Early mobilisation practices in Windhoek intensive care units: A retrospective review of patient profiles and physiotherapy practice
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Abstract
Background. Early mobilisation (EM) is safe and feasible with positive patient outcomes in various settings. However, data from Namibia in southern Africa are lacking, and the status of intensive care unit (ICU)-based mobilisation is unknown.
Objectives. To describe the mobility practices and profiles of critically ill patients in ICUs in Windhoek, Namibia.
Methods. A retrospective, descriptive record review was conducted in two private hospitals in Windhoek. Data were extracted using a self-designed electronic data abstraction form. The primary outcomes were the profile of ICU patients and documented mobility practices. Secondary outcomes included the timing and frequency of mobilisation, physiotherapy techniques used, and adverse events during physiotherapy. Patients with incomplete datasets or illegible records were excluded.
Results. The review included charts of 870 adult patients admitted to the participating ICUs between January and December 2016. Patients were predominantly male (61.8%; n=538), with a mean (standard deviation (SD)) age of 56 (14.9) years. Most admissions were planned (66.3%; n=577), mainly for coronary angiograms (20.6%; n=179), cardiac conditions (13.0%; n=113) and cardiac surgery (10.3%; n=90). The mean (SD) length of ICU stay was 3.41 (3.3) days, and the mean duration of mechanical ventilation was 0.7 (2.1) days. The overall ICU mortality rate was 5.2% (n=45). Of the 870 patients, 352 (40.5%) received physiotherapy, with 345 of these (98.0%) being mobilised. The median (interquartile range) length of ICU stay for mobilised patients was 3 (2 - 5) days, compared with 2 (2 - 3) days for non-mobilised patients (p<0.0001). Adverse events during physiotherapy were rare, occurring in only 5 patients (1.4%).
Conclusion. EM is often implemented as part of physiotherapy practice in Windhoek ICUs; however, fewer than half of the patients in this study received physiotherapy, highlighting the need for improved implementation of EM protocols and screening for readiness to mobilise.
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