Date of Graduation

Summer 8-8-2025

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Department/Program

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First Advisor

David Ainsworth

Second Advisor

Liesel Buchner

Abstract

Abstract

Background: Hospital-acquired pneumonia (HAP) is a preventable complication associated with increased morbidity, prolonged hospital stays, and elevated healthcare costs. Early mobility, particularly positioning patients out of bed for meals, is a key strategy to mitigate this risk. Problem: On a 42-bed telemetry unit, only 24% of eligible patients were positioned out of bed for meals. This low rate of mobility presented an opportunity to reduce the risk of HAP and improve patient outcomes. Interventions: This quality improvement initiative, guided by the Donabedian Model, employed a nurse-led intervention that included daily mobility assessments, visual bedside cues, and targeted staff education. A Plan-Do-Study-Act (PDSA) cycle framework was used to drive iterative improvements. Outcome Measure: The primary outcome was the percentage of eligible patients positioned out of bed for meals. The target was to increase from 24% to 35% by July 2025. Results: The project achieved a relative improvement of 38%, increasing the out-of-bed for meals rate from 24% to 33%. Although the target was not fully met, no new cases of HAP were recorded during the implementation period, suggesting a positive correlation between the intervention and reduced HAP risk. Conclusion: Nurse-led, structured mobility interventions can significantly improve patient positioning practices and potentially reduce hospital-acquired complications such as pneumonia. Sustained improvement may be supported through continued staff engagement and integration of mobility protocols into routine care.

Keywords: hospital-acquired pneumonia, early mobility, patient positioning, mealtime mobility, non-ventilator HAP, and quality improvement.

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