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Purpose: Growing evidence suggests that early mobilization benefits intensive care unit (ICU) patients. However, national practices and the culture of individual ICUs influence mobilization activities. Materials and Methods: In a 1-day, Swiss point prevalence study conducted in 35 ICUs (representing 45% of all ICUs), the highest level of mobilization for mechanically ventilated patients was characterized using the validated ICU Mobility Scale, along with data collection for potential safety events and mobilization barriers. Results: Among 161 mechanically ventilated patients, a total of 33% (n = 53) had active mobilization, with walking achieved by only 2% (n = 4). More severe organ failure was associated with lower mobilization (respiratory Sequential Organ Failure Assessment score: P =.037, cardiac: P =.008, neurology: P <.001). Barriers to mobilization were reported in 71% (n = 115), with deep sedation significantly higher among patients receiving passive versus active mobilization (14% vs 0%, P =.005). Potential safety events occurred in 20% (n = 33) of patients without significant differences between passive and active mobilization. Availability of physiotherapists and appropriate equipment were not reported barriers. Conclusion: Mobilization during mechanical ventilation occurred infrequently with greater organ failure associated with lower mobilization. Addressing the identified modifiable barriers via structured efforts to achieve multidisciplinary culture change is essential to decrease the common use of bed rest in Swiss ICUs. [ABSTRACT FROM AUTHOR]

Background Diaries in the Intensive Care Unit ( ICU) support patients and relatives during and after a stay on the ICU. Barriers to implementation of the ICU diary are workload, unwanted closeness to patients and lack of time. Aims and objectives The purpose of the study was to evaluate the time nurses consume writing an ICU diary. Further questions were to examine whether the first diary entry, which includes a more detailed description about the admission, consumes more time than other entries and whether the time taken depends on experience or workload of the nurses. Design Quantitative, prospective, international observational multicentre study in four ICUs within the international diary network in Germany (two ICUs), Sweden and Switzerland (one ICU each). Method During a 6-month period in 2012/2013 nurses measured the time they consumed writing a diary in minutes and seconds, the number of diaries they contributed to and total number of diary entries, the nurse-patient ratio, their level of experience in writing diaries, interruptions while writing in a diary and additional information like photographs or follow-up visits. Results In summary 29 diaries were collected which included 195 written entries. The first entry needed significantly more time than following entries (first entry: mean 13:33 min versus following entries: mean 5:31, p < 0·001). The mean time for following entries differed significantly between the countries: Switzerland: 6:14, Sweden 5:31 and Germany 3:36 ( p < 0·001). Nurses with more experience used more time to write a diary (not significant). With increasing nurse-patient-ratio the time decreased for following entries (ratio 1:1: mean 5:42, ratio 1:2: mean 5:27, ratio 1:3: mean 3:12, p = 0·007). Conclusion Writing a diary for patients and relatives means an additional amount of time and workload, but according to the increased quality of nursing the time seems to be feasible for implementation. The measured time was self-reported, thus including possible bias for the results. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to explore experiences and needs of parents visiting critically ill family members in intensive care units (ICUs) accompanied by their underaged children (<18 years)., Methods: Six semistructured interviews with parents were conducted in a qualitative design. Data analysis and synthesis were performed using Braun and Clarke's thematic analysis. This study was conducted in five adult ICUs in Switzerland., Findings: Parents opted for early and truthful involvement of their children, and the majority initiated the visits themselves. Five themes were identified: feeling of shock by the entire family; crying in front of the children; feeling welcome with the children; knowing that the children can cope with it; and holding the family together. Parents felt only partially welcomed in the ICU when accompanied by their children. In one case, the parents withdrew the child from the visit., Conclusions: Parents experienced the visit to a critically ill family member in the ICU with their underaged children as challenging. They were emotionally vulnerable and yet took the initiative to keep the family together. Parents had to mediate between their children, the critically ill family member, and the treatment team. Awareness of the needs of the parents visiting with underaged children is important in clinical practice. There is a need for family-centred structures and processes, including adequate visiting times and rooms suitable for children with books, pictures, and toys., (Copyright © 2024 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)