Year of Publication

2017

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Sheila Melander

Clinical Mentor

Dr. Catharine Morgan

Committee Member

Dr. Carol Thompson

Abstract

Objective: To evaluate the effectiveness of a previously implemented, nurse driven early mobility screening protocol, called “MOVE”, during its first 6 months of use.

Methods: A retrospective electronic medical record review was conducted (n=100) at Norton Audubon Hospital in Louisville, KY. Eligible electronic medical records were randomly selected and audited for the following variables: age, sex, ethnicity, admission diagnosis, comorbidities, ventilator days, invasive catheters, utilization of vasoactive or inotropic medications, restraint use, continuous sedation medications, Richmond Agitation Sedation Score (RASS), Confusion Assessment Method for the ICU (CAM-ICU), nurse adherence to charting of MOVE enrollment eligibility, 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, intensive care unit (ICU) length of stay (LOS), hospital LOS, initial consult and discharge Activity Measure for Post-Acute Care (AM-PAC) mobility scores, and discharge disposition. Data were analyzed using descriptive statistics.

Results: No statistically significant relationships between the MOVE program mobility practices and characteristics specific to the patient population were found. Crosstabulation of data revealed: 7% of the sample (n=100) met criteria for the MOVE program and received early mobility via PT/OT intervention; 64% did not meet criteria; and 29% were never screened for eligibility. Of the 7 patients who met criteria and received early mobility, 100% (n=7) received active/passive ROM, 57.1% (n=4) sat edge of bed, 28.6% (n=2) stood edge of bed, and 14.3% (n=1) ambulated while on the ventilator.

Conclusion: This study resulted in recommendation for evaluation of nurse knowledge of MOVE early mobility screening protocol importance and procedure. Evaluation of perceived barriers to adherence of screening protocol should also be investigated to increase stakeholder buy in and ensure future program success.

Share

COinS