Implementation and Assessment of an Early Mobility Interprofessional Education Simulation
Background: In the intensive care unit setting, lack of mobility can cause deconditioning and weakness, common problems for patients that require mechanical ventilation. Early mobility for patients in respiratory failure has been found to be safe and feasible. The Society of Critical Care Medicine’s 2018 “Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit” describes the importance of early mobility and exercise, however, there may be a gap between what is recommended and what is done in practice. Early mobility protocols recommend a team approach including registered nurses, respiratory therapists, occupational therapists, and physical therapists, working together to deliver safe patient care. Using simulation to assist in training early mobility techniques and skills has been used to improve the confidence of students prior to clinical experience. The purpose of this project was to enable healthcare student collaboration as an interprofessional team to provide safe management and monitoring during an early mobility simulation for a patient requiring mechanical ventilation.
Methodology: Nursing students in an accelerated (n=31) and traditional (n=2) program, respiratory therapist student (n=7), occupational therapist students (n=24), and physical therapist students (n=55), participated in an early mobility simulation enhanced interprofessional educational (Sim-IPE). Teams of students participated in pre-briefing, simulation with a standardized patient, and debriefing. Students were anonymously surveyed pre/post Sim-IPE using the SPICE-R instrument with three additional questions regarding early mobility and demographic information.
Results: A total of 119 students participated in the Sim-IPE. A total of 65 (54.6%) students completed the pre-IPE survey and 67 (56.3%) completed the post-IPE survey. Pre-IPE and post-IPE surveys were matched using identification code for a completion rate of 39.5% (n=47). Results from The SPICE-R instrument indicated there was a significant improvement (p=0.037) in health professions students' perceptions of interprofessional collaborative practice.
Conclusion: Our Sim-IPE included student teams consisting of two to four professions from nursing, occupational, physical, and respiratory therapies. The students collaborated to provide safe and effective early mobility for a patient requiring mechanical ventilation. The early mobility Sim-IPE positively impacted student confidence in caring for patients who are mechanically ventilated and reported perceived benefits of the interprofessional education experience.
Implications: There are numerous published articles citing the importance of early mobility and the effectiveness of Sim-IPE, however, there is little found in the literature examining the use of early mobility simulation to enhance interprofessional communication and teamwork involving healthcare students.
