Implementation of a nurse-led multidisciplinary huddle meeting for improvement of early rehabilitation in ICU: a healthcare quality improvement project

• Published in: BMJ open quality Vol. 12; no. 3; p. e002215
• Main Authors: Naya, Kazuaki, Sakuramoto, Hideaki, Aikawa, Gen, Hayashi, Kotaro
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.09.2023; BMJ Publishing Group
• Subjects: Anesthesia; Cardiovascular disease; Clinical outcomes; Coronary vessels; Delirium; Electronic health records; Hospitals; Intensive care; Medical records; Muscle strength; Nurses; Patients; Physical therapists; Physicians; Quality improvement; Quality Improvement Report; Rehabilitation; Vein & artery diseases; Ventilators; Japan
• ISSN: 2399-6641; 2399-6641
• DOI: 10.1136/bmjoq-2022-002215

The physical decline of critically ill patients affects their discharge from the intensive care unit (ICU) and their subsequent lives. Therefore, it is essential to actively provide rehabilitation at an early stage through multidisciplinary cooperation and protocols. This paper aims to describe the results of a project to improve the implementation rate of early rehabilitation. We established the ICU Early Rehabilitation Group, consisting of nurses, intensivists and physical therapists, and developed a protocol to perform early rehabilitation. According to this protocol, a nurse-led ‘multidisciplinary rehabilitation huddle meeting’ was introduced for early rehabilitation. Rehabilitation status, muscle strength and physical function were compared 9 months before and after the introduction of the huddle meeting. In addition, we assessed adverse events during rehabilitation. Since the introduction of huddle meetings, the implementation rate has been 100%. Furthermore, rehabilitation was implemented earlier and at a higher level after introducing huddle meetings. However, no significant difference was detected in muscle strength and physical function of the patients. In addition, no adverse events occurred during rehabilitation. This quality improvement project facilitated an earlier start to rehabilitation and a higher level of rehabilitation practice. Huddle meetings were smoothly introduced and settled in through multiprofessional communication. The lack of adverse events also suggested the programme’s effectiveness in safely implementing this type of rehabilitation at an early and high level.