Early and Progressive Mobility: A Program Implementation Strategy for High Acuity Patient Care Locations
Date of Award
Doctor of Nursing Practice (DNP)
Hilary Morgan, PhD, CNM, CME
Amanda Savage, DNP, M. Ed., BSN, RN
Despite an increase in the promotion of early progressive mobility, its decrease in hospital-acquired complications and improvement of patient outcomes, there remains a reluctance in staff commitment to daily evaluation and implementation. This is largely due to the fact nurses or other interprofessional staff are the primary individuals responsible for this change in process. A lack of confidence in staff to correctly identify patients that meet criteria and anxiety regarding the safe transfer or mobilization of patients, particularly in high acuity settings have been identified as major barriers. The PICOT question that guided this program development of a CBO toolkit is: For interprofessional staff in high acuity settings such as an intensive care unit (P), how does established competency-based orientation for early and progressive mobility strategies (I) compared to no structured early and progressive mobility program (C) influence the efficacy of recognition and response prioritization for early and progressive mobility (O)? The evidence recommends that increased attention to staff education, specifically identifying criteria and the use of mobility aids increases commitment to EPM. Using the CDC Program Evaluation framework, the Agency for Healthcare Research and Quality (AHRQ) Nurse-driven early mobility protocol, New York State Partnership for Patients (NYSPFP) progressive mobility program toolkit, and Johns Hopkins Activity and Mobility Promotion (JH-AMP) were analyzed to ensure that these programs met requirements for probable success. Strong emphasis on interprofessional staff education and preparedness is imperative for EPM to be maintained. A toolkit that meets knowledge gaps and validates competency will assist with successful commitment to EPM in high acuity patient care areas.
Poland, S. (2022). Early and Progressive Mobility: A Program Implementation Strategy for High Acuity Patient Care Locations. [Doctoral project, University of St Augustine for Health Sciences]. SOAR @ USA: Student Scholarly Projects Collection. https://doi.org/10.46409/sr.TLUH7796
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Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice