Abstract 13523: Self-guided Mobilization in the Cardiac ICU During the COVID Era
Bibliographic record
Abstract
Introduction: Measures instituted to prevent the spread of COVID may have an impact on cardiac ICU care practices, such as early mobility (EM) program delivery. A structured EM program was in place in our cardiac ICU prior to COVID. Restrictions on hallway ambulation and patient-provider interaction due to COID led us to modify our EM program to a nurse-assisted, patient-guided program. To our knowledge, there are no studies evaluating patient-guided mobilization in a critical care setting. Thus, our objective was to assess whether self-guided EM was safe and feasible in the cardiac ICU during the COVID period. Methods: We reviewed consecutive records in a tertiary care cardiac ICU over a 2-month period following initiation of the self-guided EM program. Only patients who were COVID negative or presumed negative were admitted to the cardiac ICU. Nurses assessed patients using the Level of Function Mobility Score (range 0 to 5, with higher scores indicating better mobility) and provided the current functional level to patients. Patients used their own smartphones or supplied tablets to view video modules, which guided performance of level-specific mobility activities. Patients with contraindications to mobilization based on prespecified criteria were not mobilized. There were 2 mobilization opportunities per day and 3 activities per opportunity. Results: There were 52 patients admitted to the CICU during the study period (mean age 67.4 ± 16.0 years; 38.5% female). Ten patients (19.2%) had contraindications to mobilization during unit stay; all of these patients were subsequently mobilized. Two-thirds (66.7%; 208/312) of mobilization opportunities had at least one mobility activity. 72.2% (676/936) of prescribed mobility activities were performed. The adverse event rate was 0.6% (4 events/676 activities); none of these were major or life-threatening. There were no falls or line dislodgements. Conclusions: Patient self-guided mobilization was safe and feasible during a period of limited provider-patient interaction in a cardiac ICU. Self-guided EM programs can be considered during periods of restrictions on usual mobility programs. Further studies are needed to evaluate EM in other settings, such as in COVID hospital wards.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".