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Can the Use of an Early Mobility Program Reduce the Incidence of Pressure Ulcers in a Surgical Critical Care Unit?

Dickinson, Sharon MSN, RN, CNS-BC, ANP, CCRN; Tschannen, Dana PhD, RN; Shever, Leah L. PhD, RN

doi: 10.1097/CNQ.0b013e31827538a1
Original Articles

The Agency for Healthcare Research and Quality has defined pressure ulcers (PUs) an important patient safety indicator (#3). Despite the existence of evidence-based guidelines for PU prevention and treatment from the United States Department of Health and Human Services, the sustained success in reducing the development of PUs is elusive in many acute care hospitals.

Purpose: The specific aim of the study was to determine whether the implementation of an early standardized process for mobility could reduce or eliminate the development of PUs in a surgical intensive care unit.

Methods: Patient data were collected pre- and postimplementation of the early mobility protocol.

Results: The mobility compliance for patients postimplementation was 71.30% (SD = 12.73), with a range of 25% to 100%. A χ2 test for independence (with Yates continuity correction) indicated a significant association between unit-acquired PUs and the pre- and postimplementation mobility groups (χ21,1051 = 6.86, P = .009). Specifically, patients in the intervention group had significantly more unit-acquired PUs than the control group. No significant differences were identified between the 2 groups.

Implications/Conclusions: Despite implementation of the early mobility protocol, we did not see an improvement in the PU rate overall or with time as protocol compliance improved.

Surgical Intensive Care/Rapid Response, University of Michigan School of Nursing (Ms Dickinson and Dr Tschannen); and Nursing Research, Quality, and Innovation, The University of Michigan Health System (Dr Shever), Ann Arbor.

Correspondence: Sharon Dickinson, MSN, RN, CNS-BC, ANP, CCRN, Surgical Intensive Care/Rapid Response, University of Michigan, University of Michigan Hospital and Heath Centers, Box 0076, 1500 E Medical Center Dr, Ann Arbor, MI 48176 (sdickins@umich.edu).

Sharon Dickinson acknowledges shared first authorship.

The authors thank Craig Meldrum and Jan Gombert for their assistance in gathering data for evaluating their mobility program. The authors also thank all the staff of the surgical intensive care unit who have made the mobility protocol initiative safe and effective for the patients.

The authors report no disclosure of funding and no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.