4.2 Article

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

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JOURNAL OF NEUROSCIENCE NURSING
卷 55, 期 6, 页码 205-210

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/JNN.0000000000000729

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Research suggests the importance of implementing mobility protocols and evaluating patient outcomes to promote a cultural shift towards mobility in nursing teams. This study developed a comprehensive program in a neurosurgical intensive care unit, addressing the areas of frontline nursing engagement and accurate documentation of early mobilization. Results showed improvement in patient mobilization and the culture of mobility in the unit, indicating the effectiveness of the interdisciplinary program.
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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