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Nurse-led algorithm-based early mobilization protocol reduces post-intensive care syndrome in cardiac surgery ICU patients

In a randomized controlled trial of 38 cardiac surgery ICU patients, a nurse-led algorithm-based early mobilization protocol significantly reduced PICS scores (Z = -3.83, P < .001), anxiety and depression (Z = -3.52, P < .001), and improved sleep quality (Z = -3.83, P < .001) compared to usual care. No mobilization-related adverse events occurred.

Last updated: Aug 15, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score44/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Nurse-Led Algorithm-Based Early Mobilization Protocol for Reducing Post-Intensive Care Syndrome in Intensive Care Unit Patients: A Randomized Controlled Trial.

observational

Jeong Y, Lee H · The Journal of cardiovascular nursing (2026)

Participants: N/A
Duration: From 12 hours post-ICU admission until transfer (duration not specified)
Intervention: Nurse-led algorithm-based early mobilization protocol initiated 12 hours post-ICU admission until transfer
Outcome: PICS score, anxiety and depression (HADS), sleep quality (Korean Modified Leeds Sleep Evaluation Questionnaire), nursing satisfaction
Effect Size: N/A (only Z statistics reported)
Population: Adult patients following cardiac surgery in a Korean tertiary hospital ICU

Result:

PubMed: 42585547DOI: 10.1097/JCN.0000000000001373

Mechanism Graph

Early mobilization reduces physical deconditioning and ICU-acquired weakness
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Reduced physical impairment may lower risk of cognitive and psychological dysfunction
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Structured protocol may reduce anxiety and depression through increased patient engagement and autonomy
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Improved sleep quality and nursing satisfaction due to standardized care and patient interaction

Limitations

  • ⚠Small sample size (n=38) limits generalizability
  • ⚠Single-center study in a Korean tertiary hospital may not be representative of other settings
  • ⚠No long-term follow-up to assess sustainability of effects
  • ⚠Outcome assessors were not blinded (not explicitly stated)

Frequently Asked Questions

What is post-intensive care syndrome (PICS)?▼

PICS refers to new or worsening physical, cognitive, or mental health impairments that persist after critical illness and ICU stay.

How early can early mobilization start after cardiac surgery?▼

In this study, the protocol began 12 hours after ICU admission, suggesting that early mobilization can be safely initiated within the first day post-surgery.

Is nurse-led early mobilization safe for cardiac surgery patients?▼

Yes, this study reported no mobilization-related adverse events, indicating that a nurse-led algorithm-based protocol is safe in this population.

What outcomes were improved by the early mobilization protocol?▼

The protocol significantly reduced PICS scores, anxiety and depression, and improved sleep quality and nursing satisfaction compared to usual care.

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References

  1. 1.Jeong Y, Lee H. "Nurse-Led Algorithm-Based Early Mobilization Protocol for Reducing Post-Intensive Care Syndrome in Intensive Care Unit Patients: A Randomized Controlled Trial.." The Journal of cardiovascular nursing, 2026. PMID: 42585547 DOI: 10.1097/JCN.0000000000001373
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.