Post-intensive care syndrome (PICS) is a clinically significant sequela among survivors of critical illness, including patients after cardiac surgery. Clinical guidance supports early mobilization (EM) as part of recovery, but there has been limited evidence specifically evaluating nurse-led, algorithm-based EM protocols in cardiovascular intensive care units (ICUs). The study aimed to address this evidence gap by testing whether a standardized, nurse-driven mobilization algorithm applied early after ICU admission could modify PICS-related outcomes and related patient-centered measures.
The trial's primary objective was to evaluate the effects of a nurse-led algorithm-based early mobilization protocol on PICS scores in adult patients following cardiac surgery. Secondary objectives included evaluating effects on psychological distress (anxiety and depression), sleep quality, and nursing service satisfaction.
This investigation was a randomized controlled pretest–posttest study conducted at a tertiary hospital in South Korea. The trial was reported as an online ahead-of-print article in J Cardiovasc Nurs and was registered with the Korean Clinical Research Information Service (identifier: KCT0010880).
Thirty-eight adult patients who underwent cardiac surgery were enrolled and randomized to either the control group (n = 19) or the experimental group (n = 19). Random allocation details beyond group sizes were not reported in the source abstract. The experimental intervention commenced 12 hours after ICU admission and continued until the patient was transferred out of the ICU.
The experimental intervention was a standardized algorithm-driven EM protocol delivered by nurses. The protocol was initiated 12 hours post–ICU admission and was continued through the ICU stay until transfer. The abstract does not provide the stepwise details of the algorithm, specific mobilization milestones, or staff training and competency procedures; those protocol specifics were not reported in the source abstract.
Outcomes were measured using validated instruments reported in the abstract: the PICS Questionnaire to assess post-ICU syndrome burden; the Hospital Anxiety and Depression Scale (HADS) for psychological distress; the Korean Modified Leeds Sleep Evaluation Questionnaire for sleep quality; and a Nursing Service Satisfaction Tool for patient satisfaction with nursing care. Data were analyzed using nonparametric statistical tests as reported in the abstract.
Compared with the control group, the experimental group demonstrated statistically significant improvements across multiple outcomes:
Total PICS scores improved significantly in the experimental group (Z = -3.83, P < .001).
Measures of psychological distress (anxiety and depression by HADS) showed significant reduction in the experimental group (Z = -3.52, P < .001).
Sleep quality improved significantly with the intervention (Korean Modified Leeds Sleep Evaluation Questionnaire: Z = -3.83, P < .001).
All reported subdomains of nursing service satisfaction improved in the experimental group, with Z values reported in the range of -3.58 to -3.83 and P < .001 for those comparisons.
The abstract presents these group-level outcomes and associated nonparametric test statistics but does not include detailed mean or median values, effect sizes, confidence intervals, or time-to-event data in the abstract text.
No mobilization-related adverse events were reported in the experimental group according to the abstract, which the authors interpret as evidence supporting the safety of the nurse-led, algorithm-based early mobilization protocol in this patient population.
In this randomized controlled study of adult cardiac surgery patients in a tertiary-care cardiovascular ICU, a nurse-led algorithm-based early mobilization protocol initiated 12 hours after ICU admission was associated with significant reductions in PICS scores, decreases in anxiety and depression, improved sleep quality, and higher nursing satisfaction compared with usual care. No mobilization-related adverse events occurred. The authors conclude that a standardized, nurse-driven EM protocol is a safe and effective strategy to reduce PICS and improve related patient-centered outcomes and recommend integrating such protocols into routine cardiovascular ICU practice.
Clinical readers should note that the abstract reports group-level statistical comparisons and significance values but does not supply full protocol details, numerical baseline characteristics, or detailed effect size metrics in the abstract text; those specifics were not reported in the source abstract.
The study was registered with the Korean Clinical Research Information Service (CRIS) under identifier KCT0010880. The authors declared no conflicts of interest in the source record.