Holy Name Progressive Mobility in the ICU

This study is designed as a process improvement program to increase compliance to a
progressive mobility protocol in an ICU setting. The first part of the study (4-6 months
period depending on time required for implementation) will document 1st day of weight
bearing as well as the secondary outcome measures of this of progressive mobility protocol
as are currently in place in the ICU for patients that meet the inclusion/exclusion
criteria. Ease of progressive mobility implementation will be assessed. Appropriate
education will be performed as to the importance of progressive mobility.

The second part of the study (4-6 months) will document the same outcomes, however, the
progressive mobility protocol will now include a standardized process using the Total Care®
P500 Bed System combined with the Liko Lift. During the second study period, patients will
progress in a stepped protocol (see section 6.2) beginning with head of bed (HOB) at 30o to
initiate orthostatic stress three times daily with increasing time intervals, then
increasing HOB angle, time, and finally to standing and bearing weight. The Total Care® P500
Bed System and the Liko Lift will be placed on all participating units for the duration of
the second phase of the study.

Compliance to specific outcome measures again will be measured as well as the ease of
Progressive Mobility implementation. The total study period will be 8-12 months (allowing
time for bed delivery and education).

Patients who meet the inclusion/exclusion criteria for study will be enrolled. Protocol
based "up in chair" and "standing" orders will be followed for compliance, and length of
actual sitting in full chair or standing. If patients undergo "full chair" in the bed, this
will be considered "up in chair." Time/days to first weight bearing, as defined as weight
bearing in a standing position for at least 1 minute will be documented. ICU LOS, Ventilator
Days will be assessed at ICU discharge for study patients. Nursing satisfaction and ease of
PM protocol adherence surveys will be performed after each study period and will assess both
standard of care and Total Care® bed/Liko lift systems.

Inclusion Criteria:

- Patient is ≥ 18 years old.

- Patient has been admitted to the ICU for less than 3 days prior to study enrollment

- Patients require mechanical ventilation for > 48 hours

Exclusion Criteria:

- Patient has an unstable spinal injury.

- Patient weighs less than 70 pounds or more than 450 pounds

- Mobilization is contraindicated by Patient's condition. Such as hip fractures or
other injury that would impede standing posture.

- Patient was unable to walk without assistance prior to ICU admission.

- Patient was cognitively impaired prior to ICU admission.

- Patient has experienced acute stroke with neurologic impairment

- Patient's primary diagnosis is drug overdose.

- Patient has Comfort Care Measures/End of Life orders and/or is at an end stage
terminal disease state.

- Patient requires a bed other than the standard care bed for any reason.