Infection control practices and device management when mobilizing critically ill patients

Early mobilization of critically ill patients in the intensive care unit (ICU) is essential for recovery, particularly in the context of the COVID-19 pandemic. However, mobilization poses infection control and safety challenges due to the presence of invasive medical devices. This article provides practical guidance on infection prevention and device management during ICU-based mobilization, developed by an international, multidisciplinary team of rehabilitation experts. A key recommendation is to categorize medical devices as “clean,” “neutral,” or “dirty,” with specific handling protocols for each to minimize infection risk. Emphasis is placed on hand hygiene, use of personal protective equipment, and maintaining essential infusions during mobilization. For example, vasopressors and other life-sustaining medications should not be disconnected, while non-essential infusions may be temporarily paused. Proper device fixation, use of extended tubing, and structured team planning are critical to ensuring safety. The article also outlines a detailed pre-mobilization checklist to guide clinical teams in preparation. This guidance aims to reduce nosocomial infections and support safe mobilization practices through standardized infection control procedures, thus enhancing the safety and effectiveness of ICU rehabilitation.

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