Physiological Criteria for Clinical Decision-Making Regarding the Initiation of Early Mobilization in Intensive Care Units among Physiotherapists in Tripoli
DOI:
https://doi.org/10.65405/bhyp8e14الكلمات المفتاحية:
Early mobilization; Intensive Care Unit (ICU); Physiotherapy; Clinical decision-making; Physiological parameters; Mechanical ventilation; Critical care rehabilitation; Patient safety.الملخص
Early mobilization is a fundamental rehabilitation strategy in intensive care units (ICUs), aimed at minimizing the adverse effects of prolonged immobilization and improving functional recovery. However, its safe implementation depends on accurate clinical decision-making based on patients' physiological stability. This study aimed to identify the physiological variables used by physiotherapists in Tripoli as criteria for initiating and terminating early mobilization in ICU patients and to explore the factors influencing these clinical decisions. A descriptive cross-sectional survey was conducted among 25 physiotherapists working in public and private ICUs in Tripoli using a structured questionnaire developed from current international guidelines and evidence-based literature. Descriptive statistical analysis was used to summarize participants' responses. The findings revealed that 44% of physiotherapists initiated early mobilization between the second and fifth day of ICU admission, while only 28% began within the first two days. Heart rate (76%), blood pressure (68%), and oxygen saturation (68%) were the most frequently used physiological criteria for initiating mobilization, whereas important parameters such as FiO₂, PEEP, respiratory rate, and level of consciousness were considered less frequently. For terminating mobilization, the most common criteria included new cardiac arrhythmias (72%), abnormal respiratory rate (72%), systolic blood pressure >180 mmHg (64%), and severe patient agitation (60%). Most participants (64%) reported mobilizing mechanically ventilated patients when physiological stability was maintained. Patient medical stability (64%), the availability of clinical protocols (56%), safety concerns (56%), and clinical experience (52%) were identified as the primary factors influencing decision-making. The study concludes that considerable variability exists in early mobilization practices among physiotherapists in Tripoli, highlighting the need for standardized evidence-based protocols and targeted educational programs to improve clinical consistency, patient safety, and rehabilitation outcomes in intensive care settings.
التنزيلات
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