Achieving a Culture of Mobility: Implementation of a Mobility Aide Program to Increase Patient Mobilizations in an Acute Care Hospital
Achieving a Culture of Mobility: Implementation of a Mobility Aide Program to Increase Patient Mobilizations in an Acute Care Hospital
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DOI：
10.1097/jat.0000000000000058
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发表时间：
2017-07-01
影响因子：
0.5
通讯作者：
Sabus, C.
中科院分区：
文献类型：
--
作者：
Coughenour, E. T.;Salmans, K. J.;Sabus, C.
背景和目的：事实证明，住院期间患者的活动是优质护理的一个重要方面，可以降低多种并发症的风险。仅由物理治疗师 (PT) 为住院患者提供所有活动活动是不切实际的，而且成本高昂。患者动员需要采用跨专业的方法，所有工作人员都优先考虑患者活动。这项描述性研究捕捉了住院病房内患者动员计划的生产力和患者效果：在急症护理医院中实施行动辅助器 (MA) 是否会增加患者的整体动员？使用 MA 是否减轻了 PT 的工作量，以便专注于熟练干预并减少就诊频率？方法：MA 的主要职责是在 PT 的指导下与护理人员合作为患者提供活动干预，以提高活动频率并让 PT 专注于熟练干预。 PT 和 MA 对注册护士和家属进行了针对特定情况的移动技术的教育，并促进护理人员动员患者。 MA 计划实施后，记录了 519 名患者的 MA 工作量日志、物理治疗订单、治疗频率以及提供干预的专业人员/护理人员类别。这与 MA 计划实施前 1 周的护理单位水平基线动员指标进行了比较。将护理计划中物理治疗师的使用频率与计划实施前的同等时间段进行比较。结果：自这家急症护理医院实施 MA 计划以来，观察到在病房内行走的患者数量增加了 36%，而未活动的患者数量减少了 48%。 PT 遇到频率和 PT 转诊增加的趋势表明，PT 能够专注于熟练干预而不是一般动员。实施 MA 计划的成本已确定通过新 PT 转介增加 10% 来抵消。虽然 PT 每天和每天两次的就诊次数减少，但每周 1 至 3 次就诊的频率增加，表明 PT 服务的范围扩大。结论：将 MA 添加到患者的护理计划中可能是优化急症护理医院环境中患者流动性的一种经济有效的方法。医疗/外科单位增加 MA 在患者动员数量方面产生了积极成果，并改善了 PT 的使用。
Background and Purpose: Mobilization of patients during inpatient hospitalization has been shown to be an important aspect of quality care that reduces risk for a number of complications. It is impractical and cost prohibitive for physical therapists (PTs) alone to provide all mobilization activities to hospitalized patients. Patient mobilization requires an interprofessional approach with all staff prioritizing patient activity. This descriptive research captures the productivity and patient effect of a patient mobilization program within an inpatient unit: Does the implementation of a mobility aide (MA) in an acute care hospital increase overall patient mobilizations? Does the use of an MA alleviate the workload of a PT to allow focus on skilled intervention and decreased frequency of visits?Methods: The MA's primary responsibility was to provide mobility interventions for patients under the direction of the PT in collaboration with nursing staff to improve frequency of mobilization and allow PTs to concentrate on skilled interventions. The PT and MA educated registered nurses and family members on mobility techniques for specific situations and promoted patient mobilization by nursing staff. The MA workload log, physical therapy orders, treatment frequency, and category of professional/caretaker who provided the intervention were recorded for 519 patients after the MA program implementation. This was compared to nursing unit-level, baseline mobilization metrics 1 week prior to MA program implementation. Physical therapist use measured as frequency of visits in the plan of care was compared to an equivalent time period prior to program implementation.Results: Since implementation of the MA program in this acute care hospital, there has been an observed 36% increase in patients walking on the unit as well as a 48% decrease in patients with no mobilizations. Trends in PT encounter frequency and increased PT referrals suggest that the PTs are able to focus on skilled intervention rather than general mobilization. The cost of implementing the MA program has been determined to be offset by a 10% increase in new PT referrals. While daily and twice a day visits by the PT decreased, the frequency of 1 to 3 visits per week increased suggesting increased breadth of PT services.Conclusion: Adding an MA to patients' plan of care may be a cost-effective method to optimize patient mobility in the acute care hospital setting. The addition of an MA to a medical/surgical unit produced positive outcomes in number of patient mobilizations and allowed improved use of the PT.