Year of Publication

2020

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Sheila Melander

Clinical Mentor

Dr. Cassondra Degener

Committee Member

Dr. Paula Halcomb

Committee Member

Dr. Mary Czarapata

Abstract

Background: Immobilization is frequently encountered in critically ill adult patients within the intensive care unit (ICU) leading to numerous, detrimental effects including increased hospital and ICU length of stay, increased ventilator days, and increased mortality. One measure to increase early mobility of critically ill patients at the University of Kentucky Chandler Medical Center (UKMC) is implementing the VitalGo Total Lift Bed (TLB). The TLB vertically tilts a secured patient upright from zero to 82 degrees, allowing immobile patients to benefit from early weight bearing therapy and early, progressive mobility in the confines of the bed. Despite implementation of the TLB, a discrepancy exists because the TLB protocol orders are placed for the patient however nursing does not adhere to the TLB protocol. Objectives: The objectives of this retrospective and prospective electronic medical record review were to examine adherence to the TLB protocol in the acute care, progressive care, and intensive care units at UKMC before and after a formal educational intervention; to examine the change in nursing knowledge of the TLB protocol before and after an educational intervention; and to identify associations between utilization of the TLB protocol and mobility, hospital length of stay, ICU length of stay, and ventilator days. Methods: A 6-month retrospective chart review was performed on patients receiving TLB therapy from January 1, 2019 through June 30, 2019. One electronic medical record was analyzed. Formal education via a web-based training module was administered to registered nurses in July 2019. After the WBT intervention was completed, a 6-month post-intervention chart review was completed from August 13, 2019 to February 13, 2020. Three electronic medical records were analyzed. Results: There was a statistically significant increase in nursing knowledge before and after an educational intervention (61.08% and 80.18%, respectively; p Conclusion:This project demonstrated that there is a need for further education on mobility devices for nurses and other healthcare providers. Nurses and other members of the multidisciplinary team have the opportunity to benefit from education on early mobility devices as it pertains to their role in caring for patients and ultimately improving patient outcomes.

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