Intensive care unit nurses' knowledge, attitudes, and perceived barriers regarding early mobilization of patients

Nurs Crit Care. 2020 Nov;25(6):339-345. doi: 10.1111/nicc.12507. Epub 2020 Apr 13.


Background: It has been recommended that critically ill patients start mobilization as early as possible. However, the clinical utilization rate of early mobilization remains low in the intensive care unit (ICU), and respiratory therapists and nurses are the primary practitioners of early mobilization in China.

Aim: The aim of this study is to investigate the knowledge, attitudes, and perceived barriers of ICU nurses regarding the early mobilization of ICU patients.

Design: A descriptive and cross-sectional design was used.

Methods: A cross-sectional design was used, with an e-questionnaire for ICU nurses (n = 227) to assess knowledge and attitudes regarding early mobilization via the "Tencent WeChat" app on their smart phones.

Results: As the primary implementers of the early mobilization of ICU patients in China, more than half of ICU nurses passed the knowledge test (scored ≥20/25 points) and had positive attitudes (scored 45/55 points) regarding early mobilization. Nurses had good knowledge (more than 96.5%) of the benefits and stopping indications of early mobilization; however, they had a poor understanding (less than 51.1%) of the population in which early mobilization is applicable and monitoring indicators during early mobilization, and 39.2% of nurses did not support routine implementation of early mobilization for patients in the ICU. The major barriers that they perceived were very heavy workload (76.8%), insufficient equipment and devices (50.2%), lack of written protocols or guidelines (50.2%), inadequate training (47.1%), potential work risks (42.3%), and limited staffing (41.4%).

Conclusions: Although over half of ICU nurses exhibited relatively comprehensive knowledge of and positive attitudes to early mobilization, some misunderstandings, negativity, and barriers remain.

Relevance to clinical practice: Training programmes should be conducted continuously, especially focused on common misunderstandings and negative attitudes. Organizational support is required to overcome barriers to the implementation of early mobilization.

Keywords: ICU nurses; attitudes; barriers; early mobilization; knowledge.

MeSH terms

  • Adult
  • China
  • Critical Care
  • Critical Care Nursing / standards*
  • Critical Illness / nursing*
  • Cross-Sectional Studies
  • Early Ambulation / standards*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Intensive Care Units / organization & administration
  • Male
  • Surveys and Questionnaires