring after illness, injury, or surgery. With the most acute pediatric patient populations, movement of their fragile bodies may decrease or even cease. Staff anxiety of when and how to move delicate pediatric patients prevented simple care such as microshifting, turning, sitting up, or walking patients in the intensive care unit. Project Objective: Develop an early mobility protocol to allow all staff to know when and how to move patients in a pediatric intensive care unit. Method: A collaborative team was established that included nurses, physicians, physical therapists, respiratory therapists, child life, and wound care. This team discussed the barriers and goals to early mobility in the PICU. Once the team focused on the direction for the project, a protocol was developed after literature review. The protocol provided rationale and guidance to all staff on the outcomes expected and empowered the staff to advocate for early mobility. Outcome: The protocol provided rationale and guidance to all staff on the outcomes expected for mobility in the PICU. The protocol identifies patient populations, turning and activity schedule, as well as adaptions if the patient was unable to meet the expected goals. Staff would therefore have practical interventions in place to keep the patient moving forward. The implementation of early mobility decreases the number of days with sedation, ventilation, length of stay, and decreases the rate of pressure injury formation.