Year of Publication

2017

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Melanie Hardin-Pierce

Clinical Mentor

Dr. Peter Morris

Committee Member

Dr. Andrew Bernard

Committee Member

Dr. Chizimizo Okoli

Abstract

Abstract

The goal of this study was to evaluate the effectiveness of a recently implemented nurse driven early mobility program on patients in two Trauma Surgical Intensive Care Units at the University of Kentucky HealthCare (UKHC). The purpose of this study was to evaluate the effectiveness of a recently implemented nurse driven early mobility program (NDEMP) on patients in two Trauma Surgical Intensive Care Units at the University of Kentucky HealthCare (UKHC). Nursing staff are responsible for mobilizing patients to their maximum ability twice daily in addition to any therapy provided by Physical and Occupational Therapists. The study was an uncontrolled before and after design using retrospective data analysis. UKHC employs a mobility score, a tool developed by a UKHC multidisciplinary team including nurses and physical therapists. The mobility score was chosen because the nurse can quickly assess the patient’s mobility level in a quick, easy and reproducible manner. The mobility score in the ICU had a statistically significant increase in the pre-intervention mobility score of 5.7 to a post-intervention mobility score of 7.9. Hospital mobility score showed an increase of 7.5 pre-intervention to a 7.9 post-intervention score, which was also statistically significant. Ventilator mean days decreased from 2.2 pre-intervention to 1.9 post-intervention and pneumonia decreased from 7.3% pre-intervention to 5.7% post-intervention. This was not statistically significant but it did trend in the right direction. The VTE rate increased (pre = 3.0% vs. post = 4.8%) but was a non-statistically significant increase. Mean days in the ICU increased from pre-intervention of 5.7 mean days to 5.8 mean days post-intervention but was not statistically significant. A non-significant decrease in discharge to home (pre = 98.3% vs. post = 96.5%) was also found. There were no appreciable decreases in length of stay. Within a very short time frame, the TSSNDEMP showed a reduction in ventilator days and pneumonia as well as a significant increase in ICU and hospital discharge mobility scores. No adverse events occurred during the study. The success of this program supports the ability of nursing to mobilize patients safely utilizing the existing multidisciplinary team rather than adding staff.

Keywords: early mobility, immobility, critical illness neuropathy

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