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Medizinische Klinik - Intensivmedizin und Notfallmedizin

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12.10.2017 | Pflege | Pflege

PROtokollbasierte MObilisierung auf IntensivstaTIONen

Design einer clusterrandomisierten Pilotstudie

verfasst von: P. Nydahl, MScN, A. Diers, U. Günther, B. Haastert, S. Hesse, C. Kerschensteiner, S. Klarmann, S. Köpke

Erschienen in: Medizinische Klinik - Intensivmedizin und Notfallmedizin | Ausgabe 7/2018

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Zusammenfassung

Hintergrund

Trotz überzeugender Studienlage zur Frühmobilisierung von Patienten auf Intensivstationen ist deren Umsetzung in der Praxis begrenzt. Protokolle zur Frühmobilisierung mit Ein- und Ausschlusskriterien, Assessments, Sicherheitskriterien und Stufenschemas können die Umsetzungs- und Mobilisierungsrate unterstützen.

Hypothese

Patienten (Population), die sich auf Intensivstationen befinden, auf denen ein Protokoll zur Frühmobilisierung implementiert wird (Intervention), werden im Vergleich zu Patienten auf Intensivstationen, die über kein Protokoll verfügen (Kontrolle), häufiger aus dem Bett mobilisiert (Outcome).

Methode

Es wird eine multizentrische „stepped-wedge“ clusterrandomisierte Pilotstudie dargestellt. Fünf Intensivstationen erhalten ein an die jeweilige Intensivstation adaptiertes interprofessionelles Protokoll zur Frühmobilisierung. Die Implementierung des Protokolls erfolgt auf den Intensivstationen in randomisierter monatlicher Reihenfolge. Vor und nach der Implementierung werden einmal pro Monat 1‑Tages-Prävalenzerhebungen zur Mobilisierung der Intensivpatienten durchgeführt. Primärer Outcomeparameter ist die Rate der Patienten, die aus dem Bett mobilisiert werden, operationalisiert anhand eines Werts von ≥3 auf der Intensive Care Unit Mobility Scale. Sekundäre Outcomeparameter sind Beatmungs- und Verweildauer, Delirrate und -dauer, patientenspezifische Barrieren zur Mobilisierung, unerwünschte Sicherheitsereignisse während der Mobilisierung, Anteil von erreichten Mobilisierungszielen und Prozessparameter wie Barrieren, Strategien und Protokollanpassungen.

Erwartete Ergebnisse

Die Machbarkeit wird exemplarisch überprüft und die Effektstärke als Grundlage für eine spätere explanatorische Studie abgeschätzt.

Nur mit Berechtigung zugänglich

Auch wenn zur besseren Lesbarkeit die männliche Form gewählt wird, sind stets Personen aller Geschlechter gemeint.

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Titel: PROtokollbasierte MObilisierung auf IntensivstaTIONen
Design einer clusterrandomisierten Pilotstudie
verfasst von: P. Nydahl, MScN
A. Diers
U. Günther
B. Haastert
S. Hesse
C. Kerschensteiner
S. Klarmann
S. Köpke
Publikationsdatum: 12.10.2017
Verlag: Springer Medizin
Schlagwort: Pflege
Erschienen in: Medizinische Klinik - Intensivmedizin und Notfallmedizin / Ausgabe 7/2018
Print ISSN: 2193-6218
Elektronische ISSN: 2193-6226
DOI: https://doi.org/10.1007/s00063-017-0358-x

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PROtokollbasierte MObilisierung auf IntensivstaTIONen

Design einer clusterrandomisierten Pilotstudie