Just Keep MOVEN

Penn Presbyterian Medical Center (Philadelphia, Pennsylvania)

CSI Summary

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CSI Presentation

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CSI Toolkit

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Project Topic:

Increasing nurse-driven mobility of ventilated patients

Hospital Unit:

Heart and Vascular Intensive Care Unit (HVICU)

CSI Participants:

  • Elizabeth Haemmerle, BSN, RN, CCRN
  • Dolores Risica, BSN, RN, CCRN
  • Kelsey Tirona, BSN, RN, CCRN

Video Presentation

View this CSI team's project presentation video to earn CERPs.

Project Goals/Objectives:

  1. Increase registered nurses’ documentation of patient mobility on a daily basis to 90% of the time
  2. Decrease ventilator-associated pneumonia 10%
  3. Decrease ventilator days 10%
  4. Decrease HVICU length of stay for ventilated patients 7%
  5. Increase the number of ventilated patients who are mobilized on a daily basis 75%

Project Outcomes:

  1. Increased the percent of ventilated patients achieving mobility levels out of bed 36% percent
  2. Increased the average occurrence of registered nurses’ documentation of mobility per 24 hours 30.8%
  3. Decreased the median length of stay in HVICU for ventilated patients 6.6%

Project Overview:

Our CSI team members identified that ventilated patients were not being mobilized in a consistent manner in our unit. We knew that this could adversely affect the patients, since immobility of hospitalized patients causes increased production of proinflammatory markers, increased risk of delirium and cognitive decline ― and that these consequences were not just limited to the ICU. In addition, studies showed that patients with prolonged mechanical ventilation also experience prolonged functional limitations after hospital discharge.

Our project goals were to decrease ventilator days and ICU length of stay. As a first step, we surveyed our staff to determine their perceived barriers to mobilizing ventilated patients. Next, our team developed a safety screening tool for nurses to use to evaluate patients prior to mobilization and progressive mobility steps. The tool standardized and streamlined nursing’s approach to patient mobilization and set the expectation of documenting mobility throughout the day.

Throughout the year-long implementation of our project, we were able to decrease ICU length of stay for ventilated patients 11.9% and increase the percentage of ventilated patients in the ICU getting out of bed 36%.

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The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.

The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.