JHNEBP Evidence Rating Scales Research Paper

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Use of Early Mobilization to Minimize Length of Stay for ICU Patients University of Maryland School of Nursing Running head: USE OF EARLY MOBILIZATION 1 USE OF EARLY MOBILIZATION 5 Can early mobilization minimize length of stay for ICU patients who are on mechanical ventilation compared to standard of care? Author(s) and year Type of study (design) Population characteristics & sample size (n) Independent variable Dependent variable Results Evidence Strength & Quality Rating (JHNEBP) Eakin et al (2015). Quasi-experimental The study included 20 staff and faculty involved in the early rehabilitation program at Johns Hopkins Hospital Medical Intensive Care Unit. 12 out of the 20 participants were female while the rest were male. These participants had worked in a healthcare facility and any ICU for a period of between 1 and 20 years. Early rehabilitation program Outcomes of early rehabilitation programs on staff The study also looked at how to engage a multidisciplinary team in implementing and sustaining early rehabilitation programs. Interview transcripts were reviewed using the Consolidated Framework of Implementation Research Theory. These transcripts were also coded by two independent raters (TA, LU) using NViVo 10.0 software (QSR International Pty Ltd, 2013, Doncaster, Australia). 90% of participants found that a multidisciplinary team with good communication among its members is helpful. While 100% of participants stated that improved patient outcome was a vital benefit, 95% reported enhanced job satisfaction. However, 80% of participants noted that increased staff workload is the major barrier to successful implementation of early rehabilitation programs. The researchers concluded that incorporating a multidisciplinary team before implementation is crucial towards enhancing job satisfaction and changing work culture in a hospital unit. Level II Quality B. The study utilized a suitable sampling size for a qualitative research.

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The data analysis tools were suitable and valid in generating reliable findings on the research issue. Additionally, the study correlated with the findings of previous researches on barriers to early rehabilitation and generates new barriers. However, the study lacked randomization. Engel, Needham, Morris & Gropper (2013) Non-experimental, qualitative study The study did not include a group of participants since it focused on comparing three ICU early mobility quality improvement projects. The researchers reviewed and compared early mobility quality improvement projects utilized in medical ICUs at Wake University, the University of California San Francisco Medical Center, and Johns Hopkins Hospital. Early mobilization quality improvement projects Implementation of the projects and impact on clinical outcomes in critically ill patients The implementation of each of these three ICU early mobilization quality improvement projects required an interdisciplinary team-based approach. The team plays a critical role in planning, educating and implementing the early mobility program in the ICU setting. The researchers also found that establishing ICU early mobilization quality improvement program reduces hospital and ICU stay among critically ill patients. Moreover, such programs lessen the rates of delirium and need for sedation. Level III, Quality C. This non-experimental qualitative study did not have a sufficient sample size given that the three programs were not adequate enough to draw reliable conclusions on the research issue. The researchers did not provide the theoretical framework for the study though the review was carried….....

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