| Original language | English |
|---|---|
| Journal | Australian Critical Care |
| DOIs | |
| Publication status | Published (VoR) - 30 Oct 2021 |
Funding
Systematic review evidence demonstrates that interventions that are theoretically underpinned38,39 and tailored according to individual or group needs are more effective than those that are not.19 The Theoretical Domains Framework18 is a comprehensive framework derived from all behaviour models or behaviour changes that offer a comprehensive framework of the determinants to practice-related behaviours. It has been used in a range of contexts to understand the barriers to optimal practice (including mobilisation40,41) and acute environments (including intensive care 42?44). This framework allows mapping of the most appropriate and effective techniques to support practice behaviours.45 Therefore, we would recommend that interventions to support nurses in the EM of ICU patients go beyond educational interventions and use this or a theoretical approach to understand local nurse barriers and underpin tailored interventions to support optimal care. We also recommend that support strategies to address individual or patient barriers include or take a ?bottom-up? approach.46,47 ICU nurses have multiple demands upon their time, and priorities need to be set according to clinical need and outcomes in the moment. In terms of organisational barriers, for example, staffing levels, time and workload, consideration of costs, both human, e.g., morbidity and quality of life,2,4 and financial length of ICU and hospital stay1 may encourage budget holders to ensure adequate human resources if necessary.
Keywords
- Adherence
- Early mobilisation
- Intensive care unit
- Nurses
- Quality improvement