Abstract
The negative effects of bed rest and immobility of patients in the intensive care unit (ICU) has been studied for the past 20 years. These effects include increased hospital length of stay, increased ICU length of stay, decreased functional status after discharge, and increased days on the ventilator. The literature suggests that early intervention by physical/occupational therapy and early mobility leads to positive patient outcomes. This project took place at a midwestern U.S. hospital. The population studied was adult ventilated patients who had been ventilated for more than 48 hours, did not have a tracheostomy, and did not have orders for palliative care at any point during their stay. A retrospective chart review was done over a nine-month period to evaluate outcomes for patients who had a documented MOVE score (Myocardial stability, adequate Oxygenation, Vasopressor use, and Engage to voice) compared to those who did not. Six months of data was analyzed for patients that did not have MOVE scores documented. Outcome data was entered into an excel file and means were calculated for total hospital length of stay, total ICU length of stay, total number of days on a ventilator, and number of days before physical/occupational therapy was initiated. Twenty-five charts were reviewed for individuals who had a documented MOVE score; 26 for those who did not have a score. Individuals who did not have a documented MOVE score had 4 fewer days in the ICU, 4 fewer days on a ventilator, and 3 fewer days related to overall hospital length of stay. Days after ICU admission when PT/OT services were initiated was approximately the same for both groups. While a documented MOVE score may provide information regarding when to begin rehabilitation services, for this particular group of patients, informal face to face interdisciplinary collaboration and dialogue regarding a patient's ability to begin therapy proved to be more valuable than doing a formal assessment using a MOVE score.