While literature supports evidence of improved outcomes with early mobility,
changes in practice can present challenges. Winkelman and Peereboom (2010)
performed a descriptive study examining the nurses’ perceptions of the barriers to and
facilitators of progressive mobility. Data were collected in a semi-structured interview
conducted with 33 nurses prior to implementing any patient activity related to mobility.
The goal of the interview was to determine the nurses’ perception related to patient
readiness or inability to increase mobility activities. Of 49 activities identified by nurses
during the interview, 41 were limited to in-bed activity, including frequent manual
turning or passive range of motion exercises. Only one nurse planned active range of
motion exercises. Unstable vital signs and low respiratory tolerance were the common
reasons for restricting activity. Safety concerns (fear of patient falling or risk to tubing or
catheter integrity) were cited in 34% of the interviews. Eleven nurses (27% of interviews)
reported sedation to be an important barrier to out of bed activity. The nurses did not cite
physicians’ orders as either a barrier or facilitator.