Literature Evaluation Table: PICOT

Published by James Taylor

Student Name:

PICOT Statement: Early mobilization in the Intensive Care Unit (ICU) to improve patient outcomes and decrease the length of hospital stay than complete bed rest at Scripps Memorial Hospital

Criteria	Article 1	Article 2	Article 3	Article 4
Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article	Trees, D. W., Smith, J. M., &Hockert, S, American Journal of Physical Therapy,https://doi.org/10.2522/ptj.20110401	Ngitit, E., American Journal of Critical Care Nurse, http://165.193.178.96/login?	Engel, H. J., Tatebe, S., Alonzo, P. B., Mustille, R. L., & Rivera, M. J., American Journal of Physical Therapy, https://doi.org/10.2522/ptj.20110420	Clark, D. E., Lowman, J. D., Griffin, R. L., Matthews, H. M., &Reiff, D. A., American Journal of Physical Therapy, Retrieved from http://165.193.178.96/login?
Article Title and Year Published	Innovative Mobility Strategies for the Patient With Intensive Care Unit- Acquired Weakness, 2013	EB106 Step Forward: Implementing Mobilization in the Intensive Care Unit, 2014	Physical Therapist-Established Intensive Care Unit Early Mobilization Program, 2013	Effectiveness of an early mobilization protocol in trauma and burns intensive care unit, 2013
Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study	There is no well established and defined process of making a decision and specific treatment strategies concerning patients who acquired weaknesses while in the ICU. Purpose- To describe the condition of a patient who acquired weaknesses while in the ICU in the long-term acute care hospital (LTACH) setting together with strategies of mobilization including therapeutic devices.	Use of Critical Care Pain Observation Tool (CPOT) is effective while dealing with patients who are unable to express or report about themselves. Purpose-To evaluate the effectiveness and reliability of CPOT.	Usual care carried out in the ICU is a barrier to early mobilization on patients. Purpose- describe an adopted quality improvement project by a physical therapist.	Bed rest together with Patient immobility in ICU has harmful effects. Purpose-assess the effects of early mobilization on the length of stay in ICU for patients with burn and trauma
Design (Type of Quantitative, or Type of Qualitative)	Descriptive	Descriptive and experimental	Descriptive, Experimental	Retrospective Cohort
Setting/Sample	Setting-long-term acute care hospital (LTACH) sample- 73 years old woman who has developed complications after going through ICU treatment	Setting- ICU and Hospital board room or hall. A sample of 40 nurses and ICU patients who met the criteria.	Setting- Hospital, ICU Sample – a group of ICU professionals, a physical therapist and ICU patients.	Setting- UAB hospital registry Sample- 2176 patients admitted with critical injuries as a result of trauma and burns
Methods: Intervention/Instruments	Observation	Survey and observation	Experiments	Document analysis
Analysis	Narrative	Descriptive statistics and inferential	Descriptive statistics and inferential	Descriptive statistics
Key Findings	Involvement of a mobilization program using exercise tools such as mobile leg press increases the recovery process for patients with ICU weaknesses.	CPOT is simple and easy to put into practice. It helps to analyze pain in patients who cannot communicate. CPOT also increases the frequency of pain assessment.	There was an increase in the number of patients receiving Physical therapy while in the ICU from 2009 to 2010. With the introduction of physical therapy, the time spent in ICU reduced to 2 days.	Early mobility program results in decreased complications like pneumonia. Post early mobility program decreases the conditions resulting from ICU admission including Vascular and pulmonary complications,
Recommendations	Patients in the ICU should be engaged in physical exercises through the application of graded mobilization programs	Nurses should use CPOT while treating ICU patients who cannot communicate.	Nurses should introduce quality improvement t projects in ICU to reduce the time spent by patients.	Early and post early mobility programs should be adopted by hospital administrators to improve a patient’s outcome and prevent other related complications.
Explanation of How the Article Supports EBP/Capstone Project	The article supports the project by showing how the application of early mobilization of ICU patients helps to improve their health through a sample case. Early mobilization reduces the time of stay, therefore, lowering other risks(Trees, Smith, &Hockert, 2013). Also, it gives an idea on how to carry out mobilization through a graded program and the tools which are required.	Capstone Project aims at enhancing early mobilization in ICU by decreasing the length of stay of patients. The article recommends the use of CPOT which will enable quick assessment of patient pain. CPOT will, therefore, lead to prompt treatment reducing the time spent in ICU. In turn, cost and other related risks will be reduced(Ngitit, 2014)	The article supports the Capstone Project by offering a way out of reducing time spent in ICU by patients. It recommends the abolishment of the ordinary patient care to improved programs like physical therapy to minimize time spent in ICU. Physical therapy will lead to the quick recovery of patients to get out of the ICU within a short time(Engel et al., 2013)	The article supports the project by a suggestion on how to better implement the mobilization program. It suggests that hospitals should adopt a culture of mobilization to make the program successful and help improve patients’ outcome. Management should adopt a plan to direct the nurses on mobilization strategies(Clark et al., 2013). It shows that the project will be successful once implemented.

