Abstract

Early Mobilization (EM) in Pediatric Intensive Care Units (PICU) is safe and feasible, but there are issues preventing the adoption of EM into clinical practice. The objective of this study was to describe the patient safety concerns and how nurses develop strategies to safely deliver EM to their patients. The second objective was to explore, describe and analyze nurses' perceptions of barriers and facilitators to performing EM, and to identify strategies nurses perceive would assist them to overcome barriers and increase adoption of EM within the PICU. This focused ethnographic study included 15 in-depth interviews with 10 PICU nurses. Data were analyzed using thematic analysis. This is a three article-based dissertation. The first article is a scoping review of the literature examining nurses' and family caregivers' perceptions of EM programs in the PICU, and identified the scope of the dissertation study after the gaps in the literature were identified. In the second article, nurses discussed their concerns and for patient safety related to EM and how they developed strategies to overcome patient safety concerns. The third article describes nurses' perceptions of barriers and facilitators to EM in the PICU. The overarching theme that integrated these categories was nurses' commitment to EM because they recognize the benefit and see the positive outcomes. This study demonstrates the importance of thoughtfully considering the burden evidence-based programs have on the nurses who carry out EM. EM activities fall primarily on nursing staff, and organizational structures and resources must be allocated to reliably deliver this essential care. By better understanding the barriers, leaders can analyze and develop strategies to better integrate EM into practice.

Description

This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 30310454; ProQuest document ID: 2792192012. The author still retains copyright.

Author Details

Chelsea E. Noone, PhD, RN, CNS, CCRN-K

Sigma Membership

Non-member

Type

Dissertation

Format Type

Text-based Document

Study Design/Type

Ethnography

Research Approach

Qualitative Research

Keywords:

Pediatric Critical Care, Rehabilitation, Early Mobility

Advisors

Rehm, Roberta S.||Franck, Linda S.||Stavesju, Sandra L.

Degree

PhD

Degree Grantor

University of California, San Francisco

Degree Year

2023

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2023-09-20

Full Text of Presentation

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