Dear Editor:

We would like to thank the staff of the Mayo Clinic, Jacksonville, Florida, for their feedback and for sharing their own findings. We recognize that many neuro-intensive care units have been safely mobilizing patients with external ventricular drains for a long time and may have been standard practice at many institutions. However, after an exhaustive literature review, we identified a paucity of data describing the process, safety, and feasibility of this practice. In addition, available literature revealed a lack of established pathways or protocols to mobilize this unique patient population. Our goal was both to formalize the practice through a standard protocol with built-in safety mechanisms and to disseminate our findings to permit safe mobilization of this patient population.

The Mayo Clinic's data reinforce that the mobilization of this patient population is both safe and feasible. We are encouraged that their data support our findings and add to the currently scarce body of literature. We continue to collect data at our institution as part of our phase II early mobility initiative to explore the outcome of nurse-driven mobilization and further add to the literature.

Sincerely,

Megan Moyer