Date of Graduation

5-2019

Document Type

Capstone

Keywords

Early progressive mobility; Intensive care; Protocols

Degree Name

Doctor of Nursing Practice (DNP)

Degree Level

Graduate

Advisor/Mentor

Casida, Jessie

Abstract

Background: More people are requiring intensive care unit stays for their illnesses due to the complexity of individuals care needs. Many patients remain in bed during their hospital stay due to the severity of their illness, resulting in increased time spent on the ventilator and increased length of stay in the intensive care unit (ICU). There are many risks to of being bed bound, including decreased muscle mass, development of pressure ulcers, increased hospital stay and increased time on the ventilator. All of these factors drive up hospital costs for the hospital and the consumer. Purpose of Project: The purpose of this project was to create a standardization of mobilizing patients by implementing an early progressive mobility protocol in the ICU. The desired outcomes for this project included decreased time on the ventilator and decreased length of stay in the intensive care unit. Methods: The project focused on developing a protocol using the early progressive mobility protocol used at Johns Hopkins Medical Center as a guide and tailoring it for the use at Washington Regional Medical Center in Fayetteville, Arkansas. Education was then provided to healthcare staff in the intensive care unit and on the use of the protocol for implementation into daily practice. A comparison of data including length of stay in the ICU and length of time on the ventilator in hours was then performed for 30 days preimplementation and 30 days post-implementation. Results: Pre implementation data included 42 patients, 26 males and 16 females. Post implementation included 26 patients, 18 females and 18 males. Length of time on the ventilator was decreased by 6.49 hours and length of stay was decreased by 7.52 hours. Recommendations: It was recommended that the utilization of the early mobility protocol be continued. Education opportunities for nursing staff as well as physicians should also be continued for further success of this project.

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