Podium Presentation: Impact of an Interprofessional Culture of Mobility Training on Documentation of Patient Mobility Activities

Background: Adults, and particularly elder adults, suffer many adverse consequences when restricted to the bed with no mobility activities for extended periods of time. During a hospital visit, adults are often subjected to bedrest inappropriately, contributing to outcomes such as hospital-acquired infections or injury, muscle wasting, or falls with injury. All outcomes may cause an increased length of stay and risk likelihood of discharge to an extended care facility versus home. At one community-based hospital, a needs assessment revealed several staff self-reported barriers to mobilizing patients. Simultaneously, no evidence-based practice mobility program existed within the hospital. Purpose: The purpose of this evidence-based practice project was to educate nurses and therapy staff on the Johns Hopkins’ evidence-based practice culture of mobility program and to optimize mobility charting. Methods/Approach: In June of 2021, an interprofessional team including clinical Registered Nurses, nurse leaders, Nurse assistants, a Clinical Documentation specialist, and a physical therapist, rolled out an educational offering. All caregivers involved in mobilizing patients who worked on three adult, non-critical care medical/surgical units, were invited to participate. The education was based on the Johns Hopkins culture of mobility toolkit. Caregivers learned how and where to document patient mobilization activities, as well as how to calculate and document the highest level of mobility score. Flyers summarizing the education were hung throughout the participating units. Monthly charting reports were generated and sent to leaders, who shared unit-specific and overall findings with staff. The unit with the biggest change in documentation scores won a staff party at the end of the three-month trial. Leaders also gave small gift cards to staff who were “caught in the act” mobilizing and charting patient activities. Results: Three months post-implementation of the education, over 2000 patient encounters were documented on the pilot units. Length of stay remained stable (3.7 days pre, 4.0 days post). Documentation rates overall increased significantly for the highest level of mobility (25% versus 43%, p\u3c0.01) and mobility activity (63% versus 70%, p\u3c0.05). Conclusion: Our project supports that delivery of a targeted educational intervention with interprofessional staff and leadership involvement can improve caregiver documentation of mobility activities. Challenges conflicted with the long-term sustainability of the project, including staffing reduction during COVID-19 surges and leadership changes. However, the project holds promise to provide enhanced patient and caregiver outcomes. Future work should be completed to validate the patient outcomes linked to implementation of an evidence-based practice mobility program. Implications for practice: Mobilization of hospitalized patients should be an integral part of every patient care plan. Proper education delivered by the interprofessional team to all caregivers who help mobilize patients is a first step to driving a culture of mobility. Stengem, D., Bigand, T., Rampley, T., Billings, C., Hoople, J., Chase, C., Gallant, A., Herber, E., Crooks, E. Perceived Barriers to Early Mobilization Among Nursing Staff in the Hospital Setting. (2021). Presented at Inland Northwest Research Symposium, April 2021.Dickerson, L., & Latina, A. (2017). Team nursing; A collaborative approach improves patient care. Nursing2017,47(10), 16-22. Miranda Rocha AR, Martinez BP, Maldaner da Silva VZ, Forgiarini Junior LA. Early mobilization: why, what for and how?. Med Intensiva. 2017;41(7):429-436