Implementation of an Interdisciplinary Team - Driven Mobility Protocol

Purpose:
The consequences of immobility during hospitalization are well-established and are associated with increased length of stay and medical care costs, functional decline, and a higher risk for hospital-acquired conditions.

Significance:
This protocol enables nurses to advance mobility as a standing order and thus improve patient sensitive outcomes related to minimizing or preventing falls; increasing mobility that can result in a decrease length of stay and avoid unnecessary tests and treatments such as physical therapy consults.

Strategy and Implementation:
Fifteen (15) adult inpatient units in an acute care hospital in a southeastern state implemented this interdisciplinary team-driven mobility protocol adapting the “get up and go test” of the Hendrich II Fall Risk Assessment Model to include appropriate nursing and physical therapy interventions developed for each of its four levels of mobility. "Get Up and Go scores" identifie don the Hendrich II Fall Risk Assessment of 0, 1, 3, & 4 were paired with targeted mobility interventions to either prevent a loss of mobility or re-establisher higher levels of mobility for the acute care adult patient during hospitalization. Scores were documented on the patients whiteboard and electronic medical record to communicate to all disciplines the actions taken for mobiity and the patients progress. This resulted in augmenting our patient and family teaching on mobility and risk for falling. This innovative approach has not been found in the literature to date.

Evaluation:
During a pilot study,descriptive and inferential statistics were used to establish content validity (>.90); interpret staff evaluations; and audit mobility scores. Medical records (43) showed a decrease in falls, length of stay, and less unnecessary physical therapy consults.

Implications for Practice:
The pilot findings support the use of an team-driven mobility protocol as an effective approach to improve clinical outcomes. This mobility protocol has been implemented hospital-wide. Our poster or presentation will demonstrate effectiveness after full implementation.