Evaluation of early mobilization practices in Turkey pediatric intensive care units: Nurses' opinions

Pediatric patients hospitalized in pediatric intensive care units (PICU) may face defects such as venous thromboembolism, pressure sores and muscle weakness due to immobility. It is important to establish a standard rehabilitation and mobilization plan to reduce the complications of immobility in PICU patients. This study was planned to evaluate early mobilization practices in PICUs in Turkey. The study was conducted between March and October 2024 by using an online platform and reaching responsible/senior nurses working in 75 of 102 PICUs according to the Ministry of Health 2024 data. The data were obtained using the "Participant and Unit Evaluation Form" and "Early Mobilization Evaluation Form" prepared by the researchers and analyzed using the appropriate statistical package program. According to the data obtained; it was stated that 2 out of 75 units had an 'early mobilization protocol/guideline', early mobilization was started for inpatients in 57.3% of the units 'as soon as the patient became stable enough' and 81.3% of nurses participated in early mobilization practices. Participants reported that "the importance of early mobilization for inpatients in the unit" was 'important and priority' with a mean score of 3.13±1.004 out of 5 points and "the necessity of early mobilization practices" was necessary with a mean score of 8.4±1.724 out of 10 points. Participants stated that "reduction in contracture formation due to immobility", "improvement in participation in daily life after discharge", "improvement in the psychological impact of PICU care on the patient", "reduction in the risk of thromboembolism" were the highest benefits of early mobilization. In addition, "lack of written guidelines/protocols", "inadequacy of healthcare workers and equipment", "level of sedation and severity of patients' illness", and "high workload of staff" were reported as perceived potential barriers to the implementation of early mobilization. In line with the findings obtained in the study, it was reported that there was almost no early mobilization protocol in the participating units, and that early mobilization was considered important and prioritized, as well as highly necessary. In line with these results, it is recommended that each institution should establish a written protocol prepared in the light of current literature, regular in-service trainings and randomized controlled studies should be conducted in order to implement early mobilization.