背景：早期动员（EM）因其在危重病人康复中的安全性和益处而被公认，然而,其在重症监护病房(ICU)的实施仍然与既定指南不一致.这种差异凸显了理论认可与实际应用之间的差距。虽然对EM的障碍已经进行了广泛的研究，ICU护士对EM的意图和感知做法，特别是在某些地理区域，没有被充分理解。
目的：本研究的目的是评估感知，ICU护士在ICU环境中为患者实施EM的实际做法和意图。
方法：横截面，多中心,基于调查的研究。
结果：该研究通过电子问卷收集了北京八家医院227名ICU护士的数据，中国,关于他们的经历，与EM相关的实践和意图。调查回复率为50%(227人中的114人)，表明目标人群的参与程度适中。在接受调查的参与者中，68.7%(n=156)的人报告有重症患者的EM经历。在这些经验丰富的护士中，49.3%(n=77)表示他们进行EM的频率低于每周一次，而只有29.5%(n=46)的患者报告致力于EM活动超过20分钟。只有24.2％（n=55）的参与者确认其工作场所存在特定的EM指南。值得注意的是,指南依从性可能会受到患者病情严重程度的影响，这可能会影响这些协议的应用方式。值得注意的是,EM实践的方法和频率显示出不同ICU的显着差异。绝大多数（75%，n=170)的参与者表达了实施EM的强烈意愿，显著相关的因素，如具有较高的教育水平（学士学位或更高），获得部门支持，遇到更少的感知障碍，属于特定科室，如呼吸（SICU）和外科（RICU）。与会者提到的EM指南主要侧重于具体的协议和指南，强调在临床环境中对EM的结构化方法的重视。
结论：尽管ICU护士有公认的EM经验，他们的做法与EM指南中概述的建议之间存在明显差异。这项研究强调了建立明确,可操作的指导方针，除了提供有针对性的教育计划和强大的支持系统，以促进在ICU设置中持续有效地实施EM。
结论：本研究强调了ICU环境中EM的临床意义，倡导制定精确的EM指南以改善患者预后。
Early mobilization (EM) is acknowledged for its safety and benefits in the recovery of critically ill patients, yet its implementation in intensive care units (ICU) remains inconsistently aligned with established guidelines. This discrepancy highlights a gap between theoretical endorsement and practical application. While barriers to EM have been extensively studied, the intentions and perceived practices of ICU nurses towards EM, especially in certain geographical regions, have not been adequately understood.
The objective of this study is to assess the perceptions, actual practices and intentions of ICU nurses regarding the implementation of EM for patients in the ICU setting.
A cross-sectional, multi-centre, survey-based study.
The study collected data through an electronic questionnaire from 227 ICU nurses across eight hospitals in Beijing, China, concerning their experiences, practices and intentions related to EM. The survey response rate was 50% (114 of 227), indicating a moderate level of engagement by the target population. Among the surveyed participants, 68.7% (n = 156) reported having experience with EM for critically ill patients. Of these experienced nurses, 49.3% (n = 77) indicated they carried out EM less frequently than once per week, while only 29.5% (n = 46) reported dedicating more than 20 min to EM activities per patient. Only 24.2% (n = 55) of participants confirmed the presence of specific EM guidelines in their workplace. Notably, guideline adherence could be influenced by the patient\'s condition severity, which may affect how these protocols are applied. Notably, the approach and frequency of EM practices showed significant variation across different ICUs. A substantial majority (75%, n = 170) of participants expressed a strong intention towards implementing EM, correlating significantly with factors such as having a higher education level (bachelor\'s degree or higher), receiving departmental support, encountering fewer perceived barriers, and belonging to specific departments like respiratory (SICU) and surgery (RICU). The EM guidelines mentioned by participants were primarily focused on specific protocols and guidance, highlighting the emphasis on structured approaches to EM in their clinical settings.
Despite the recognized experience with EM among ICU nurses, there is a notable divergence between their practices and the recommendations outlined in EM guidelines. This study underscores the need for the establishment of clear, actionable guidelines, alongside the provision of targeted educational programmes and robust support systems, to foster the consistent and effective implementation of EM in ICU settings.
This study underscores the clinical relevance of EM in ICU settings, advocating for the development of precise EM guidelines to improve patient outcomes.
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