We Like to Move It!

Overlake Medical Center and Clinics (Bellevue, Washington)

CSI Summary

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CSI Presentation

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CSI Toolkit

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Project Topic

Mobility in a critical care unit

Hospital Unit(s)

South 3 Adult Critical Care Unit (CCU)

CSI Participants

Kelsey Blissett, BSN, RN
Deanne Ishee, BSN, RN, CCRN
Akane Itoh, BSN, RN, CCRN
Alyssa Nguyen, BSN, RN, CCRN

Project Goals/Objectives

  1. To mobilize 80% of CCU patients to their daily mobility goal
  2. To create a “mobility team” to facilitate early mobilization of high-acuity CCU patients
  3. To increase staff comfort with early mobilization of CCU patients

Project Outcomes

  1. Increased mobility rate from 65.5% to 67.3%
  2. Decreased average ventilator days 4%
  3. Decreased average patient CCU days 11.2%
  4. Decreased total ventilator-associated pneumonia 100%
  5. These outcomes resulted in an estimated annual fiscal impact of $3,540,501

Project Overview

Nurses on our unit were aware that improving patient mobility would help minimize patient complications and have a positive impact on them. However, we didn’t have a tool to identify appropriate activity levels and exclusion criteria for our patients. We also didn’t have systematic mobility plans on our unit.

After researching articles and consulting with a respiratory therapist, physical therapist and group of CCU doctors, we educated our staff on how to identify daily activity goals and exclusion criteria, progress critically ill patients’ early mobility, and use our mobility equipment. Our CSI team started mobility rounds on our unit and played a board game we created, called “Mobility Land” to encourage staff to mobilize their patients.

Staff were engaged and had fun competing with each other to get their names on the board by mobilizing their patients. After few months, we achieved the intended goal of the board game – increased mobilization of patients – and celebrated with a taco party. After six months, we reduced occurrences of ventilator-associated pneumonia, ventilator days and average CCU length of stay. Our future goal is to include mobility education in our CCU orientation packet for new staff, and we would like to play the board game again!

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Disclaimer
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.