Evaluating a Nurse-Driven Mobility Algorithm for Hospitalized General Medicine Patients: A Pilot Study

Abstract

Purpose: 

Mobility of hospitalized patients declines substantially after transfer from an intensive care unit focused on “early mobility” to a general medicine floor. Barriers to appropriately mobilize patients are nursing staff's confidence and the perceived risks related to mobility. This study examined the effect of a nurse-driven mobility algorithm on nurse ability to identify level of functional mobility. Participants were 24 general medicine patients and 2 pairs of physical therapist (PTs) and registered nurse (RN) raters.

Methods: 

Each PT/RN pair was asked to classify level of mobility for each patient using predefined tiers. RNs were given an algorithm as a guide, and PTs assessed the patient's mobility without any guidelines for predefined tiers. Comparison of the tiered level from each rater was analyzed using κ statistics.

Results: 

A sample of convince consisted of 24 general medicine patients. Fair to moderate agreement was found among both sets of raters (κ= 0.40).

Conclusion: 

Although the algorithm did not result in high agreement between PTs and RNs, discrepancies were largely in the tiering regarding whether the patient needed supervision versus being independent. The mobility-driven algorithm may be useful to assist nursing staff in determining the appropriate level of mobility for general medicine patients with further refinement.