Effect of implementing mobility protocol on selected outcomes among critically ill elderly patients

Abstract

Background Implementing mobility protocol for critically ill elderly patients may help prevent the sequelae of bed rest and improve patient outcomes. Aim To investigate the effect of implementing mobility protocol on selected outcomes among critically ill elderly patients. Research hypothesis Elderly critically ill patients who will be exposed to predesigned mobility protocol will have an improvement in their selected outcomes than those who will not. Design A quasi-experimental research design was used. Sample A purposive sample consisting of 60 critically ill elderly patients was included in this study within a period of 6 months. Setting This study was conducted at a medical ICU affiliated to a selected university hospital in Zagazig. Tools Two tools were developed, tested for clarity, and feasibility: (a) personal characteristics and medical data, and (b) patient outcome assessment sheet. Results Half (50%) of the control group and study group were males and the other half were females. The majority of study group were in the age group of 60 to less than 70 years. Concerning the past medical history, the majority of the control group and study group had a cardiac problem. The two groups were equal according to the presence of medical problems. In pretest, there were insignificant statistical differences (P>0.05) between the two groups regarding cardiovascular system outcomes. The two groups were equal, except for capillary refill (χ2=4.32, P=0.04). Moreover, more than two-thirds (73.3%) of the control group had sluggish capillary refill compared with 93.3% of the study group, and approximately two-thirds (60%) of the control group had nonpitting edema in the right and left upper arms compared with 36.7% of the study group. In posttest, there were significant statistical differences in cardiovascular system outcomes between study group and control group in peripheral pulses (χ2=4.32, P=0.04), edema of right upper arm (χ2=10.13, P=0.006), edema of left upper arm (χ2=10.13, P=0.006), edema of right lower leg (χ2=5.96, P=0.03), and edema of left lower leg (χ2=4.95, P=0.04). Conclusion Early mobilization and rehabilitation of critically ill elderly patients may help prevent the sequelae of bed rest and improve patient outcomes. Recommendation Integrating mobility protocol into daily nursing care has shown to be imminent. As well, studying the effect of implanting mobility protocol on selected outcomes of critically ill intubated patients. In addition replication of this study on a larger probability sample from the different geographical locations in Egypt is recommended. Replication of this study on a larger probability sample from different geographical locations in Egypt is recommended.