(1280) Post-Pandemic Multidisciplinary Revitalization of Early Mobility in an Oncology Intensive Care Unit

Introduction: Early mobility reduces functional, cognitive, and mental impairments acquired during intensive care unit (ICU) stays. While evidence supports early mobility programs (EMPs) for improved outcomes, few studies focus on oncology patients or the post-COVID-19 context. The pandemic's impact on ICU staffing shortages created gaps in EMP delivery. This quality improvement project aimed to revitalize an EMP with a multidisciplinary approach in a 52-bed oncology ICU.

Methods: A pre- and post-intervention survey were conducted to assess staff knowledge, attitudes, and behaviors towards EMP. Baseline data on mobility tasks were collected during a 4-week period, with post-intervention data gathered over two separate 2-week periods at weeks 4 and 12. Interventions included education, training, enhanced multidisciplinary rounding and communication, staff recognition, and award-based competition. Mobility levels were assessed with the Johns Hopkins Highest Level of Mobility Scale (JH-HLM) and statistically analyzed using the Fisher’s Exact Test and t-tests.

Results: During the pre-intervention period, there were 590 patient encounters, followed by 320 at week 4 and 246 at week 12.The number of patients mobilized daily increased from 46% to 58% by week 4 (P <.001) and 64% by week 12 (P <.001), while patient participation in active mobility (JH-HLM ≥ Level 3) improved by 10% by week 4 (P <.001) and 14% by week 12 (P <.001). Of the patients mobilized, initiation by nursing staff increased from 54% to 72% by week 12 (P <.001). Additionally, the average time patients spent in an occupational or physical therapy session increased from 38 to 50 and 33 to 40 minutes respectively (P <.001). Post-intervention survey results showed an increase in staff agreeing they received adequate mobility training (8%), staffing supports mobility (22%), and mobility should occur daily (11%).

Conclusions: A multidisciplinary approach to revitalizing an EMP after the pandemic for ICU oncology patients provides a valuable opportunity to enhance education, training, communication, and collaboration to improve staff compliance and confidence in the delivery of an EMP. Our results emphasize a collaborative approach can significantly improve quantity and quality of mobility for ICU oncology patients.