HS8884: Early, Goal-Directed Mobilisation in The Surgical Intensive Care Unit: Evidence-Based Practice Assignment, NYP, Singapore

Background:  Immobilisation predicts adverse outcomes in patients in the surgical intensive care unit (SICU). Attempts to mobilize critically ill patients early after surgery are frequently restricted, but we tested whether early mobilization leads to improved mobility decreased SICU length of stay, and increased functional independence of patients at hospital discharge.

2. Written Assignment (Individual) – 
Select ONE (1) research article from the pool of 10 articles of the chosen topic for the written assignment. In your written assignment, explain why you chose the topic. The topic should be consistent with your group presentation.
You are expected to use an appraisal tool checklist to evaluate the methodological quality, strengths, and weaknesses of the research article. Develop your essay by demonstrating how you critically appraise di evaluated its content using an appropriate appraisal tool checklist.

Methods We did a multicentre, international, parallel-group, assessor-blinded, randomized controlled trial in SICUs of ive university hospitals in Austria (n=1), Germany (n=1), and the USA (n=3). Eligible patients (aged 18 years or older, who had been mechanically ventilated for <48 h, and were expected to require mechanical ventilation for ≥24 h) were randomly assigned.

Findings:  Between July 1, 2011, and Nov 4, 2015, we randomly assigned 200 patients to receive standard treatment (control; n=96) or intervention (n=104). Intention-to-treat analysis showed that the intervention improved the mobilization level (mean achieved SOMS 2·2 [SD 1·0] in the intervention group vs 1·5 [0·8] in the control group, p<0·0001), decreased SICU length of stay (mean 7 days [SD 5–12] in the intervention group vs 10 days [6–15] in the control group, p=0·0054), and improved functional mobility at hospital discharge (mm FIM score 8 [4–8] in the intervention group vs 5 [2–8] in a control group.

Introduction: More than 5·7 million patients in the USA and more than 2 million patients in Germany are treated annually in intensive care units, of which about one-third are admitted to these wards after an elective or emergency surgical procedure. Muscle weakness is as common as arterial hypotension in the surgical intensive care unit (SICU),1–3, and is predictive of adverse outcomes in critically ill patients.

Checklist For Randomized Controlled Trials

Introduction: JBI is an international research organization based in the Faculty of Health and Medical Sciences at the University of Adelaide, South Australia. JBI develops and delivers unique evidence-based information, software, education, and training designed to improve healthcare practice and health outcomes. With over 70 Collaborating Entities, servicing over 90 countries, JBI is a recognized global leader in evidence-based healthcare.

JBI Systematic Reviews
The core of evidence synthesis is the systematic review of the literature of a particular intervention, condition, or issue. The systematic review is essentially an analysis of the available literature (that is, evidence) and the judgment of the effectiveness or otherwise of practice, involving a series of complex steps.