Nurse-driven progressive mobility in the medical intensive care unit

Purpose of Project: A Nurse-Driven Progressive Mobility Protocol can facilitate patient engagement that is conducive to reducing complications of immobility. Evidence-based literature revealed criteria outlined in protocols were safe and beneficial to patients by reducing delays in care. The purpose of this study was to evaluate the mobility protocol on clinical outcomes evident by reduced length of stay, ventilator liberation, and changes in nurses’ attitudes, behaviors, and beliefs. Methodology: A quality improvement (QI) project design was developed to enhance mobilizing patients to a Level 3 activity within 48 hours of admission to the Medical Intensive Care Unit. The study was conducted in a medical intensive care unit at a Level – 1 Trauma Center in Northern New Jersey. The sample size consisted of thirty MICU nurses. An 8-week retrospective chart review and project implementation was conducted from September 2020 to November 2020. Results: A Mann-Whitney U test was used to analyze data, resulting no significant increase in length of stay in the post-intervention group (M = 5.73 days, SD = 6.24 days) compared to the pre-intervention group (M = 2.99 days, SD = 3.86 days), U = 10106, p < .0001. The number of days on a ventilator did not significantly differ between groups (pre-intervention group M = 1.44 days, SD = 3.15 days; post-intervention group M = 3.21 days, SD = 5.98 days), U = 8168, p = .182. Within the first 48 hours of arriving in the ICU, 29 out of 95 patients (30.5%) reached at least Level 3 of mobility. The nurses’ at 9AM completed 351 range of motion sessions, followed by 305 sessions at 3PM, and 212 sessions at 9PM. Implications for Practice: The implication of the early mobility protocol had facilitated a new care process that was conducive to increasing compliance. The study demonstrated that successful integration of a nurse driven early mobility protocol can enhance patients’ outcomes.DNPIncludes bibliographical reference