Multidimensional Factors Influencing the Implementation of Early Mobilization in Critically Ill Patients From Healthcare Providers' Perspectives: A Systematic Review.
TL;DR
Early mobilization in ICUs should be understood as a multidimensional implementation process rather than a single rehabilitation task and sustainable practice depends on the characteristics of the intervention, organizational readiness, clearly defined interprofessional roles, patient engagement and process-level strategies such as preplanning, real-time monitoring, debriefing and feedback.
Abstract
Aims
This meta-synthesis of qualitative studies aimed to explore the experiences and perspectives of healthcare providers in the Intensive Care Unit (ICU) setting regarding the implementation of early mobilization.
Design
A qualitative systematic review and meta-synthesis was conducted. The review protocol was registered with PROSPERO (CRD420251057721). DATA SOURCES Six databases (PubMed, EMBASE, Web of Science, CINAHL, CNKI and Wanfang Data) were searched from inception to March 5, 2025. A total of 759 records were identified, and 34 studies met the eligibility criteria and were included in the final meta-synthesis. REVIEW
Methods
We evaluated the quality of the included studies using the Critical Appraisal Skills Programme-Qualitative Research Checklist.
Results
Thirty-four studies conducted in 13 countries and involving 699 ICU healthcare providers were included. Four analytical themes were generated: characteristics of early mobilization, the inner setting of implementation, the key role system and core determinants of successful implementation.
Conclusion
Early mobilization in ICUs should be understood as a multidimensional implementation process rather than a single rehabilitation task. Sustainable practice depends on the characteristics of the intervention, organizational readiness, clearly defined interprofessional roles, patient engagement and process-level strategies such as preplanning, real-time monitoring, debriefing and feedback. The findings support the development of context-sensitive implementation strategies to translate early mobilization evidence into routine ICU care. IMPACT This review underscores the critical importance of organizational support, team collaboration mechanisms and the professional capacity building of healthcare providers in advancing early mobilization within ICU settings. Frontline clinicians should be equipped with targeted training and structured planning tools, while leadership is encouraged to foster a culture of shared responsibility and continuous improvement. PATIENT OR PUBLIC CONTRIBUTION This qualitative systematic review did not involve original patients or the public. Therefore, this is not applicable.