Critically ill patients often have extended length of stay in the hospital due to complications. There are many factors that should be considered when appropriately caring for these patients such as mobilizing as soon as possible and preventing intensive care unit (ICU) associated delirium. Early mobilization is believed to be effective in reducing the patient’s length of stay as well as ICU delirium (Hunter et al., 2020).

There is currently no protocol in place for early mobilization in the critical care areas at Parkland Hospital. Patients are only mobilized once the provider places orders for physical therapy and occupational therapy to work with the patient. Activity orders are then placed after the patient’s level of mobility is assessed which usually happens days to weeks into the hospitalization. The plan is to create a protocol that would help identify patients that are eligible for early mobilization. A culture change in the critical care areas would require the collaboration and open communication between the multidisciplinary team which includes physicians, nurses, physical therapists, occupational therapists, and respiratory therapists (Harris and Shahid, 2014).

Creating a standard protocol will allow every patient the opportunity to participate in early mobilization if appropriate. Without an official protocol, mobilization could be easily overlooked when considering top priorities for the patient. As part of the requirement for the Master of Science in Nursing (MSN) Administration track, this led to the following PICOT question: In adult critically ill patients (P) how does early mobilization (I) compared to strict bed rest (C) decrease length of stay and risk of delirium (O) over the course of three months (T)?

Date of publication

Winter 12-9-2020

Document Type

MSN Capstone Project (Local Access)



Persistent identifier



Master of Science in Nursing Administration