Development of an Ambulation Program at Kent Hospital
An important aspect of nursing care in a hospital setting is mobilizing patients. Numerous studies have documented that prolonged bed rest is associated with negative patient outcomes. An ambulation program can assist patients to maintain functional status during the hospital stay in preparation for discharge. Nurses are the member of the health care team with responsibility for mobilizing patients. In order to do this successfully, nurses require updated knowledge related to implementing an ambulation program. Several factors facilitate ambulating patients on a regular basis, including adequate staffing, appropriate equipment, and availability of a mobility protocol. The purpose of the project was to develop and implement an educational program for nursing staff regarding ambulation of medical-surgical patients in the hospital setting. First, a comprehensive needs assessment was conducted; concurrently, a recently formed Task Force developed a mobility protocol. A two hour educational program was developed based on the literature and clinical experience, with a focus on the negative consequences of immobility in the hospital setting, patient assessments in relation to mobility, the benefits of mobilizing patients, and the role of the nurse and the Physical Therapist with mobilizing patients. The program was implemented and included administration of pre and post surveys and a program evaluation. Results indicated a ten point improvement in knowledge scores from the pre to the post survey, and staff positively evaluated the program. The Advanced Practice Registered Nurse (APRN), especially the Clinical Nurse Specialist (CNS) can play a major role in formally and informally educating nursing staff related to ambulation as well as in development, implementation, and evaluation of a mobility protocol. Further research regarding what is ‘optimal’ mobility in various health care settings is critically needed. The CNS is the ideal member of the inter-disciplinary team to lead quality and legislative initiatives in this area at the local and national level.