Early mobility intervention for hip fracture patients
Christina Vejnovich, DNP, RN, AGCNS-BC, PCCN-K
- Sigma Affiliation
- Tau Tau
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Problem: When geriatric patients are immobilized or placed on bedrest, loss of function and decreased activity levels are common. Prolonged immobility is associated with a decline in muscle strength and mass, as well as physical and cognitive function, thereby leading to delays in functional recovery as well as delays in hospital discharge. The purpose of this project was to address the consequences of prolonged immobility in hip fracture patients and evaluate a potential solution to improve patient outcomes.
Intervention: Nursing staff initiated an early mobility intervention that comprised of mobilization of hip fracture patients on the day of surgical repair. The early mobility intervention included dangling the patient on the side of bed and performing range of motion exercises to the upper extremities within 8 hours of patient returning from surgery. The intervention was repeated on post-operative day one.
Measures: Hospital length of stay and prevalence of hospital acquired delirium was evaluated in the pre and post intervention group. Delirium was assessed by nurses utilizing the Nurse Delirium Screening Scale (NuDESC). The prevalence of positive delirium scores at discharge were compared in the pre and post intervention group.
Results: Results of the study were clinically significant (length of stay decreased by 0.7 days and hospital acquired delirium at discharge decreased from 20% to 0%); however, not statistically significant (Hospital Length of Stay: t(19.579)= (-0.92572), p = 0.3659, Presence of hospital acquired delirium: χ2(1) = 0.11324, p = .7365).
Conclusion: Early mobilization on the day of surgery decreased hospital LOS and the prevalence of hospital acquired delirium. Additionally, the study found that initial mobilization of hip fracture patients can safely and effectively be performed by bedside nursing staff.
|Type||DNP Capstone Project|
|Review Type||Faculty Approved: Degree-based Submission|
|Research Approach||Translational Research/Evidence-based Practice|
|Keywords||Early Mobilization of Hip Fractures;
Early Mobility Protocols
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