An observational study of sitting out of bed in tracheostomised patients in the intensive care unit

Objective: To define the number of occasions of sitting out of bed in patients in the intensive care unit (ICU) following tracheostomy formation. Design: Descriptive observational study. Setting: ICU, Guy’s and St. Thomas’ National Health Service Foundation Trust, London, UK. Participants: Convenience sample of 30 mechanically ventilated patients requiring a tracheostomy. Main outcome measures: The number of occasions of sitting out of bed and/or sitting on the edge of the bed during the patient’s stay on the ICU, the number of occasions that patients did not sit out of bed or sit on the edge of the bed as defined due to being ‘medically unwell’ or ‘other’, and ICU outcome. Results: This preliminary work demonstrated that 63% (19/30) of patients sat out of bed during their ICU stay. The median number of occasions of sitting out of bed was two. Thirty-seven percent (11/30) of patients did not sit out of bed and demonstrated a higher mortality rate than the patients who did sit out of bed during their ICU stay. There was no significant difference in age, gender, Apache II scores or length of ICU stay between patients that did and did not sit out of bed. Conclusions: This study found that a culture of patient mobilisation exists on the ICU at St. Thomas’ Hospital, but its frequency of delivery is reduced by the construct that patients are considered too unwell for it to be indicated at times. The effects, risks and benefits of early mobility within the ICU environment require further exploration in order to add to the literature and develop clinical practice.