2.50
Hdl Handle:
http://hdl.handle.net/10755/158439
Type:
Presentation
Title:
Barriers and Facilitators to Activity in the Intensive Care Unit
Abstract:
Barriers and Facilitators to Activity in the Intensive Care Unit
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2009
Author:Winkelman, Chris, PhD
P.I. Institution Name:Case Western Reserve University
Title:Frances Payne Bolton School of Nursing
Contact Address:10900 Euclid Ave, Cleveland, OH, 44106, USA
Contact Telephone:216.368-0700
Co-Authors:C. Winkelman, E. Liou, K. Peereboom, R. Hejal, J. Tenhover, J. Rowbottom, J. Daly, , Case Western Reserve University, Cleveland, OH;
Purpose: Identify staff-perceived barriers and facilitators to activity in mechanically ventilated patients in the intensive care unit (ICU). Little is known about WHY inactivity is common in this population. Specific aims were: (1) Describe factors identified by staff that directly influence a decision to implement activity; (2) Correlate patient characteristics such as age, acuity and comorbidities with planned bedrest or out-of-bed activity. Framework: Theory of Planned Behavior (Ajzen,1988). Subjects: 21 registered nurses (RNs) in medical ICU (n=1;12) or surgical ICU (n=9) at an academic medical center provided 28 interviews. Sample characteristics: aged 32 years, female, and 7 years of ICU experience (median 3 years). RNs were caring for patients with hemodynamic stability and 11 days (mean) of mechanical ventilation at the time of the interview. Method: Descriptive, correlational, and cross-sectional. Semi-structured interview. Analyses: RNs planned "no activity/in-bed activity only" among 40% of SICU RNs and 80% of MICU RNs; this resulted in bedrest for 17 patients. The most common reason for bedrest was low respiratory or oxygen reserves in the patient (11/17 patients). Other reasons were risk for compromising tubes or lines and patient weakness (both 9/17). Less common reasons for bedrest were risk for fall (5/17); procedure is planned (2/17) and patient's weight (2/17). RNs planned "out-of-bed activity" for 11 patients; the most common reasons for this level of activity were: stable vital signs (9/11); patient alertness (7/11) and cooperation (7/11); and good respiratory reserve (5/11) or oxygenation (7/11). A less common reason for out-or-bed activity was prescription/order (2/11). Correlations indicated that type of activity (in-bed versus out-or-bed) were not associated with patient age, severity of illness or number of comorbidities. Interpretation: Findings suggest that patient condition rather than resources or prescription/orders drive planned activity. Relevance: Possible misconceptions about barriers to activity such as patient weakness have implications for nursing practice and education.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleBarriers and Facilitators to Activity in the Intensive Care Uniten_GB
dc.identifier.urihttp://hdl.handle.net/10755/158439-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Barriers and Facilitators to Activity in the Intensive Care Unit</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Winkelman, Chris, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Case Western Reserve University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Frances Payne Bolton School of Nursing</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">10900 Euclid Ave, Cleveland, OH, 44106, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">216.368-0700</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">chris.winkelman@case.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">C. Winkelman, E. Liou, K. Peereboom, R. Hejal, J. Tenhover, J. Rowbottom, J. Daly, , Case Western Reserve University, Cleveland, OH;</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Identify staff-perceived barriers and facilitators to activity in mechanically ventilated patients in the intensive care unit (ICU). Little is known about WHY inactivity is common in this population. Specific aims were: (1) Describe factors identified by staff that directly influence a decision to implement activity; (2) Correlate patient characteristics such as age, acuity and comorbidities with planned bedrest or out-of-bed activity. Framework: Theory of Planned Behavior (Ajzen,1988). Subjects: 21 registered nurses (RNs) in medical ICU (n=1;12) or surgical ICU (n=9) at an academic medical center provided 28 interviews. Sample characteristics: aged 32 years, female, and 7 years of ICU experience (median 3 years). RNs were caring for patients with hemodynamic stability and 11 days (mean) of mechanical ventilation at the time of the interview. Method: Descriptive, correlational, and cross-sectional. Semi-structured interview. Analyses: RNs planned &quot;no activity/in-bed activity only&quot; among 40% of SICU RNs and 80% of MICU RNs; this resulted in bedrest for 17 patients. The most common reason for bedrest was low respiratory or oxygen reserves in the patient (11/17 patients). Other reasons were risk for compromising tubes or lines and patient weakness (both 9/17). Less common reasons for bedrest were risk for fall (5/17); procedure is planned (2/17) and patient's weight (2/17). RNs planned &quot;out-of-bed activity&quot; for 11 patients; the most common reasons for this level of activity were: stable vital signs (9/11); patient alertness (7/11) and cooperation (7/11); and good respiratory reserve (5/11) or oxygenation (7/11). A less common reason for out-or-bed activity was prescription/order (2/11). Correlations indicated that type of activity (in-bed versus out-or-bed) were not associated with patient age, severity of illness or number of comorbidities. Interpretation: Findings suggest that patient condition rather than resources or prescription/orders drive planned activity. Relevance: Possible misconceptions about barriers to activity such as patient weakness have implications for nursing practice and education.</td></tr></table>en_GB
dc.date.available2011-10-26T21:03:17Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:03:17Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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