September 24
by Jonathan Downham
Mobilisation in the ICU raises two big questions: is it safe, and will staff embrace it?
In this discussion, Jonathan explores both sides of the story:
Safety first:
Large prevalence studies show mobilisation is happening, though often inconsistently.
A systematic review of 1,800+ sessions found serious adverse events in only 0.6% — most minor and short-lived.
Even patients on CRRT can safely mobilise with planning, adequate staff, and the right equipment.
Consensus guidelines outline clear safety screens, covering oxygen, ventilator settings, vasopressors, and line security.
Culture and barriers:
Staff concerns include safety fears, deep sedation, lack of hands, limited kit, and “whose job is this anyway?”
Interviews reveal gaps in knowledge and confidence, differing beliefs about risks and benefits, and role confusion between professions.
Success breeds success: once teams see mobilisation working, attitudes shift.
Daily goals, interdisciplinary huddles, and local champions help make mobilisation the default, not the exception.
Takeaway: Mobilisation in ICU is both safe and achievable — but safety checks alone aren’t enough. Embedding it into everyday culture is the real key to making it routine.
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