1614 - Early Mobility as Curriculum: Empowering Nurses and Residents in the Intensive Care Unit

Thursday, February 19, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

AV

Andrea C. Velez, MD

Second-Year Internal Medicine Resident
Hospital Universitario Dr. Ramon Ruiz Arnau - Universidad Central del Caribe School of Medicine
San Juan, Puerto Rico, United States

Co-Author(s)

JJ

Javier F. Jusino Alamo, MD

PM&R Research Fellow
Larkin Community Hospital, South Miami Campus
Riviera Beach, Florida, United States
DO

Danisa I. Oyola Soto, BS

Medical Student
Universidad Central del Caribe
Toa Alta, Puerto Rico, United States
RA

Rodolfo R. Alicea, MD

PM&R PGY2
Larkin Community Hospital South Miami
Pembroke Pines, Florida, United States

Submitter(s)

aV

andrea C. Velez, MD

Hospital Universitario Dr. Ramon Ruiz Arnau - Universidad Central del Caribe School of Medicine
San Juan, Puerto Rico, United States

Objectives: Prolonged immobility in the intensive care unit (ICU) leads to complications including muscle wasting, venous thromboembolism, delirium, and prolonged ventilator dependence. Bed rest has not demonstrated therapeutic benefit, and outcomes worsen with immobility. Early mobility interventions consistently reduce complications, hospital length of stay, and resource use across patient populations. While most studies occur in large academic centers with multidisciplinary teams, small community hospitals often lack resources, underscoring the need for nurse-driven, education-centered approaches. This project analyzes the applicability of a standardized, nurse-driven early mobility protocol in the ICU of a community hospital. Emphasis is placed on educating nurses and residents to implement, sustain, and evaluate the protocol despite staffing and resource limitations.

Design: A quasi-experimental pre-post intervention design is used in the general ICU of a community hospital. Phase 1 includes baseline data collection on ICU length of stay, wound care needs, and 30-day readmission rates. Phase 2 involves protocol implementation, guided by comprehensive educational materials for nurses and residents. Pre- and post-training assessments measure knowledge and confidence, while anonymous surveys capture perceived barriers and facilitators. Post-intervention outcome data will be compared with baseline measures using paired t tests, Wilcoxon signed-rank tests, and chi-square analyses.

Results: This initiative prioritizes interprofessional education by equipping nurses and residents with skills to identify safe candidates, implement stepwise mobility progression, and document adherence. The focus on confidence-building and ownership addresses unique challenges in community hospital ICUs, such as high nurse-to-patient ratios and limited physical therapy coverage.

Conclusions:
This project will demonstrate reductions in ICU length of stay, wound care needs, and 30-day readmission rates while improving providers’ knowledge and confidence in early mobility interventions. Beyond clinical outcomes, this work underscores how education can empower frontline providers to champion evidence-based mobility practices, informing broader adoption of nurse-driven protocols in resource-limited critical care settings.