Implementation of a Nurse-Driven Mobility Protocol in Critical Care

Kim M. Uustal, Rhode Island College

Abstract

Prolonged immobilization plays an important role in negative outcomes of critically ill patients. Immobility is widely documented in the literature as a cause of increased mortality and complications. Despite the growing evidence in support of early mobility, many ICUs are unable to effectively integrate early/progressive mobility into their daily practice. Literature supports early mobilization and physical therapy as a safe and effective intervention that can have a significant impact on functional outcomes. A progressive mobility tool may help to force a daily structured assessment of current mobility status, which supports the critical thinking process by the nurse and team to ensure effective and safe evaluation of the mobility level. The purpose of this project was to increase critical care nurses’ understanding of the concept and benefits of early mobility during an educational program in which a nurse-driven progressive mobility protocol was introduced. Nurses were asked to voluntarily take a pre- and post- test surrounding the implementation of the protocol. Descriptive statistics were used to analyze study variables and differences between pre and post scores. Nurses’ knowledge regarding mobility of critical care patients increased and 83.3% of nurses responding felt they provided earlier mobility.