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Planning, implementation and evaluation of an adaptive platform for the early mobilization of patients in intensive care units

Background and objective
Early mobilization is a safe and feasibly intervention to reduce the risk of functional decline in intensive care unit (ICU) patients due to bed rest and prolonged immobility [1, 2]. However,
most common barriers to adequate early mobilization are time constraints, equipment and inadequate staff training [3–6]. The multidisciplinary project* MobIPaR aims to develop and pretest an acceptable, feasible and safe device (VEMO) to overcome those barriers and to support frequent early mobilization in ICU patients. The object of the project is to guide the development, implementation and evaluation within the pretesting from a nursing science perspective using the scope of the MRC framework for complex interventions [7]. The Project lasts from April 2017 until September 2020.


Methods
Within the scope of the dissertation a mixed method approach is followed. Requirements for the use of VEMO have been explored within a group discussion with nurses from ICU. To explore barriers and facilitators of implementing robotic devices in nursing care an integrative review has been conducted. User tests of VEMO in practice will be accommpied by observations and subsequently evaluated within group discussions with regard to its applicability. Thereby we take into account the perspective of involved health professionals (nurses and physiotherapists).
(expected) Results From the ICU nurses‘ perspective, easy handling with little preparation and follow-up work in additon to ensured patient safety are the key requirements for the application of the proposed robotic solution in daily practice. The review identified barriers and facilitators for the implementation of robotic devices in nursing from different dimensions. The results serve as a basis for implementation in ordner to reduce potential barriers and promote the integration of elements which facilitate implementation. Currently we are testing VEMO in practice and expect an safe and feasible device, which has a benefit for all involved parties.

Outlook Findings from the review, user tests, and an evaluation of the user training will serve as a basis for the development of a suitable implementation strategy for VEMO. This might also contribute to the overall approach of implementing innovations such as robotics in nursing.

 

*Project Partners: Schön Klinik Bad Aibling SE & Co. KG (SKBA), Reactive Robotics GmbH
(RR), Leibniz University Hannover (LUH), Protestant University of Applied Sciences Ludwigsburg (EH), Technical University Munich (TUM)

 

1.Adler J, Malone D (2012) Early mobilization in the intensive care unit: A systematic review. Cardiopulm Phys Ther J 23(1): 5–13.

2. Bailey P, Thomsen GE, Spuhler VJ et al. (2007) Early activity is feasible and safe in respiratory failure patients. Crit Care Med 35(1): 139–145. doi: 10.1097/01.CCM.0000251130.69568.87.

3. Dafoe S, Chapman MJ, Edwards S et al. (2015) Overcoming barriers to the mobilisation of patients in an intensive care unit. Anaesth Intensive Care 43(6): 719–727.

4. Barber EA, Everard T, Holland AE et al. (2015) Barriers and facilitators to early mobilisation in Intensive Care: A qualitative study. Aust Crit Care 28(4): 177-82; quiz 183. doi: 10.1016/j.aucc.2014.11.001.

5. Jolley SE, Regan-Baggs J, Dickson RP et al. (2014) Medical intensive care unit clinician attitudes and perceived barriers towards early mobilization of critically ill patients: A cross-sectional survey study. BMC Anesthesiology 14(1): 84. doi: 10.1186/1471-2253- 14-84.

6. Dubb R, Nydahl P, Hermes C et al. (2016) Barriers and Strategies for Early Mobilization of Patients in Intensive Care Units. Ann Am Thorac Soc 13(5): 724–730. doi: 10.1513/AnnalsATS.201509-586CME.

7. Medical Research Council (2006) Developing and evaluating complex interventions: new guidance, London.

MITGLIED IM KOLLEG

seit

Betreuer Technische Hochschule Rosenheim:

Prof Dr. Martin Müller, MPH

Die Forschung von Prof. Müller befasst sich mit der Entwicklung und Evaluation komplexer Interventionen zum Nutzen von Pflegebedürftigen und deren Angehörigen in der Akut- und Langzeitpflege. Zentraler Fokus ist dabei die Erhaltung und Förderung der soziale Teilhabe bei chronischen Krankheiten und Pflegebedürftigkeit, die Gestaltung von Übergängen im Kontext des Eintritts von Pflegebedürftigkeit, sowie die Evaluation und Implementierung neuer digitaler Technologien, insbesondere robotischer Systeme für die Pflege.

Betreute Projekte:

Publikationen

Servaty R., Kersten A., Brukamp K., Moehler R. und M. Mueller (2020):
Barriers and fa-cilitators of implementing robotic systems in nursing care: an integrative review. BMJ Open 10(9). https://bmjopen.bmj.com/content/10/9/e038650.info

Beer T., Bleses H., Buhtz C., Hirt J., Krause J., Meyer G., Müller M., Paulicke D. und R. Servaty (2019):
Symposium: Robotik in der Pflege – eine Standortbestimmung und Implikationen für zukünftigeForschungsinitiativen. 20. Jahrestagung des EbM-Netzwerks.

Servaty R., Kersten A., Brukamp K., Moehler R. und M. Müller (2018):
Barriers and facilitators of implementing robotic systems in nursing care – a systematic review. Konferenzbeitrag; 1. Clusterkonferenz Zukunft der Pflege, Oldenburg.

Servaty R., Hösl M. und M. Mueller (2018):
Nurse’s perspective on the requirements for successful implementation of an adaptive platform for mobilization of intensive care unit patients – results of a focus group study. Posterbeitrag; Forschungswelten, 9. Internationaler wissenschaftlicher Kongress für Pflege- und Gesundheitsforschung.

Ricarda Servaty

Ricarda Servaty

Technische Hochschule Rosenheim

Koordination

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Dr. Sabine Fütterer-Akili

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