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Implementing a patient-centered walking program for residents in long-term care

A quality improvement project

Kazana, Izabela DNP, AGPCNP-BC (Former DNP Student)1; Pencak Murphy, Marcia DNP, ANP-BC, FAHA, FPCNA (Program Director)2

Journal of the American Association of Nurse Practitioners: July 2018 - Volume 30 - Issue 7 - p 383–391
doi: 10.1097/JXX.0000000000000037
Quality Improvement

Background and purpose: This quality improvement (QI) project was designed to increase walking activity for eligible residents in long-term care (LTC). Walking programs have positive benefits; however, they are underused in LTC.

Methods: The Model for Improvement and Plan-Do-Study-Act cycles were used to implement the key components including building a guiding coalition, environment and policy assessment, development of a patient-centered walking program protocol, staff education, mobility huddle to motivate and mentor staff, and ongoing evaluation and feedback.

Results: Of the 78 residents screened for walking activity, 13 (17%) were eligible. Data were collected weekly. After 20 weeks, 69% (n = 9) of the enrolled residents were still in the program. The majority of residents were provided walking activity between 60% and 90% of the time. None of the residents experienced a fall during the activity. Average adherence to documenting the activity was 79%.

Conclusions: The QI project provided the implementation and evaluation of a consistent walking program in a LTC setting.

Implications for Practice: The project findings may assist nurse practitioners in implementing QI initiatives in LTC to increase walking activity of eligible residents and aid in evaluating those programs. However, leadership commitment and ongoing support are essential to sustain the effectiveness of a program.

1VA Quality Scholars Fellow, Louis Stokes VA Medical Center, Cleveland, Ohio,

2Adult-Gero Primary Care NP and CNS programs, Rush University College of Nursing, Chicago, Illinois

Correspondence: Izabela Kazana, DNP, AGPCNP-BC. Tel: 708-420-6806; E-mail:

Competing interests: The authors report no conflicts of interest.

Authors' contributions: Izabela Kazana developed the quality improvement project, collected chart data, and wrote the initial draft of the article. Marcia Murphy was a content expert during the quality improvement project development and revised the article for the final submission.

Received February 12, 2018

Accepted February 12, 2018

© 2018 American Association of Nurse Practitioners
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