DescriptionPurpose of Project: Although research findings show that mobilizing patients in the intensive care unit (ICU) is safe and produces many benefits, patients hospitalized in the ICU still spend excessive time on bed rest. The purpose of this Quality Improvement project (QI) was to make a change in practice through modifying, implementing, and evaluating a Progressive Mobility Protocol (PMP) in a comprehensive ICU at a community hospital in Southern New Jersey.
Methodology: An existing PMP was modified with specific patient screening criteria. The nursing staff at the ICU were educated about the PMP via in-person sessions and an online module. In the first two weeks of implementing the PMP, morning interdisciplinary rounds were used to promote the PMP and initiate physical therapy consults. Reports from electronic health records were reviewed to compare rates of the PMP utilization before and after this QI project. Correct utilization of the PMP was evaluated through analysis of the completion of PMP activities. Feedback on the use of the PMP was elicited from nurses via an online survey.
Results: Data analysis revealed a 194% increase in the daily assessments of mobility in the two weeks after the QI project was implemented. Review and comparison of the completion of the protocol activities were inconclusive due to insufficient details included in data collection. 36% of the staff completed the online survey, and it revealed that 96.3% of respondents understood the requirements of the PMP, 85.19% reported daily use of the PMP, while only 51.85% felt they had adequate staff and resources to implement the PMP.
Implications: A stepwise approach to implementing a PMP in the ICU successfully increased its daily utilization. A strong multidisciplinary approach is needed to further improve patient outcomes through early mobility activities in the ICU.