Heather Granada

Introduction/Problem

Improving hospital mobility is not a novel concept and it is fundamental to improving patient outcomes. There are known benefits to mobilizing patients early, consistently, and frequently. The literature is clear on the importance of preventing adverse outcomes associated with immobility. At our organization, we identified opportunities with mobility on our inpatient medical surgical (MS) units. A random chart audit revealed no documentation of any mobility on over 90% of our patients. Additionally, nurse interviews revealed gaps in knowledge of mobility protocols and competing priorities interfering with mobility. Both chart audits and nurse interviews revealed a gap in practice.

Methods

This is a quality improvement (QI) approach was used that examined the impact of a mobility technician (MT) combined with education on progressive mobility protocols on two similar MS units, one with the MT and one without a MT. The outcomes measured were patient mobility in feet and HAP rates. Education was completed prior to implementation of progressive mobility protocol, comprehensive mobility assessment tool (CMET) and expectations around mobility.

Findings

Sixty patients from each MS department was included in the project. An independent t-test indicated a significant difference in distance ambulated between the two patient populations, t(64.26)=7.22, p<.001. MS 2 had a mean of 1446.27 (SD=1390.07) which was greater than MS 1 with a mean of 122.87 (SD=293.71). On average there was 1323.4 additional feet, more frequent ambulation of 7.0 episodes, and quicker ambulation by 5.2 hours on MS 2 which had the MT. There was a stronger culture of mobility on the unit with the MT as all job roles actively participated in mobility as compared with the unit without the MT. There were zero cases of HAP in both MS units during the implementation timeline.

Practice Implications

The addition of a MT to a nursing unit improved hospitalized patient mobility related to average distance traveled, frequency, and time to first ambulation. With the nursing shortage upon us, challenges around nursing workload and deficient staffing reduce time and resources available to adequately mobilize our patients in a hospital setting. The MT is an effective way to ensure mobility continues to be prioritized. Funding: This study was not funded.