Childrens Healthcare of Atlanta

Early Mobility Among Pediatric Intensive Ventilated PatientsMelinda Marshall Dr.Ph, MPA, RRT-NPSClinical Leader Childrens Healthcare of Atlanta at Scottish Rite PICU

Championing MobilityHello! My name is Melinda MarshallI am from Childrens Healthcare of Atlanta where we have changed the culture and mindset our staff within the Intensive Care Unit.By mobilizing our ventilator dependent neonatal/pediatric patients.Over the past year we created a viable Protocol for Early Mobilization within the ICU areas: Neonatal, and Pediatric patient care areas.

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Childrens Healthcare of Atlanta

Cultural-Environmental Attitudes Past Care Giver MindsetSedated patients are Great Patients!Muscle Wasting is just apart of being Ventilated?Patients can regain their strength after their sickness is over.Physical therapy in bed is useless when patients are sedated!

Current & Environmental ChangesAllow Sedation Vacations to ensure diaphragmatic exercise.Physical therapy integrated into the ICU is essential to improved patient care outcomes.Patients improve faster with early mobilization prior to being discharged to rehab.3

Childrens Healthcare of Atlanta

Early Mobility in the ICU at CHOA!!ICU early mobility involves more than changing the patients position.It is a cognitive and physical rehabilitation among critically ill patients. Also, muscle weakness in Children occurs within 4 days of their ICU admission (Cameron, et al. ,2015) . It is imperative that we mobilize our patients immediately before negative side effects take place.Respiratory Therapists can lead the way in providing Early Mobility among ventilated patients within their ICU areas.

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WalkingStandingSitting

Childrens Healthcare of Atlanta

Researching Early Mobility OutcomesObjective: to compare the process utilized to implement an early mobility program in ICUs at CHOA at Scottish Rite while assessing the impact on clinical outcomes in among critically ill patients.Design: A quantitative study of 100 patients within SR Pediatric PICU was assessed. Additionally, patients were in the ICU on Ventilators, BiPAPs, and RAM Cannulas. With an age range of 1month to 21 years of age as a criterion. All were placed on early mobilization as quality improvement project within CHOA.Setting: Among PICU inpatients within CHOA at Scottish Rite.Results: Establishing an ICU early mobilization quality improvement program resulted in a decrease ICU and Hospital length of stay at our institution.

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Childrens Healthcare of Atlanta

EPIC MOBILITY TEMPLATE DROPDOWN MENU

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Childrens Healthcare of Atlanta

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ICU Mobility Door Sign*************7

We Are On The Move0-3 monthsProgressive Mobility Developmental Goals:being held by caregivers (i.e. kangaroo care)sitting in feeder seat, bouncy seat, swing or car seatdevelopmentally appropriate care ideas: developmental care strategies using swaddle, external supportive devices, visual engagement with caregivers as tolerated, read me a book-audio

Meet Your Team:PT- ____________________ Ascom: 35894OT- ____________________ Ascom: 35297ST- ____________________ Ascom: 35296

Childrens Healthcare of Atlanta

Mobility Data8

Childrens Healthcare of Atlanta

How are we doing with Mobility9

Childrens Healthcare of Atlanta

Forms of Early Mobility in the PICU a team centered approach when initiating RN/RT/PTSitting Up in Bed

Wheelchair Mobilization

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Childrens Healthcare of Atlanta

Who Meets ICU Mobility Criterion?11

Everyone Can meet any modified form of mobilization

Childrens Healthcare of Atlanta

MOBILITY STAR 12

I hope to continue to see you next year with our data!13