Article

Prolonged bed rest in hospitalized patients leads to deconditioning,
impaired mobility, and the 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. DESIGN : A quasi-experimental design was
used before and after intervention in a 16-bed adult medical/surgical intensive
care unit (ICU) and a 26-bed adult intermediate care unit (IMCU) at a large
community hospital. METHOD: 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 therapists or occupational therapists 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 longer. RESULTS: In the 3 months prior to
implementation of the Move to Improve project, 6.2% (12 of 193) of the ICU
patients and 15.5% (54 of 349) of the IMCU patients ambulated during the first 72
hours of their hospitalization. During the 6 months following implementation,
those rates rose to 20.2% (86 of 426) and 71.8% (257 of 358), respectively.
LIMITATIONS: The study was carried out at only one center. CONCLUSION: The
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.

Langue : ANGLAIS