Nurse-Led Intervention: Implementing Early Mobilization of Patients in the Intensive Care Unit

Abstract

Practice Problem: Immobility of patients in the hospital intensive care unit can cause longer stays in the intensive care unit and the hospital. Evidence-based early mobilization of patients helps to reduce length of stay (LOS) and avoid many detrimental sequelae, leading to short and long-term debilitation. PICOT: The PICOT question that guided this project was: In the adult medical and surgical intensive care units (P), how does implementation of a nurse-driven protocol for early mobility (I), affect the LOS in the intensive care units and the LOS in the hospital (O), as opposed to not using a protocol for early mobility (C) within 8-weeks (T). Evidence: Evidence supported using the intervention of the Johns Hopkins Inpatient Mobility Short Form © and the Johns Hopkins Highest Level of Mobility tool to reduce the LOS in the intensive care units and the hospital. Intervention: The nurse-led intervention used the tools to set a daily mobility goal and mobilize the patient in an activity session three times a day. Outcome: The outcomes showed LOS of post-intervention patients compared to pre-intervention patients. While statistical significance was not found in this short project, clinical significance was shown in a reduction in the mean LOS from 6.22 days to 5.33 days in the hospital. Conclusion: The project outcomes showed the practice change was not statistically significant. Clinical significance was shown in a reduction of LOS in the hospital. A longer timeframe would be expected to show a statistically significant reduction in LOS.