Walking Toward Discharge “WTD”

Grady Memorial Hospital (Atlanta, Georgia)

CSI Summary

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CSI Presentation

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CSI Toolkit

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Project Topic:


Hospital Units:

7KIS Cardiovascular Intensive Care Unit (CVICU)
5A Cardiovascular Telemetry

CSI Participants:

  • Alicia Carstarphen, BSN, RN
  • Jodian Douglas-Watson, BSN, RN
  • Julia Tran, BSN, RN
  • Elia Vazquez, BSN, RN
  • Keneisha Young, BSN, RN

Video Presentation

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

Project Goals/Objectives:

  1. To increase mobility of patients either (1) medically cleared by physicians, physical therapy (PT) and occupational therapy (OT) or (2) upon assessment by the registered nurse (RN) utilizing the Get Up and Go score (GUG)
  2. To increase early mobility 80%
  3. Decrease length of stay (LOS) 5-6%

Project Outcomes:

  1. Increased unit 5A’s Get Up and Go scores 11%
  2. Increased patient mobility 43%
  3. Reduced 7KIS CVICU’s total average time from post-operative arrival to out-of-bed 2.7 hours (11%)
  4. Decreased hospital-associated conditions (HACs) on unit 5A: falls 100%, CAUTI 100% and CLABSI 100%, plus maintained zero HAPIs
  5. Decreased HACs on CVICU: CAUTI 100% and CLABSI 50%, plus maintained zero falls and HAPIs

Project Overview:

A lack of consistent mobility practices in our units resulted in nurses often being unaware of a patient’s mobility status. Chart audits revealed an opportunity to improve nurse assessment of patient’s mobility status and familiarity with mobility documentation, both of which could potentially impact length of stay.

Our CSI team implemented interventions and tools that we shared with our unit colleagues during our project kickoff. We provided education about mobility scoring, documenting patients’ mobility, the SNAP report and use of mobility equipment. In 2022, our units’ frequency of mobility assessment and mobility documentation increased 12% and 43%, respectively. Unfortunately, length of stay increased in 2022 amid the COVID-19 pandemic surges.

Our CSI project was positively received by our peers and the interdisciplinary team. It facilitated collaboration among team members and stimulated the exchange of ideas and interventions for finding common ground with unmotivated patients.

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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.