Removing Rehabilitation Barriers to Early Mobility in the Intensive Care Unit for Adult Patients With Femoral Arterial and Hemodialysis Catheters

Background and Purpose: The objective of this project was to assess the safety of mobilizing patients with femoral arterial and hemodialysis (HD) catheters in the intensive care unit (ICU). These catheters had previously been perceived as barriers to mobility at our institution, restricting these patients to bed-rest. Approach: An interprofessional team developed a protocol for the mobilization of patients with femoral arterial and HD catheters. A prospective review of patients with these catheters was conducted in 3 ICUs. Patients were mobilized to a maximal level of mobility and monitored for adverse events. Outcomes: Twenty-eight consecutive patients with femoral arterial catheters (57.1%) and/or HD catheters (42.9%) participated in 49 mobility encounters. The maximum level of mobility performed was: 67.3% therapeutic exercise, 12.3% sitting edge of bed, 2.0% standing edge of bed, 4.1% transferring bed to chair, and 14.3% ambulating. No adverse events were identified. Discussion/Conclusion: Interprofessional participation in development, education, and implementation of a novel standardized protocol for mobilizing patients with femoral arterial and HD catheters facilitated a practice change and eliminated this perceived barrier to mobility. A 0% adverse event rate suggests that mobilizing patients with femoral arterial and HD catheters using a standardized algorithm is safe at our institution.