Implementing an early mobility protocol for patients in intensive care unit
Review TypeNone: Degree-based Submission
Repository Posting Date2020-05-18T19:44:07Z
Author(s)Crane, Allison Nicole
Author DetailsDr. Allison Nicole Crane, DNP, BSN, CCRN, AGACNP-BC
Lead Author Sigma AffliationGamma Alpha
TypeDNP Capstone Project
Level of EvidenceQuality Improvement
Research ApproachQuantitative Research
CINAHL HeadingsEarly Ambulation; Protocols; Intensive Care Units; Critically Ill Patients; Program Implementation
Background: Limited mobility and prolonged bedrest were thought of as necessary to promote safety and hemodynamic stability in critically ill intensive care patients historically, but recent research does not support this idea. Newer research is suggesting that mobilizing critical ill patients in the intensive care unit can limit the negative effects of immobility and improve patient outcomes (Adler & Malone, 2012; Morris, et al., 2008; Perme & Chandrashekar, 2009; Perme, Lettvin, Throckmorton, Mitchell, Masud, 2011). Objective: The objective of this clinical scholarly project is to educate the healthcare team about the importance of early mobility in the intensive care unit (ICU) patient population, and to implement an “Early and Aggressive Mobility Protocol” in an effort to decrease length of stay (in both hospital and ICU), mortality rate, and duration of time spent on mechanical ventilation between the pre- and post-implementation groups. Methods: Healthcare staff were educated on how to mobilize ICU patients safely utilizing an “Early and Aggressive Mobility Protocol” owned by Tenet Health Systems. After the education was completed, the protocol was implemented on April 1, 2016. Patient outcomes were assessed and compared between the pre-implementation and post-implementation groups. Results: Results for mortality, ICU LOS, hospital LOS, and mechanical ventilation duration were not statistically significant, indicating that the implementation of the “Early and Aggressive Mobility Protocol” had no affect on ICU patient outcomes. Many limitations were identified and addressed to improve implementation for future patients. Conclusion: As the project continues to evolve at this community hospital, implementation should continue to improve. The goal of this CSP was not just to show positive results, but to put into place a framework for a quality improvement project that can be utilized to improve patient outcomes for many years to come. Hopefully with further refinement, this CSP will have a positive effect on patient outcomes. Keywords: early, mobility, protocol, ICU, mortality, length of stay, mechanical ventilation, clinical scholarly project.
DescriptionThis dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 10255444; ProQuest document ID: 1870805325. The author still retains copyright.
Degree GrantorBrandman University
NotesThis item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
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