Changing practice to an evidence-based perspective must have essential
components in place for implementation. Support from hospital administrators, available
resources, strong unit-based clinical leadership, mentoring, and feedback are some of
these essential components. Clinical experts must be in place to guide and mentor staff
from the identification of a practice issue to the channeling of those ideas that will
ultimately improve patients’ outcomes. Staff who identify the problem are often
committed to solving the issue and are determined to change practice (Lusardi, 2012).
Barriers encountered at individual and organizational levels hinder clinical nurses in their
ability to deliver evidence-based practice. Advanced practice nurses act as knowledge
brokers in promoting EBP among clinical nurses. Advanced practice nurses promote the
uptake of evidence by developing the knowledge and skills of clinical nurses through
role-modeling, teaching, clinical problem solving and facilitating change (Gerrish et al.,
2011).
In summary, the research supports implementation of progressive mobility
protocols. The safety, feasibility, and impact on functional outcomes has been supported
in multiple studies and reviews of the literature. While the focus in critical care has been
on disease diagnosis and highly technological treatment, nursing must commit to
reclaiming the fundamentals of nursing care that are essential to positive outcomes and
use evidence-based practice to drive the transformation (Vollman, 2009). Protocols and
training in early mobility should help increase knowledge to promote incorporation of
early mobility into patient care. Staff education on the complications of immobility may
lead to an increase of ICU mobility within patient care activities (Ross & Morris, 2010).
Next, the theoretical framework guiding this project will be described.