Hospitalized Adult Patient Characteristics Associated With Participation in a Volunteer-Assisted Mobility Program: A Feasibility Study

Student-Led Mobility Interventions for Hospitalized Adults: A Mixed-Methods Feasibility and Acceptability Study

BACKGROUND

Inactivity in hospitalized patients often leads to functional decline. We created an undergraduate course to promote mobilization, provide hands-on learning, and address staff shortages.

PURPOSE

To assess the feasibility and acceptability of undergraduate students providing mobility-focused interventions for hospitalized adults.

METHODS

This mixed-methods study was conducted at a level 1 trauma academic center. We analyzed program feasibility and acceptability using quantitative data and thematic analysis of interviews and focus groups.

RESULTS

In total 47 individuals (n = 14 students, n = 9 patients, and n = 24 clinicians) were included. Students averaged 4.1 mobility sessions per 4-hour shift. All stakeholders agreed the program is acceptable, and 98.6% affirmed the program is feasible. The themes identified included positive impacts on patient care, enhanced student professional development, and practical implementation challenges.

CONCLUSIONS

Student-led mobility interventions can be an acceptable strategy to mitigate immobility harm in hospitalized patients. The integration of students enhances patient care and provides valuable educational experiences.

Adding a Mobility Champion to an Existing Progressive Mobility Protocol: An Evidence-Based Initiative

PURPOSE

This evidence-based initiative assessed the effect of adding a mobility champion to an existing progressive mobility protocol on functional decline in hospitalized older adults as evidenced by recommended discharge to home versus an inpatient rehabilitation facility.

METHOD

Older adults admitted from home to a 47-bed medical-surgical telemetry unit who were assessed as ambulatory, either independently or with assistance (Level 5), and with a progressive mobility order in the electronic health record were included in the initiative. Patient care associates who volunteered to be mobility champions were trained how to safely ambulate patients.

RESULTS

Patients who worked with a mobility champion were less likely to be referred to inpatient rehabilitation post discharge for further care due to functional decline.

CONCLUSION

Mobility has a critical role in the maintenance of hospitalized older adults' functional abilities and is a determinate of their post discharge disposition. [Journal of Gerontological Nursing, 50(11), 37-43.].

Deconditioning in Hospitalized Patients with Cancer

OBJECTIVES

Provide an overview of hospital-associated deconditioning in hospitalized patients with cancer, including risk factors and trajectory of deconditioning. Discuss interdisciplinary roles in preventing deconditioning, best practices, and oncology nursing implications.

METHODS

A literature search was conducted in PubMed and on Google Scholar using search terms Hospital*, Mobility, Immobility, Deconditioning, Cancer, and Oncology. Peer-reviewed research studies, review articles, and websites of professional organizations were reviewed to provide an overview on mobility concerns in hospitalized patients with cancer.

RESULTS

Thirty-eight references were included in this overview of hospital-associated deconditioning (HAD) in patients with cancer. HAD is a widespread phenomenon with grave consequences. Patients with cancer are particularly vulnerable to HAD due to their cancer diagnosis and treatment effects. Physical activity in hospitalized patients is one of the most important practices to prevent HAD and is achieved through standardized mobility assessment and interdisciplinary collaboration.

CONCLUSIONS

Promoting mobility in hospitalized patients with cancer is essential to prevent the complications of HAD.

IMPLICATIONS FOR NURSING PRACTICE

Nurses are leaders of the interdisciplinary approach to enhance inpatient mobility. As they are most often at the bedside, nurses assess patients' level of mobility, recognize risk factors for HAD, and implement safe mobility interventions. Nurses experience barriers to promoting mobility including workforce shortages, high workloads, and competing priorities.

Outcomes of a COVID Mobility Team

The detrimental effects of immobility are well documented in the literature, yet immobility still plagues the hospitalized adult. As the influx of COVID-19 patients began, patient mobility was further compromised. The purpose of this quality improvement project was to assess the impact of COVID mobility teams, composed of deployed coworkers, on COVID-19–positive and person under investigation patient outcomes. Using mobility teams improved mobility in COVID-positive and person under investigation patients. Increasing patient mobility results in improved patient outcomes by preventing hospital-acquired functional decline, preventing intensive care unit transfers, and decreasing length of stay.

Increased Mobility and Fall Reduction: An Interdisciplinary Approach on a Hematology-Oncology and Stem Cell Transplantation Unit

Patients in the hematology-oncology and stem cell transplantation (SCT) setting are at high risk for functional decline and falls related to prolonged hospitalizations and inactivity during inpatient treatment. After underperforming on the Press Ganey National Database of Nursing Quality Indicators benchmark for falls in 2018, staff on a hematology-oncology and SCT unit implemented a practical and evidence-based fall prevention program. Fall rates from 2018 to 2019 ranged from 3.4 to 4.8 falls per 1,000 patient days. After the introduction of the unit-based gym program, early mobility increased and falls decreased to 2.57 per 1,000 patient days.