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Effect of Early Multiprofessional Mobilization on Quality Indicators of Intensive Care in a Less Economically Developed Country: An Action on "Rehabilitation 2030" in Brazil.
Biazon, Thaís Marina Pires de Campos; Pott, Henrique; Caruso, Flávia Cristina Rossi; Bonjorno, José Carlos; Castello-Simões, Viviane; Lazzarini, Maria Thereza Bugalho; Taconelli, Mariana; Borghi-Silva, Audrey; Mendes, Renata Gonçalves.
Afiliação
  • Biazon TMPC; Cardiopulmonary Physical Therapy Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, Brazil; Department of Anesthesiology and Intensive Care Unit at the Irmandade da Santa Casa de Misericórdia de São Carlos, Sao Carlos, Brazil.
  • Pott H; Department of Medicine, Federal University of Sao Carlos, Sao Carlos, Brazil.
  • Caruso FCR; Cardiopulmonary Physical Therapy Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, Brazil.
  • Bonjorno JC; Department of Anesthesiology and Intensive Care Unit at the Irmandade da Santa Casa de Misericórdia de São Carlos, Sao Carlos, Brazil; Department of Medicine, Federal University of Sao Carlos, Sao Carlos, Brazil.
  • Castello-Simões V; Cardiopulmonary Physical Therapy Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, Brazil.
  • Lazzarini MTB; Department of Anesthesiology and Intensive Care Unit at the Irmandade da Santa Casa de Misericórdia de São Carlos, Sao Carlos, Brazil.
  • Taconelli M; Department of Anesthesiology and Intensive Care Unit at the Irmandade da Santa Casa de Misericórdia de São Carlos, Sao Carlos, Brazil.
  • Borghi-Silva A; Cardiopulmonary Physical Therapy Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, Brazil.
  • Mendes RG; Cardiopulmonary Physical Therapy Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, Brazil. Electronic address: renatamendes@ufscar.br.
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 OUTCOME

MEASURES:

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.
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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
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

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