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dc.contributor.authorClarissa, Catherine; orcid: 0000-0002-9302-513X
dc.contributor.authorSalisbury, Lisa
dc.contributor.authorRodgers, Sheila
dc.contributor.authorKean, Susanne
dc.identifierpubmed: 30680218
dc.identifierdoi: 10.1186/s40560-018-0355-z
dc.identifierpii: 355
dc.identifierpmc: PMC6337811
dc.identifier.citationJournal of intensive care, volume 7, page 3
dc.descriptionFrom PubMed via Jisc Publications Router
dc.descriptionHistory: received 2018-10-23, accepted 2018-12-11
dc.descriptionPublication status: epublish
dc.description.abstractMechanically ventilated patients often develop muscle weakness post-intensive care admission. Current evidence suggests that early mobilisation of these patients can be an effective intervention in improving their outcomes. However, what constitutes early mobilisation in mechanically ventilated patients (EM-MV) remains unclear. We aimed to systematically explore the definitions and activity types of EM-MV in the literature. Whittemore and Knafl's framework guided this review. CINAHL, MEDLINE, EMBASE, PsycINFO, ASSIA, and Cochrane Library were searched to capture studies from 2000 to 2018, combined with hand search of grey literature and reference lists of included studies. The Critical Appraisal Skills Programme tools were used to assess the methodological quality of included studies. Data extraction and quality assessment of studies were performed independently by each reviewer before coming together in sub-groups for discussion and agreement. An inductive and data-driven thematic analysis was undertaken on verbatim extracts of EM-MV definitions and activities in included studies. Seventy-six studies were included from which four major themes were inferred: (1) , (2) , (3) and (4) . The first theme indicates that EM-MV is either not fully defined in studies or when a definition is provided this is not standardised across studies. The remaining themes reflect the diversity of EM-MV activities which depends on patients' characteristics and ICU settings; the negotiated decision-making process between patients and staff; and their interdependent relationship during the implementation. This review highlights the absence of an agreed definition and on what constitutes early mobilisation in mechanically ventilated patients. To advance research and practice an agreed and shared definition is a pre-requisite.
dc.sourcepissn: 2052-0492
dc.subjectArtificial respiration
dc.subjectCritical illness
dc.subjectEarly ambulation
dc.subjectEarly mobilisation
dc.subjectIntegrative review
dc.subjectIntensive care unit
dc.subjectMechanical ventilators
dc.titleEarly mobilisation in mechanically ventilated patients: a systematic integrative review of definitions and activities.

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