Toward a Common Language for Measuring Patient Mobility in the Hospital: Reliability and Construct Validity of Interprofessional Mobility Measures

Hoyer, Erik H.; Young, Daniel L.; Klein, Lisa M.; Kreif, Julie; Shumock, Kara; Hiser, Stephanie; Friedman, Michael; Lavezza, Annette; Jette, Alan M.; Chan, Kitty S.; Needham, Dale M.

doi:10.1093/ptj/pzx110

Cited by 100 publications

(105 citation statements)

References 53 publications

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“…A 12-month pilot study of the Johns Hopkins inpatient mobility program found more days of ambulation, increases in the proportion of individuals whose mobility levels improved over their hospital stay, and shorter hospital stays in individuals participating in the program. 43 A cohort study demonstrated the feasibility of the SIT to STAND program, which employs a progressive model of loaded sit-to-stand exercises to prevent loss of muscle strength is hospitalized men. 44 This program has not been tested in a randomized controlled trial.…”

Section: The Whomentioning

confidence: 99%

The Case for Mobility Assessment in Hospitalized Older Adults: American Geriatrics Society White Paper Executive Summary

Wald¹,

Ramaswamy

Perskin

et al. 2018

J American Geriatrics Society

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Mobility can be defined as the ability to move or be moved freely and easily. In older adults, mobility impairments are common and associated with risk for additional loss of function. Mobility loss is particularly common in these individuals during acute illness and hospitalization, and it is associated with poor outcomes, including loss of muscle mass and strength, long hospital stays, falls, declines in activities of daily living, decline in community mobility and social participation, and nursing home placement. Thus, mobility loss can have a large effect on an older adult's health, independence, and quality of life. Nevertheless, despite its importance, loss of mobility is not a widely recognized outcome of hospital care, and few hospitals routinely assess mobility and intervene to improve mobility during hospital stays. The Quality and Performance Measurement Committee of the American Geriatrics Society has developed a white paper supporting greater focus on mobility as an outcome for hospitalized older adults. The executive summary presented here focuses on assessing and preventing mobility loss in older adults in the hospital and summarizes the recommendations from that white paper. The full version of the white paper is available as Text S1. J Am Geriatr Soc 67:11–16, 2019.

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Section: The Whomentioning

confidence: 99%

The Case for Mobility Assessment in Hospitalized Older Adults: American Geriatrics Society White Paper Executive Summary

Wald¹,

Ramaswamy

Perskin

et al. 2018

J American Geriatrics Society

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“…In our study, nurses used a feasible and reliable measurement of mobility, the Johns Hopkins Highest Level of Mobility tool, to measure the level of mobility that a patient actually performed (Hoyer et al, ; Pottenger et al, ). Our results demonstrate that lower levels of mobility are associated with increased call bell use, which is related to higher nurse workload.…”

Section: Discussionmentioning

confidence: 99%

“…At our institution, documentation of JH‐HLM is a hospital‐wide policy for nurses at least once per shift; daily documentation rates for the units in this study were >90%. We have previously examined nursing recorded JH‐HLM scores, and they have excellent test–retest and interrater reliability (Hoyer et al, , ; Klein et al, ). The maximum daily JH‐HLM scores for each patient day were averaged across their hospitalization.…”

Section: Methodsmentioning

confidence: 99%

Association between ambulatory status and call bell use in hospitalized patients—A retrospective cohort study

et al. 2019

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Aim: Characterize the relationship between patient ambulatory status and in-hospital call bell use.Background: Although call bells are frequently used by patients to request help, the relationship between physical functioning and call bell use has not been evaluated. Methods:Retrospective cohort study of 944 neuroscience patients hospitalized in a large academic urban medical centre between April 1, 2014 and August 1, 2014. We conducted multiple linear regression analyses with number of daily call bells from each patient as the primary outcome and patients' average ambulation status as the primary exposure variable. Results:The mean number of daily call bell requests for all patients was 6.9 (6.1), for ambulatory patients 5.6 (4.8), and for non-ambulatory patients, it was 7.7 (6.6).Compared with non-ambulatory patients, ambulatory patients had a mean reduction in call bell use by 1.7 (95% CI 2.5 to −0.93, p < .001) calls per day. In a post hoc analysis, patients who could walk >250 feet had 5 fewer daily call bells than patients who were able to perform in-bed mobility.Conclusion: Ambulatory patients use their call bells less frequently than non-ambulatory patients.Implications for Nursing Management: Frequent use of call bells by non-ambulatory patients can place additional demands on nursing staff; patient mobility status should be considered in nurse workload/patient assignment. | 55CAPO-LUGO et AL.

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“…Standardized AM‐PAC scores were used for analyses in this study (AM‐PAC, ). The JH‐HLM and AM‐PAC are valid and reliable tools when scored by nursing (Hoyer et al, ). The mobility nurse recorded whether an additional staff nurse and/or an assistive device was required to safely mobilize the patient.…”

Section: Methodsmentioning

confidence: 99%

“…Standardized AM-PAC scores were used for analyses in this study (AM-PAC, 2017). The JH-HLM and AM-PAC are valid and reliable tools when scored by nursing (Hoyer et al, 2018).…”

Section: Mobility Sessionsmentioning

confidence: 99%

Towards improving hospital workflows: An evaluation of resources to mobilize patients

et al. 2018

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Toward a Common Language for Measuring Patient Mobility in the Hospital: Reliability and Construct Validity of Interprofessional Mobility Measures

Abstract: The AM-PAC IMSF and JH-HLM had excellent interrater reliability and test-retest reliability for both physical therapists and nurses. The evaluation of convergent validity suggested that AM-PAC IMSF and JH-HLM measured constructs of patient mobility and physical functioning.

Cited by 100 publications

References 53 publications

The Case for Mobility Assessment in Hospitalized Older Adults: American Geriatrics Society White Paper Executive Summary

The Case for Mobility Assessment in Hospitalized Older Adults: American Geriatrics Society White Paper Executive Summary

Association between ambulatory status and call bell use in hospitalized patients—A retrospective cohort study

Towards improving hospital workflows: An evaluation of resources to mobilize patients

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