Date of Graduation

Fall 12-14-2018

Document Type

Project/Capstone

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

First Advisor

Cathy Coleman

Abstract

Abstract

PROBLEM: Hospitalization, especially among older adults aged 65 or over, can result in decreased mobility and functional decline. This decreased mobility can lead to accelerated bone loss, falls, increased length of stay, and delirium. In this medical-surgical unit, a pattern reflecting lack of adequate patient mobility has persisted over one year.

CONTEXT: Northwest (NW), a 42-bed community hospital medical-surgical unit- part of an integrated regional health care delivery system, has not been maximizing the mobilization of their patients for the past year based on internal data.The improvement project described in this paper focused on creating a culture of continuous learning to identify evidence-based practices and to implement the use of a standardized progressive mobility protocol.

INTERVENTIONS: The project intervention consisted of a targeted educational series for nurse leaders and frontline staff that emphasized the need for early patient mobilization.

MEASURES: A set of metrics was developed to address outcome, process, and balancing measures. The outcome measure was defined as the calculated average daily mobility score. The regional organizational mobility score goal is 4.8 and the specific project aim for the medical-surgical microsystem was to meet or exceed that metric.

RESULTS: Over nine months, the practice change project resulted in improved patient and organizational outcomes as reflected in clinical, financial, and operational metrics. The unit mobility score increased from 4.3 in January 2018 to 5.1 in October 2018.

CONCLUSION: Mobilization contributes to improved outcomes of hospitalized patients. The intervention of early and progressive mobilization is the most significant and specific nursing measure to optimize quality outcomes and prevent costly complications related to immobility.

Keywords: early mobilization, progressive mobility protocol, immobility, hospitalization

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