2.50
Hdl Handle:
http://hdl.handle.net/10755/156954
Category:
Abstract
Type:
Presentation
Title:
Early Progressive Mobility Program For Ventilated Adult Critical Care Patients
Author(s):
Bills, Pamela S.
Author Details:
Pamela S. Bills, RN,ADN,AA,CCRN, Washington Hospital, Fremont, California, USA, email: pamccrn@comcast.net
Abstract:
POSTER PURPOSE: This multidisciplinary study evaluates the implementation of an early mobility program in an effort to improve outcomes in adult critical care patients receiving mechanical ventilation. How does early mobilization compared with bed rest affect duration of ventilation, length of stay (LOS), and cost in this patient population? BACKGROUND/SIGNIFICANCE:Preimplementation data revealed that our ventilator patients were on bed rest with the head of bed (HOB) at 30¦ as their activity event. Recent literature states that deconditioning, muscular atrophy, and ventilator-associated pneumonia (VAP) can result from immobility. We hypothesized that immobility can prolong time on the ventilator and increase critical care LOS and overall hospital LOS, which increases cost. METHOD: A convenience sample of 22 patients meeting specific inclusion criteria were enrolled in the study. A retrospective chart analysis yielded a preimplementation control group of 44 patients. The program consisted of 5 activity events: range of motion (ROM) exercises, HOB elevation, edge of bed (EOB)/dangle, stand and pivot to chair, and ambulation. These patients participated in 215 activity events during the study. These patients were compared with a retrospective usual care group. A daily progressive mobility data collection tool was developed and used by the study team and staff. Descriptive and inferential statistics were used for analysis. RESULTS: Analysis revealed that ventilator days decreased from 11.75 days to 10.59 days, critical care LOS decreased from 15.84 days to 14.68 days, and hospital LOS decreased from 22.93 days to 19.32 days. Although these decreases are encouraging, they are not statistically significant. No cases of VAP occurred. The highest activity level achieved for 5% of the patients was ROM exercises; for 58% it was HOB up 60 degrees with legs in dependent position; for 18% it was EOB/dangle; for 14% it was stand and pivot to chair; for 5% it was ambulation. CONCLUSIONS: An early progressive mobility program decreases time on the ventilator by 1.16 days, critical care LOS by 1.16 days, and overall LOS by 3.61 days. From these results, we can infer a cost reduction that will be calculated after additional data are collected to increase the postimplementation sample size to at least 44 patients. Another positive outcome of this study is that we are beginning to see a culture change in our unit regarding the value of early mobility in adult critical care patients.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866
Conference Date:
2010
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleEarly Progressive Mobility Program For Ventilated Adult Critical Care Patientsen_GB
dc.contributor.authorBills, Pamela S.en_GB
dc.author.detailsPamela S. Bills, RN,ADN,AA,CCRN, Washington Hospital, Fremont, California, USA, email: pamccrn@comcast.neten_GB
dc.identifier.urihttp://hdl.handle.net/10755/156954-
dc.description.abstractPOSTER PURPOSE: This multidisciplinary study evaluates the implementation of an early mobility program in an effort to improve outcomes in adult critical care patients receiving mechanical ventilation. How does early mobilization compared with bed rest affect duration of ventilation, length of stay (LOS), and cost in this patient population? BACKGROUND/SIGNIFICANCE:Preimplementation data revealed that our ventilator patients were on bed rest with the head of bed (HOB) at 30¦ as their activity event. Recent literature states that deconditioning, muscular atrophy, and ventilator-associated pneumonia (VAP) can result from immobility. We hypothesized that immobility can prolong time on the ventilator and increase critical care LOS and overall hospital LOS, which increases cost. METHOD: A convenience sample of 22 patients meeting specific inclusion criteria were enrolled in the study. A retrospective chart analysis yielded a preimplementation control group of 44 patients. The program consisted of 5 activity events: range of motion (ROM) exercises, HOB elevation, edge of bed (EOB)/dangle, stand and pivot to chair, and ambulation. These patients participated in 215 activity events during the study. These patients were compared with a retrospective usual care group. A daily progressive mobility data collection tool was developed and used by the study team and staff. Descriptive and inferential statistics were used for analysis. RESULTS: Analysis revealed that ventilator days decreased from 11.75 days to 10.59 days, critical care LOS decreased from 15.84 days to 14.68 days, and hospital LOS decreased from 22.93 days to 19.32 days. Although these decreases are encouraging, they are not statistically significant. No cases of VAP occurred. The highest activity level achieved for 5% of the patients was ROM exercises; for 58% it was HOB up 60 degrees with legs in dependent position; for 18% it was EOB/dangle; for 14% it was stand and pivot to chair; for 5% it was ambulation. CONCLUSIONS: An early progressive mobility program decreases time on the ventilator by 1.16 days, critical care LOS by 1.16 days, and overall LOS by 3.61 days. From these results, we can infer a cost reduction that will be calculated after additional data are collected to increase the postimplementation sample size to at least 44 patients. Another positive outcome of this study is that we are beginning to see a culture change in our unit regarding the value of early mobility in adult critical care patients.en_GB
dc.date.available2011-10-26T19:17:29Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:17:29Z-
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.conference.date2010en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationWashington, D.C., USAen_GB
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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