Date of Award

Fall 12-21-2017

Degree Type

Final Project

Degree Name

DNP Doctor of Nursing Practice

Department

Nursing

Advisor

Mary Ellen Roberts, D.N.P.

Committee Member

Katherine Hinic, Ph.D.

Committee Member

Dorothy Jean Graham-Hannah, D.N.P.

Abstract

Purpose: The purpose of this quality initiative is to introduce the nurse driven evidence-based practice change related to patient mobility in the hospital setting with the aim to improve nurse knowledge, attitude, and behavior on a medical-surgical unit.

Significance of Project: The proposed DNP quality project is devised from the American Academy of Nursing (AAN) Choosing Wisely campaign unique to the elements of “don’t let older adults lay in bed or only get up to a chair during their hospital stay” to achieve a practice change. A significant aspect of patient care in a hospital setting is patient mobility. The mobilization of hospitalized adult patients is an often overlooked aspect of nursing care. Implementation of mobility level decision/algorithm with nursing interventions can promote physical activity and enhance nurse expertise in mobilizing hospitalized older adult patients.

Methods: The quality improvement plan included a four phase process: The needs assessment to identify and target perceived barriers to mobilizing hospitalized adult patients by medical/surgical nurses; stakeholder support was sought through interdisciplinary and senior leadership buy-in and participation; implementation of early-mobility Survey Monkey, structured educational sessions, bedside coaching sessions and unit team huddles, assure day-to-day practice changes. The Johns Hopkins Highest Level of Mobility (JH-HLM) Scale was a vital driving algorithm for nurse to make decisions about whether to ambulate, how to ambulate, and when to ambulate hospitalized adult patients. The PDSA cycle was shorthand for testing a change in the real work environment by planning, implementation, and evaluation to assess the change.

Results: The results of this study indicated that the nurse driven evidence-based IMOVE intervention suggested a significant impact on patient mobility knowledge, and behavior towards patient mobility by the nursing staff. The anticipated effect improved in the knowledge and behaviors of the nursing staff in the improved patient mobility.

Conclusion: The comprehensive implementation of an Advanced Nursing Practice (ANP) led early mobility program played a vital role to high quality of care delivered, practice change, and promoted patient well-being. Nurses are a part of the healthcare team that is responsible for mobilizing patients. To achieve this end result, nurses require updated knowledge related to the ambulating program in the healthcare organization.

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