Abstract: Mobility Matters! Addressing the Triple Threat Impacting Nursing Quality by Ensuring Competent Evidence Based Care (5th Annual NDNQI Data Use Conference (January 26-28, 2011))

Wednesday, January 26, 2011

Michael J. Kingan, MSN, RN, CWOCN , Department of Nursing, Washington Hospital Center, Washington, DC

Sheila R. Johnson, BSN, RN , Department of Nursing, Washington Hospital Center, Washington, DC

Rachel L. Palmieri, MS, RN , Department of Nursing, Washington Hospital Center, Washington, DC

Jill C. Schie, MS, OTR/L , Physical Medicine and Rehabilitation, Washington Hospital Center, Washington, DC

Susan M. Serdensky, MSN, RN , Department of Nursing, Washington Hospital Center, Washington, DC

C. DeAnne Zwicker, DrNP, APRN, BC , Department of Nursing, Washington Hospital Center, Washington, DC

Joanne Pritchett, BSN, MA, RN , Washington Hospital Center, Washington DC, DC

Rachel L. Friedman, MSOTR/L , Physical Medicine and Rehabilitation, Washington Hospital Center, Washington, DC

Emily C. Shields, DPT , Physical Medicine and Rehabilitation, National Rehabilitation Hospital at Washington Hopital Center, Washington, DC

Brigitte G. Henry, PT, DPT , Physical Medicine and Rehabilitation, NRH@WHC, Washington, DC

paper4269.pdf (281.7 kB)

Purpose:
To create an interdisciplinary approach for a safe healing environment for patients at Washington Hospital Center where clinical associates are competent at preventing patient falls, pressure ulcers, and physical deconditioning.

Significance:
The skills acquisition program, Mobility Matters!, provided interactive education, evaluated competency, and assessed on-going compliance monitoring for prevention of falls, pressure ulcers, and the effects of immobility.

Strategy and Implementation:
"Mobility Matters!" was created in five steps: 1 Goal Identification, 2 Course Design to include registration, prepwork, and objectives, 3 Content of Training Sessions, 4 Bedside Competency Validation, 5 Ongoing Monitoring and Evaluation of Program. Content experts defined the objectives for five sessions, Introduction and Pretest, Hendrich© Scale & Prevention of Patient Falls, Out of Bed Mobility Algortithm, Braden© Score Risk Assessment & the Nursing Process, Use of Equipment, and integration of the content from all sessions in the final Plan of Care Development session. Sessions were interactive and conducted over 4 hours with two large group sessions and four small group break-out sessions. Education was provided in case study format whereby participants had to address the needs of each patient in small groups. Competency on covered content was assessed at the bedside using a train the trainer format/process with a defined method for on-going monitoring.

Evaluation:
Associates evaluated the program positively. Measures of effectiveness include: Pretest Knowledge Assessment, Bedside Competency Evaluation, hospital-specific and NDNQI comparative for falls and hospital acquired pressure ulcer rates, Plan of Care audits, and Change of Shift Handoff Checklists.

Implications for Practice:
A bundled skills acquisition program provided RN associates with knowledge to prevent falls, pressure ulcer, and the effects of immobility. Competency validation facilitated peer-to-peer accountability through unit-based champions' assessment of competency to keep patients safe and improve outcomes.

48 Mobility Matters! Addressing the Triple Threat Impacting Nursing Quality by Ensuring Competent Evidence Based Care