Effect of Early Multiprofessional Mobilization on Quality Indicators of Intensive Care in a Less Economically Developed Country: An Action on "Rehabilitation 2030" in Brazil.
Arch Phys Med Rehabil
; 2024 Aug 31.
Article
em En
| MEDLINE
| ID: mdl-39222873
ABSTRACT
OBJECTIVE:
To investigate the effects of implementing early multiprofessional mobilization on quality indicators of intensive care in Brazil.DESIGN:
This is a retrospective cohort study.SETTING:
A Brazilian educational and research-intensive care unit (ICU).PARTICIPANTS:
A total of 1047 patients were hospitalized from May 2016 to April 2018.INTERVENTIONS:
Implementation of early multiprofessional mobilization using the MobilizAÇÃO Program (MAP). MAIN OUTCOMEMEASURES:
Clinical, ventilation and safety quality indicators, and physical function before (preprogram period) and after (postprogram period) the MAP.RESULTS:
There was a reduction in sedation time (4 vs 1d), hospital stay (21 vs 14d) and ICU stay (14 vs 7d), mechanical ventilation (8 vs 4d), hospital death rate (46% vs 26%) (P<.001), and ICU readmission (21% vs 16%; P=.030) from pre to post MAP. Successful weaning (42% vs 55%) and discharge rate (50% vs 71%) (P<.001) increased after MAP. No differences were found to safety quality indicators between periods. After MAP, complex physical functions assessed using the Manchester Mobility Score (MMS) were more frequent. The in-bed intervention was a predictor for readmission (P=.009; R²=0.689) and death (P=.035; R²=0.217), while walking was a predictor for successful weaning (P=.030; R²=0.907) and discharge (P=.033; R²=0.373). The postprogram period was associated with the MMS at ICU discharge (P<.001; R²=0.40).CONCLUSIONS:
Early mobilization implementation through changes in low mobility culture and multiprofessional actions improved quality indicators, including clinical, ventilation, and physical functional quality, without compromising patient safety in the ICU.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
País/Região como assunto:
America do sul
/
Brasil
Idioma:
En
Revista:
Arch Phys Med Rehabil
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Brasil
País de publicação:
Estados Unidos