The words “intensive care” may summon images of very sick, bedridden patients, but a glimpse into the Medical Intensive Care Unit (MICU) at North Shore University Hospital or LIJ Medical Center reveals a new model of care. Patients there are sitting up, standing and even walking about, because a new initiative focuses on helping them get back into motion.
“Mobility means different things for different patients,” said Mangala Narasimhan, DO, chief of critical care medicine at LIJ. “For patients who have been extremely sick for a long time, moving may mean sitting up and dangling their feet from the bed. If patients came to the hospital walking and talking, we may try to get them to stand or walk.”
The Start of a Movement
Getting patients back into motion while they’re still in the MICU represents a significant shift in treatment.
“Traditionally, hospitals kept MICU patients as calm and still as possible until their condition improved,” Dr. Narasimhan said. “We used to think that certain patients, such as those on a ventilator, should be sedated so they were less likely to disturb their treatment. However, new studies show that limiting mobility isn’t as helpful as we once believed.”
In fact, mobilized MICU patients need less time with assistive devices like ventilators, according to research in the medical journal Critical Care. The approach also reduces mortality and improves outcomes. “This means that patients leave the hospital healthier than they would without mobilization,” Dr. Narasimhan said.
Improving patients’ mobility within the MICU is no simple task. “It takes time and preparation,” said Dr. Narasimhan. “Our team of doctors, nurses, respiratory therapists and physical therapists identify how to help each patient become mobile, then carefully coordinate a plan to make it happen.”
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