Nurses' perceived barriers and educational needs for early mobilisation of critical ill patients

Background: Early mobilisation (EM) of critically ill patients is an evidence-based intervention designed to improve treatment outcomes and enhance the quality of life after intensive care. However, several barriers exist to its establishment in clinical practice. Thus, the objective of the present study was to identify barriers perceived by critical care nurses, corresponding educational needs, and provide useful information for program implementation in Korea. Methods: A cross-sectional study was conducted from April to June 2017 using a structured, self-administered questionnaire that was completed by 151 critical care nurses from three tertiary hospitals and four secondary hospitals located in Seoul. The survey was designed to rate experiences with EM, identify educational experiences, and measure perceived barriers regarding attitudes, knowledge, behaviours, and educational needs. Data were analysed using descriptive statistics, t-tests, and analyses of variance. Results: The mean number of perceived barriers was 3.13 ± 0.38 out of 5 on a Likert scale. Attitude-related barriers (3.25 ± 0.49) were higher than behaviour-related (3.21 ± 0.44) and knowledge-related (2.94 ± 0.59) barriers. The top five barrier items were high workload, patients’ inability to exercise, lack of time, inappropriate nurse/patient ratio, and absence of relevant education. Educational needs for early mobilisation were rated 3.74 ± 0.78 out of 5. Educational items were prioritised as identifying potential problems in EM and possible solutions, related protocols and guidelines, and procedures for special conditions. Conclusions: The present study revealed that critical care nurses in Korea perceive various barriers to successfully implementing evidence-based EM interventions for critically ill patients, as well as the educational needs necessary to overcome such challenges. Accordingly, an educational program should be developed based on the educational needs revealed in the present study. In parallel, organisational efforts should also be made to meet environmental conditions.