Date Available

12-1-2016

Year of Publication

2016

Degree Name

Doctor of Nursing Practice

Advisor

Dr. Elizabeth Burckardt

Committee Member

Dr. Melanie Hardin-Pierce

Committee Member

Dr. Sheila Melander

Co-Director of Graduate Studies

Dr. Steven Peterson

Abstract

Purpose: The purpose was to: (i) conduct a retrospective electronic medical record review to evaluate current practice related to mobility, (ii) determine the association between current mobility practice patterns and characteristics specific to the patient population, and (iii) make recommendations for the implementation of an evidence-based progressive early mobility protocol for non-surgical mechanically ventilated patients.

Population: Non-surgical, ventilated patients in the Intensive Care Unit (ICU)

Inclusion Criteria: Ventilated patients at least 18 years old who have been ventilated for at least 48 hours and did not have major surgery lasting more than one hour at any point during their hospital stay from January 1, 2015- December 31, 2015.

Design and Methods: A retrospective electronic medical record review was conducted (n=100) in a large local hospital over a one-year time span. Electronic medical records were randomly selected, and were audited for the following variables: admission diagnosis, comorbidities, age, ethnicity, sex, ventilator days, invasive catheters, use of vasoactive or inotropic medications, physical therapy (PT) intervention, occupational therapy (OT) intervention, range of motion (ROM), sitting on the side of the bed, standing on the side of the bed, ambulation, RASS, CAM-ICU, ICU length of stay (LOS), hospital LOS, and discharge disposition. Descriptive statistics were used.

Results: No statistically significant relationships between the current mobility practices and characteristics specific to the patient population were found. The data revealed a low incidence of all mobility variables ICU admission. This study resulted in a recommendation for a development and implementation of a progressive early mobility program for ventilated patients in the ICU.

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