Implementation of an Interprofessional Mobility Program in a Neurosurgical Intensive Care Unit.

Katie Broadway, Cristina M Nuila
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Abstract

Abstract: BACKGROUND: Emerging research suggests the need for implementation of mobility protocols and consistent evaluation of the impact on patient outcomes. Standardized mobility guidelines may be a solution for promoting nurse-driven mobility efforts and influencing a shift in the culture of mobility among nursing teams. In a 36-bed neurosurgical intensive care unit, 2 key areas of opportunity were identified related to patient mobility: strengthening of frontline nursing engagement in mobility and accuracy of documented early and safe mobilization. METHODS: Using a plan-do-study-act performance improvement framework, an interprofessional team developed a comprehensive early patient mobility program. Defined criteria and mobility rounds assisted in identifying the patient's functional ability and level of assistance. Nursing staff received education in case study format to enhance understanding and improve practical application of the phases of mobility. Chart reviews served as continuous assessment of documented mobilizations within the appropriate phases of mobility, and surveys evaluated staff perceptions of program success. RESULTS: On a rating scale of 1 to 5, clinicians reported a rating of 4.32 in overall observation that patients are safely mobilized earlier and more frequently and 4.48 on overall improvement in the neurosurgical intensive care unit culture of mobility. CONCLUSION: An interprofessional mobility program focusing on safe and early mobilization may improve overall culture, confidence, and empowerment of the frontline clinicians.

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神经外科重症监护室跨专业流动计划的实施。
摘要:背景:新兴的研究表明,有必要实施移动性协议,并对对患者结果的影响进行一致的评估。标准化的流动指南可能是促进护士驱动的流动努力和影响护理团队流动文化转变的解决方案。在一个拥有36张床位的神经外科重症监护室中,确定了与患者流动性相关的两个关键机会领域:加强一线护理人员在流动性方面的参与,以及记录的早期和安全动员的准确性。方法:使用计划-研究-行动绩效改进框架,一个跨专业团队制定了一个全面的早期患者流动计划。确定的标准和行动轮次有助于确定患者的功能能力和援助水平。护理人员接受了案例研究形式的教育,以增强对流动阶段的理解并改进其实际应用。图表审查是对流动的适当阶段内记录的流动情况的持续评估,调查评估了员工对项目成功的看法。结果:在1至5的评分表中,临床医生报告称,患者更早、更频繁地安全动员的总体观察评分为4.32,神经外科重症监护室活动文化的总体改善评分为4.48。结论:专注于安全和早期动员的跨专业流动计划可以提高一线临床医生的整体文化、信心和能力。
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