Criteria	Article 5	Article 6	Article 7	Article 8
Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article	Messer, A., Comer, L., & Forst, S., American Journal of Critical Care Nurse, https://doi.org/10.4037/ccn2015469	Dafoe, S., Chapman, M. J., Edwards, S., & Stiller, K., Journal of Anaesthesia and Intensive Car, http://165.193.178.96/login?	Anderson, R. J., Sparbel, K., Barr, R. N., Doerschug, K., & Corbridge, S., American Journal of Critical Care Nurse. https://doi.org/10.4037/ccn2018813	Castro, E., Turcinovic, M., Platz, J., & Law, I., Journal of Critical Care Nurse, https://doi.org/10.4037/ccn2015512
Article Title and Year Published	Implementation of a Progressive Mobilization Program in a Medical-Surgical Intensive Care Unit, 2015	Overcoming barriers to the mobilization of patients in an intensive care unit, 2015	Electronic Health Record Tool to Promote Team Communication and Early Patient Mobility in the Intensive Care Unit, 2018	Early Mobilization: Changing the Mindset, 2015
Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study	Through education, nurses can overcome obstacles which prevent mobility and also create awareness on the constructive effects of mobility. Purpose- evaluate the effectiveness of training on ICU progressive mobilization program on performance and knowledge.	There are some barriers preventing mobilization of patients in ICU which are resulting in a gap in the evidence-based practice of mobilization. Purpose- to find out how staff perception affects mobilization programs in ICU	Electronic health record communication supports mobility in ICU. Purpose- to show how the implementation of health record tools in existing mobility programs can enhance inter-professional communication between ICU staff.	ICU staff collaboration helps to improve patient mobilization. Purpose- to describe how an interdisciplinary team can be used to implement early mobility in ICU
Design (Type of Quantitative, or Type of Qualitative)	Experimental	Experimental	Experimental	Experimental
Setting/Sample	Setting- Hospital in the ICU as well as in board room for education Sample- 41 medical-surgical nurses working in ICU	Setting-Royal Adelaide Hospital, ICU Sample- 25 senior medical staff, 300 nursing staff, three physiotherapists	Setting – 26 bed ICU at the Magnet-recognized academic medical center Sample- a medical team including physicians, nurse practitioners, nurse managers, physical and respiratory therapist. Also, all patients admitted in ICU during the period.	Setting- Hospital, ICU Sample- ICU nursing leaders, staff nurses, attending and assistant physicians
Methods: Intervention/Instruments	Observation	Survey	Survey	Survey
Analysis	Descriptive statistics and inferential analysis	Descriptive statistics	Descriptive statistics	Descriptive statistics
Key Findings	Education program increased adoption of mobilization program in ICU. It also increased nurses’ knowledge of mobility benefits in patients who are critically ill.	Lack of leadership on early mobilization program, inadequate education on staff and faulty communication between departments are the barriers to implementation of mobilization strategies.	Length of stay in ICU decreased with inter-professional communication. Cost of ICU also reduced.	Coordination among ICU and other staffs increases recovery of patients undergoing mechanical ventilation. Also, early mobilization on patients reduces the length of stay.
Recommendations	Hospitals should adopt a culture of educating nurses on mobility programs to have knowledge of their application and understand their importance.	Hospital management to develop mobilization strategies and communicate them to the ICU staff. The administration also to offer regular education on mobilization to nurses and encourage them on the roles.	Hospitals should combine educational reviews with electronic health record communication to improve mobility program and patient outcome.	ICU council should enhance and improve interdisciplinary collaboration to improve early mobilization.
Explanation of How the Article Supports EBP/Capstone	The article supports the project which aims at implementing early mobilization in ICU by giving way out to overcome barriers for implementation. It suggests that nurses should be taught on the importance of the program and how to implement it for success(Messer, Comer, & Forst, 2015).	The article supports the Capstone project by offering tips on what is needed to implement and make mobilization program successful. It points out that management should educate, encourage and provide a plan for staff to follow in their mobilization program(Dafoe et al., 2015).	The article provided an insight into the Capstone project on how to better improve mobility program. It suggests that hospitals to adopt health record communication tool to have a successful mobility program(Anderso et al., 2018).	Capstone project seeks to implement an early mobilization program in ICU an issue which the article addresses. The article informs the project to ensure interdisciplinary collaboration for success. Collaboration ensures the flow of work in the same direction reducing the time taken to attend a patient(Castro et al., 2015).

