Nurses’ experiences and needs in implementing early mobilisation in the adult intensive care unit: a qualitative meta-synthesis

Objectives: The objectives of this study were to explore nurses’ experiences and needs in implementing early mobilisation (EM) in adult intensive care units and also to provide recommendations to enhance the implementation of EM. Methods: This meta-synthesis followed the Thomas and Harden approach. A systematic search was conducted in Web of Science, PubMed, Embase, and Scopus for studies published between March 1, 2015, and March 1, 2025. Qualitative studies published in peer-reviewed journals that examined nurses’ experiences and needs related to EM in adult intensive care units were eligible and included. Two reviewers independently screened and extracted data. All included studies were critically appraised using the Critical Appraisal Skills Programme tool. Results: A total of 10 studies with 87 nurses were included. Three analytical themes and nine descriptive themes were identified. The first analytical theme, Systemic and Institutional Experiences, encompassed four descriptive themes: lack of institutional policies and adequate staffing, role ambiguity, time constraint due to workload, and lack of a standardised risk assessment tool. The second analytical theme, Interpersonal and Professional Experiences, included difficulties with patient engagement, lack of interdisciplinary teamwork, and insufficient leadership. The final analytical theme, Expressed Needs for Effective Implementation, reflected the need for training and the need for support and motivation. Conclusions: This thematic synthesis reveals that nurses mostly encounter negative experiences when implementing EM, highlighting significant gaps and opportunities for improvement. To strengthen EM practices and optimise patient outcomes, it is crucial to equip nurses with structured, evidence-based education, clearly defined roles, sufficient resources, and a collaborative environment supported by hospital policymakers and administrators. Registration: The review was registered on the International Prospective Register of Systematic Reviews with the number CRD420251006731.