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Published on: April 8, 2022
Implementing Early Mobility Practices in a Respiratory Care Unit: A Quality Improvement Project
So Yang Cho1, Karin Smith, Geraldine Hider
1Author Affiliations: Department of Nursing, Kyungdong University, Wonju-si, Gangwon-do, Republic of Korea (Dr Cho); Department of Nursing, Mayo Clinic, Rochester, Minnesota (Dr Cho); Department of Nursing, Bradley University, Peoria, Illinois (Dr Smith); and Department of Humanities, Carrol Community College, Westminster, Maryland (Mrs Hider).
Background:
Early mobility (EM) is beneficial for critically ill patients, but adoption in intermediate care units remains limited.
Local Problem:
At the project site, fewer than 10% of patients admitted to the respiratory care unit (RCU) engaged in EM due to clinical severity, lack of staff confidence, and limited collaboration with physical therapy.
Methods:
A pre- postimplementation quality improvement design was used to assess mobility outcomes.
Interventions:
A nurse-driven EM program was implemented in a 10-bed RCU at a tertiary center. A multidisciplinary team delivered staff education, introduced an evidence-based protocol, and addressed barriers.
Results:
Forty-eight patients were included in the project (22 preimplementation and 26 postimplementation). The number of physical therapy consultations increased from 36% to 73% ( P = .01), with 69% of patients achieving higher discharge mobility postimplementation versus 59% preimplementation. Length of stay and mortality were unchanged.
Conclusions:
EM practices improve mobility in intermediate care through education and collaboration.
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