Management of patient tubes and lines during early mobility in the intensive care unit

Objective: The purpose of this study was to better understand the impact of patient tubes/lines on early mobility therapy sessions for patients in the intensive care unit (ICU). Background: Early mobility improves patient outcomes in the ICU, but its use is suboptimal. Significant barriers to early mobility include the risk of dislodging patient tubes/lines, nursing workload, and staffing constraints. Method: Secondary statistical analyses were conducted on an existing quality improvement dataset collected during the observation of 22 early mobility therapy sessions in four ICUs at two hospitals using descriptive statistics, Pearson's correlation coefficient, and Spearman rho's calculations. Results: Patients had an average of 8.6 tubes/lines. During each early mobility session, staff spent an average of 12.4 minutes, or 61.4% of the total duration of time, focused on the management of patient tubes/lines. Significant positive correlations were found between; 1) the number of patient tubes/lines and the amount of time needed by staff to organize and manage them during early mobility activities (r = 0.517, p = 0.014), and 2) the number of patient tubes/lines and the number of staff required to assist during early mobility activities (r = 0.630, p = 0.002). Conclusion: Patient tube/line management has significant implications on ICU staff time and workload during early mobility. Additional research is needed to better understand how nurses and other frontline staff manage patient tubes/lines during mobilization in the ICU. Application: Researchers, healthcare providers, and engineers should identify tube/line management strategies to reduce workload and staffing barriers to early mobility in the ICU.