Implementation of an Interprofessional Mobility Program in a Neurosurgical Intensive Care Unit

Abstract

BACKGROUND: Emerging research suggests the need for implementation of mobility protocols and consistent evaluation of the impact on patient outcomes. Standardized mobility guidelines may be a solution for promoting nurse-driven mobility efforts and influencing a shift in the culture of mobility among nursing teams. In a 36-bed neurosurgical intensive care unit, 2 key areas of opportunity were identified related to patient mobility: strengthening of frontline nursing engagement in mobility and accuracy of documented early and safe mobilization. METHODS: Using a plan-do-study-act performance improvement framework, an interprofessional team developed a comprehensive early patient mobility program. Defined criteria and mobility rounds assisted in identifying the patient's functional ability and level of assistance. Nursing staff received education in case study format to enhance understanding and improve practical application of the phases of mobility. Chart reviews served as continuous assessment of documented mobilizations within the appropriate phases of mobility, and surveys evaluated staff perceptions of program success. RESULTS: On a rating scale of 1 to 5, clinicians reported a rating of 4.32 in overall observation that patients are safely mobilized earlier and more frequently and 4.48 on overall improvement in the neurosurgical intensive care unit culture of mobility. CONCLUSION: An interprofessional mobility program focusing on safe and early mobilization may improve overall culture, confidence, and empowerment of the frontline clinicians.

A Crucial Step Forward in Implementing Early Mobility Protocols for Stroke Care

“…Dear Editor, I read with great interest the article on implementation of an interprofessional mobility program. 1 I am writing to emphasize the critical importance of implementing an early mobility protocol for stroke patients, particularly those receiving thrombolytics (alteplase or tenecteplase), or those undergoing mechanical thrombectomy procedures. Our comprehensive stroke center implemented a pilot program for early mobility after intervention in June 2022 and has since seen great success in being adopted by the interdisciplinary team.…”

“…Integration of this protocol into standard stroke care practices is imperative to optimize patient outcomes and resource utilization. Therefore, we applaud Broadway and Nuila 1 and urge healthcare providers and policymakers to prioritize the adoption of early mobility protocols to enhance rehabilitation outcomes for stroke survivors.…”