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Nurse-Led Mobility Program

Driving a Culture of Early Mobilization in Medical-Surgical Nursing

Jones, Renata A. DNP, RN; Merkle, Sarah MSN, RN, AOCNS; Ruvalcaba, Lynze BSN, RN; Ashton, Pippin BSN, RN; Bailey, Casey PT; Lopez, Mary PhD, RN

doi: 10.1097/NCQ.0000000000000404
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Background: Hospitalized medical-surgical patients are at risk for adverse health outcomes due to immobility. Despite well-documented consequences, low mobility is prevalent.

Local Problem: In a 547-bed hospital, medical-surgical patients were mobilized less frequently than expected. Physical therapists were inappropriately consulted 22% of the time for routine mobility of patients. A preimplementation survey of registered nurses indicated a lack of knowledge and confidence to safely mobilize patients.

Methods: This quality improvement project implemented a nurse-led mobility program in an effort to increase early mobilization, reduce physical therapy referrals for routine mobility, and reduce the sequelae of immobility.

Interventions: The Bedside Mobility Assessment Tool and standardized interventions were implemented on 5 medical-surgical units.

Results: Postimplementation, nurse-led patient mobilizations increased by 40%, inappropriate physical therapy orders decreased 14%, and no significant change in patient falls or pressure injuries was noted.

Conclusion: A nurse-led mobility program was effective in increasing safe, early mobilization of patients and improving the culture of mobility.

Department of Quality and Performance Excellence, PIH Health Hospital, Whittier, California.

Correspondence: Renata A. Jones, DNP, RN, Department of Quality and Performance Excellence, PIH Health Hospital, 12401 Washington Blvd, Whittier, CA 90602 (renata.jones@pihhealth.org).

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com).

Accepted for publication: February 25, 2019

Published ahead of print: March 18, 2019

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