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Early Mobility for Critically Ill Patients: Building Staff Commitment Through Appreciative Inquiry.

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Appreciative inquiry workshops improved intensive care unit staff commitment to early progressive mobility. This quality improvement method enhanced patient mobility treatments and sustained positive outcomes long-term.

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Area of Science:

  • Quality Improvement in Healthcare
  • Critical Care Medicine
  • Patient Mobility Therapy

Background:

  • Immobility in critically ill patients leads to adverse outcomes.
  • Early progressive mobility mitigates these sequelae but faces implementation challenges.
  • Appreciative inquiry is a change philosophy focused on organizational strengths.

Purpose of the Study:

  • To assess if appreciative inquiry can revitalize an early progressive mobility initiative in a medical intensive care unit.
  • To improve and sustain staff commitment to bedside mobility therapy.
  • To contribute to the literature on appreciative inquiry in healthcare and critical care settings.

Main Methods:

  • Staff participated in appreciative inquiry workshops utilizing the 4-D cycle.
  • Evaluated staff attitudes and knowledge regarding early progressive mobility pre- and post-workshops.
  • Tracked early progressive mobility activity performance at baseline, 3 months, and 10 months post-intervention.

Main Results:

  • 96-98% of participants found workshops improved understanding, responsibility, and commitment.
  • Mobility treatment orders increased from 62% to 88% at 3 months.
  • Documentation (52% to 89%) and observation (39% to 87%) also significantly improved and were sustained at 10 months.

Conclusions:

  • Workshop participation enhanced staff attitudes and performance of mobility treatments.
  • Appreciative inquiry shows promise as an adjunct to traditional quality improvement methods.
  • This approach can effectively improve and sustain early progressive mobility in critical care.