Date of Award

Summer 2023

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Faculty Chair

Dr. Cheryl Emich

Preceptor

Dr. Bethany Anders

Abstract

Background: Intensive care unit acquired muscle weakness (ICUAW) is a syndrome of general weakness that occurs while a patient has a critical illness. Almost half of all ICU patients develop ICUAW. The most common occurrence of ICUAW is seen in patients diagnosed with prolonged mechanical ventilation, severe sepsis, or difficulty weaning from mechanical ventilation (MV). Bedrest is the number one risk factor for the development of ICUAW and the elderly are at higher risk. The best treatment for ICUAW is early mobility which has shown positive effects for decreasing ventilator days and intensive care unit (ICU) length of stay (LOS).

Purpose: The purpose of this quality improvement project is to decrease ventilator days and decrease ICU LOS through the implementation of a nurse-driven early mobility protocol in critical care.

Methods: The Medical Research Council (MRC) sum score was used to compare the muscle strength of ICU patients on admission to and discharge from the ICU. Patient outcomes measured will include ICU length of stay and number of ventilator days.

Results: Results of a two-sample t-test to measure ICU LOS and ventilator days in two ICUs showed there was no statistical significance.

Conclusion: Early mobility remains the safe and effective standard of care in critical care. The results of the quality improvement project tell us that a robust multidisciplinary plan of implementation is needed. Barriers must be mitigated to deliver the best results.

Keywords: Early mobility, intensive care unit acquired muscle weakness (ICUAW), MRC sum score, Liberation Bundle

Included in

Nursing Commons

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