Cardiovascular Intensive Care Unit Nurses‘ Perceptions of the Factors Affecting, Barriers to, and Facilitators of Early Mobilization

Background: Although early mobilization has well-documented benefits for patients in intensive care units, it is not implemented as frequently as recommended. Previous studies have identified patient-related factors, time constraints, and inadequate staffing as barriers to the early mobilization of cardiovascular intensive care unit (CICU) patients.

Aim: This study aimed to explore CICU nurses' perceptions of the factors affecting, barriers to, and facilitators of early mobilization in CICU patients.

Methods: A descriptive qualitative study design was employed. Seven CICU nurses were recruited using purposive sampling. Data were collected through semi-structured interviews. Audio-recorded interviews were transcribed verbatim and analyzed using qualitative content analysis. Codes were generated from the transcripts and subsequently organized into categories and themes.

Results: Participants reported that early mobilization is beneficial for CICU patients and should be prioritized according to each patient's clinical condition. Three themes and seven categories emerged: factors affecting early mobilization, barriers to early mobilization, and facilitators of early mobilization. Factors affecting mobilization included patient-related factors (hemodynamic stability, pain, fear, and muscle strength), environmental factors (limited space and medical equipment), and personnel-related factors (staff shortages and lack of experience). Barriers were categorized as physical (e.g., hemodynamic instability and pain) and psychological (e.g., fear and lack of self-confidence). Facilitators included preoperative education and adequate staffing support.

Conclusion: The findings suggest that CICU nurses perceive patient-related factors, environmental conditions, and staffing issues as key influences on early mobilization. Improving staffing support, developing written protocols, and providing education may facilitate the implementation of early mobilization in CICUs.

Keywords: Barriers, cardiovascular surgery, early mobilization, facilitators, intensive care unit, qualitative study