into daily practice nurses can effectively mitigate multiple factors related to

Into daily practice nurses can effectively mitigate

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into daily practice, nurses can effectively mitigate multiple factors related to prolonged immobility. Key Stakeholders Key stakeholders regarding early mobilization include bedside nurses, doctors, physical therapists, respiratory therapists, and case managers. Nurses are a constant presence at the bedside and with their skills, knowledge, and scope of practice. Nurses play a key role in the initiation and performance of early mobilization (Bilodeau, Gallagher, & Tanguay 2018). Nurses must constantly evaluate patients to ensure interventions are successful also and monitor patient status. They are the first line of the healthcare team and typically the first person to notice any minute changes with their patients signaling improvement or decompensation. Physicians oversee a group of patients within the ICU and work closely with nursing staff to ensure the appropriate interventions are ordered and performed to stabilize the patient. Once the patient has
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Translational Research 4 been stabilized, the physicians encourage nurses to begin early mobilization. They must rely on the judgement of nurses to report any signs signaling decompensation and act accordingly to order the appropriate interventions. They confer with nurses and other ancillary staff to identify patients stable for mobilization. Physical therapists work in conjunction with nursing staff to evaluate patient’s functional status and help safely implement early mobilization interventions. They have extensive knowledge in assessing neuromuscular function and can recommend appropriate interventions to nursing staff (Bilodeau, Gallagher, & Tanguay 2018). Physical therapists can typically achieve a high level of mobilization as they primarily focus on neurological function and returning patients to activity levels prehospitalization (Cameron, et al., 2015). Since many patients within the ICU require mechanical ventilation or other forms of supplemental oxygen, respiratory therapists work closely with nurses in times of mobility. In many cases they monitor and maintain the airway in patients undergoing mechanical ventilation. Within this local hospital and many others there are policies in place stating only respiratory therapists and qualified physicians (pulmonologist and medical intensivists) are the only ones able to adjust ventilator settings. During any transport or mobilization out of the bed, respiratory therapists are required to be present to ensure appropriate ventilator and airway management. Case Managers monitor patients from admission to discharge to ensure all needs are met, whether inpatient rehabilitation or home services such as home health and physical therapy. They will often conference with nursing staff to monitor patient condition and possible discharge needs. If a patient requires new medical equipment post discharge from the hospital such as home oxygen or ambulation aids, case managers will act as a liaison to facilitate those services required at discharge.
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  • Fall '19
  • Nursing, Intensive care medicine, ICU, translational research

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