Authors (including presenting author) :
Ho LP (1), Lee YTM(1), Kam TY(1), Tang WY(1), Tang WY(1), Cheng SM(1)
Affiliation :
(1)Department of Paediatrics, Prince of Wales Hospital
Introduction :
It has been demonstrated in multiple studies that immobilization and prolonged bed rest in PICU would associate with many adverse consequences. On contrary, earlier sit out could improve physical functioning, muscle and respiratory strength, reduction number of ventilator days as well as length of stay in ICU.
In the past, patients in our PICU were always kept bed rest due to haemodynamic unstable or concerns for safety.
Based on the existing evidence demonstrating favorable outcomes of sit out, we would like to implement a sit out program in our PICU.
Objectives :
1. To promote early mobility and sit out safely.
2. To enhance patients and parent’s satisfaction.
3. To improve staff’s knowledge on early mobilization.
Methodology :
First, we reviewed the current practice on safety and feasibility of sitting out. Pre-test survey was performed. Secondly, we provided briefing and training program for nursing staff. Thirdly, inclusive and exclusive criteria were set up and Medical Research Council Scale for muscle power was employed to assess patient’s muscle strength before every episode of sit out to safeguard the safety. Outcome measure was obtained by comparing pre and post survey on sit-out episodes and duration. And we had measured the parents/patients’ satisfaction level on the program.
Result & Outcome :
By comparison the pre and post sit-out episodes; at pre-training period (4-weeks interval), there were only 2 patients out of 20 patients (10%) fulfilled our selective criteria was sat out. During the post-training period (4-weeks interval), there were 5 patients out of 9 patients (56%) were sat out. It showed that sit out episodes was mark increased from 10 to 56 %. More patients whom met the inclusive criteria could have opportunities of being sat out. The result indicated increasing staffs' willingness to sit out patient. It also implied their compliance rate was increased.
Overall, from May 2018 to Apr 2019, there were 20 patients were being sat out. The age is 3-15 years old. Sit out duration was 5-120 minutes. Mean was 53 minutes.
And we had surveyed 14 parents/patients on their satisfaction level, overall mean satisfactory score is 4.43 (maximum is 5). All parents/patients were satisfactory with our program.
In conclusion, sit out program facilitated early and safe mobility, enhanced patients and parent’s satisfaction, improved quality of care in PICU.
