Promoting Patient Mobility to Decrease Hospital Length of Stay

Abstract

Practice Problem: Promoting patient mobility may reduce hospital-acquired complications and length of stay (LOS). Evidence-based studies have established that there is a correlation between immobility and an increased length of stay in the hospital. How can nurse-driven mobility interventions effectively increase patient mobility and reduce the risk of complications and length of hospital stay? PICOT: The PICOT question that guided this project was: For veteran patients in the Progressive Care unit (PCU) of a medical center (P), will using the Johns Hopkins Highest Level of Mobility tool (JH-HLM) (I) compared to not using a mobility tool (C) decrease hospital length of stay (O) in 8 weeks (T). Evidence: Evidence supported the implementation of an early mobility protocol to reduce length of stay, as well as the PICOT intervention in terms of adopting an evidence-based mobility instrument with demonstrated validity and reliability. Intervention: To implement and monitor the effectiveness of a nurse-led mobility intervention with the aim of decreasing patient length of stay, through the integration of the Johns Hopkins mobility tool (JH-HLM). Outcome: The outcome showed that the average LOS prior to the use of the tool was 6.39 days and decreased to 4.27 days after its implementation for the patients who received mobility interventions. This shows a significant decrease in the length of stay for the MOB category between the two months of August (pre-implementation) and September (implementation). Conclusion: The intended outcome for this EBP project was a decrease in length of patient stay. Statistical analysis showed that the mean of LOS was statistically significant and decreased between pre-intervention, Jun/July and post-intervention, Aug/Sep time periods.