Prolonged bed rest in hospitalized patients leads to deconditioning, impaired mobility and potential for longer hospital stays.
The purpose of this study was to determine the effectiveness of a nurse-driven mobility protocol to increase the percentage of patients ambulating during the first 72 hours of their hospital stay.
A quasi-experimental design pre- and post-intervention was used for the study in a 16 bed Adult Medical/Surgical ICU and a 26 bed Adult Intermediate Care Unit (IMCU) at a large community hospital.
A multidisciplinary team developed and implemented a mobility order set with an embedded algorithm to guide nursing assessment of mobility potential. Based on the assessments, the protocol empowers the nurse to consult physical or occupational therapy when appropriate. Daily Ambulation Status Reports were reviewed each morning to determine each patient's activity level. Retrospective and prospective chart reviews were performed to evaluate the effectiveness of the protocol for patients 18 years of age and older who were hospitalized 72 hours or greater.
In the three months prior to implementation of the Move to Improve project, 6.2% (12 of 193) of ICU patients and 15.5% (54 of 349) IMCU patients ambulated during the first 72 hours of their hospitalization. During the six months following implementation, those rates rose to 20.2% (86 of 426) and 71.8% (257 of 358), respectively.
The study was carried out at only one center.
Our initial experience with a nurse-driven mobility protocol suggests that the rate of patient ambulation in an adult ICU and IMCU during the first 72 hours of a hospital stay can be increased.
Source: http://ptjournal.apta.org/cgi/content/short/ptj.20110400v1?rss=1
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