References

Anderson, R. J., Sparbel, K., Barr, R. N., Doerschug, K., & Corbridge, S. (2018). Electronic Health Record Tool to Promote Team Communication and Early Patient Mobility in the Intensive Care Unit. Critical Care Nurse, 38(6), 23–34. https://doi.org/10.4037/ccn2018813

Castro, E., Turcinovic, M., Platz, J., & Law, I. (2015). Early Mobilization: Changing the Mindset. Critical Care Nurse, 35(4), e1–e7. https://doi.org/10.4037/ccn2015512

Clark, D. E., Lowman, J. D., Griffin, R. L., Matthews, H. M., & Reiff, D. A. (2013). Effectiveness of an early mobilization protocol in a trauma and burns intensive care unit: a retrospective cohort study. Physical Therapy, (2), 186. Retrieved from http://165.193.178.96/login?

Dafoe, S., Chapman, M. J., Edwards, S., & Stiller, K. (2015). Overcoming barriers to the mobilisation of patients in an intensive care unit. Anaesthesia and Intensive Care, (6), 719. Retrieved from http://165.193.178.96/login?

Engel, H. J., Tatebe, S., Alonzo, P. B., Mustille, R. L., & Rivera, M. J. (2013). Physical Therapist-Established Intensive Care Unit Early Mobilization Program: Quality Improvement Project for Critical Care at the University of California San Francisco Medical Center. Physical Therapy, 93(7), 975–985. https://doi.org/10.2522/ptj.20110420

Messer, A., Comer, L., & Forst, S. (2015). Implementation of a Progressive Mobilization Program in a Medical-Surgical Intensive Care Unit. Critical Care Nurse, 35(5), 28–42. https://doi.org/10.4037/ccn2015469

Ngitit, E. (2014). EB106 Step Forward: Implementing Mobilization in the Intensive Care Unit. Critical Care Nurse, 34(2), e30–e31. Retrieved from http://165.193.178.96/login?

Trees, D. W., Smith, J. M., & Hockert, S. (2013). Innovative Mobility Strategies for the Patient With Intensive Care Unit- Acquired Weakness: A Case Report. Physical Therapy, 93(2), 237–247. https://doi.org/10.2522/ptj.20110401

Do you need high quality Custom Essay Writing Services?