An Early Mobilisation Practices among Intensive Care Unit Nurses: A Scoping Review of Influencing Factors

Abstract

Background: Early mobilisation on Intensive Care Unit (ICU) admission is an essential element in the management of critically ill patients in the ICU. It is associated with several advantages, including a reduction in ICU duration, the prevention of ICU-acquired complications, and improvements in functional outcomes. Despite these advantages, the implementation of early mobilisation techniques remains inconsistently applied among ICUs globally. Aim: To explore and synthesise the existing literature on factors that influence ICU nurses’ practices in early mobilisation, while also identifying gaps that contribute to inconsistent implementation. The review aims to highlight the knowledge, attitudes, organisational structures, training, and collaborative practices that influence nurses’ ability to initiate and sustain early mobilisation in critical care environments. Objectives: This scoping review aims to elucidate the current literature on factors influencing early mobilisation practices among ICU nurses, while also identifying areas that require further research and policy advancement. Methods: The review was conducted using multiple databases, including PubMed, CINAHL, Scopus, and ScienceDirect, for articles published between 2015 and 2025. An eligibility criterion was published in English and employed qualitative, quantitative, and mixed-methods approaches, focusing on the involvement of ICU nurses in early mobilisation and the factors influencing this engagement. A total of 750 papers were retrieved via database searches; 25 studies were included. This is aggregated into 45 results and classified throughout all seven domains. Findings: Various factors affect the emergency management strategies utilised by ICU nurses. The factors include the levels of training and knowledge, the demands related to workload and staffing ratios, the presence of clear protocols, the extent of interdisciplinary collaboration, and the dominant organisational culture. Many studies have revealed notable gaps in knowledge, as well as varying definitions of roles. Implications: This scoping review emphasises various individual, organisational, and systemic factors that influence ICU nurses' participation in early mobilisation initiatives. Emphasising these components is crucial for the successful implementation of targeted training, the formulation of suitable policies, and the efficient distribution of resources to enhance the execution of EM in critical care environments.

Keywords: Early ambulation, intensive care unit, critical care