Publication Name	World Journal of Critical Care Medicine
Manuscript ID	122427
DOI	10.5492/wjccm.122427
Country	United States

Category	Pediatrics
Manuscript Type	Observational Study
Article Title	Discordance between early mobility protocol expectations and nurse-led mobilizations of critically ill children: A quality improvement initiative
Manuscript Source	Invited Manuscript
All Author List	Divya Manikandan, Hallie Lenker, Colleen Mennie, Stephanie Morgenstern, Sukaina Furniturewala, Lisa Hwang, Krista Hajnik, Kristen M Brown, Nicole Shilkofski, Sapna R Kudchadkar and Jessica M LaRosa
Funding Agency and Grant Number	Funding Agency Grant Number National Center for Advancing Translational Sciences No. KL2TR003099
Corresponding Author	Jessica M LaRosa, Assistant Professor, MD, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 1800 Orleans St, Suite 6349, Baltimore, MD 21287, United States. jlarosa4@jhmi.edu
Key Words	Pediatric critical care; Early mobility; nursing-led mobility; Documentation; Rehabilitation; Post intensive care syndrome; Sedation
Core Tip	This initiative found substantial discordance between protocol-expected, health record documented, and nurse-reported mobilizations in a pediatric intensive care unit with a 12-year early mobility program. Nursing uncertainty regarding mobility levels frequently resulted in patients being mobilized at a level lower than the target. Severe disability at baseline, rather than mechanical barriers like medical equipment, was associated with discordance between nurse-reported mobility and the protocol. Early mobility protocols should be modified to include unambiguous guidance for children with baseline medical complexity, and programs should assess implementation fidelity and program efficacy to ensure safe and consistent mobilizations of critically ill children.
Citation	Manikandan D, Lenker H, Mennie C, Morgenstern S, Furniturewala S, Hwang L, Hajnik K, Brown KM, Shilkofski N, Kudchadkar SR, LaRosa JM. Discordance between early mobility protocol expectations and nurse-led mobilizations of critically ill children: A quality improvement initiative. World J Crit Care Med 2026; In press DOI: https://doi.org/10.5492/wjccm.122427
PDF	122427-in-press.pdf

Received	2026-04-20 08:34
Peer-Review Started	2026-04-20 08:35
First Decision by Editorial Office Director	2026-05-07 12:30
Return for Revision	2026-05-07 12:30
Revised	2026-05-26 21:38
Publication Fee Transferred
Second Decision by Editor	2026-06-05 03:10
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-06-05 05:44
Articles in Press	2026-06-05 05:44
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2220-3141(online)
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