Mobilisation in Critical Care- Barriers and Culture

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.