Promoting mobility in oncology patients using goal-directed care

Purpose of the Project: Oncology patients are at a higher risk of developing complications from immobility due to their disease and chemotherapy. The Johns Hopkins-Highest Level of Mobility (JH-HLM) scale is used to standardize patient mobility levels and setting mobility goals with patients to promote early mobilization. The purpose of this project was to evaluate whether use of the JH-HLM scale on an inpatient medical oncology unit would improve early mobilization. Methodology: A retrospective program evaluation using the CIPP model on the implementation of the JH-HLM scale was conducted along with distribution of a knowledge and attitudes survey to the nurses on the unit. A 12-month sample was used pre and postimplementation of the JH-HLM scale. The patient data collected included length of stay and discharge disposition. Results: There were 904 patient records reviewed. No statistical significance was found in pre and postimplementation length of stay. In the postimplementation period, a significant association between discharge disposition and patient population was found (X² = 19.701, p = <.001) and oncology patients had better outcomes in maintaining mobility (X² = 4.539, p = .033). The majority of patients did not achieve their JH-HLM goal during their hospital stay. Survey responses from nurses demonstrated an opportunity for education on the purpose of the JH-HLM scale and the role of physical therapy in mobility. Implications for Practice: The JH-HLM scale can assist in improving patient outcomes. Continued analysis of the impact of the JH-HLM scale is needed along with structured nursing education and collaboration between interprofessional teams to meet mobility goals. A mobility protocol is needed to change the culture of mobility among nursing staff. Keywords: John Hopkins-Highest Level of Mobility Scale, mobility, oncology populationD.N.P.Includes bibliographical referencesIncludes vit