Embed Size (px)
Citation preview
Poster Print Size: This poster template is 24” high by 36” wide. It can be used to print any poster with a 2:3 aspect ratio including 36x54 and 48x72.
Placeholders: The various elements included in this poster are ones we often see in medical, research, and scientific posters. Feel free to edit, move, add, and delete items, or change the layout to suit your needs. Always check with your conference organizer for specific requirements.
Image Quality: You can place digital photos or logo art in your poster file by selecting the Insert, Picture command, or by using standard copy & paste. For best results, all graphic elements should be at least 150-200 pixels per inch in their final printed size. For instance, a 1600 x 1200 pixel photo will usually look fine up to 8“-10” wide on your printed poster.
To preview the print quality of images, select a magnification of 100% when previewing your poster. This will give you a good idea of what it will look like in print. If you are laying out a large poster and using half-scale dimensions, be sure to preview your graphics at 200% to see them at their final printed size.
Please note that graphics from websites (such as the logo on your hospital's or university's home page) will only be 72dpi and not suitable for printing.
[This sidebar area does not print.]
Change Color Theme: This template is designed to use the built-in color themes in the newer versions of PowerPoint.
To change the color theme, select the Design tab, then select the Colors drop-down list.
The default color theme for this template is “Office”, so you can always return to that after trying some of the alternatives.
Printing Your Poster: Once your poster file is ready, visit www.genigraphics.com to order a high-quality, affordable poster print. Every order receives a free design review and we can deliver as fast as next business day within the US and Canada.
Genigraphics® has been producing output from PowerPoint® longer than anyone in the industry; dating back to when we helped Microsoft® design the PowerPoint® software.
US and Canada: 1-800-790-4001
Email: [email protected]
[This sidebar area does not print.]
Hospitalization poses a risk for altered functional status due to acute illness and decreased mobility. Use of prolonged bed rest, physical restraints, use of devices such as Foley catheters and intravenous lines can contribute to decline in function. We identified opportunities for improvement and bedside nurses and techs as the key transformation agents able to implement the needed changes. The project goals were to develop a nurse driven protocol that would provide the nursing staff with tools and resources to assess functional status, mobility level and implement a mobility plan. The Program was called “STEP IN”: • Support independence • Train for care at home • Encourage ADL • Prevent functional decline • Interdisciplinary approach • No exclusion, No excuses The implementation of the protocol resulted in a decrease in fall rate from a high of 18 falls per 1000 patient days pre-implementation to a rate of 4 falls per 1000 patient days post-implementation over a 6 month period. The protocol also resulted in a 30% decrease in readmission rate for the 6 month pilot period and a reduction in length of stay by 0.27days. The results were encouraging and served as a platform to implement the mobility protocol on other units of the hospital.
“Prevention of Functional Decline using a Nurse Driven Mobility Protocol”
Cristiane Fukuda, MSN,ANP-BC; Sandy Gandee, MS, RN, ACNS-BC, Meredith Lu, PT; Alisson Gowens,OT Northside Hospital - Atlanta Georgia
INTRODUCTION
METHODS AND MATERIALS
CONCLUSIONS
DISCUSSION RESULTS
REFERENCES
ABSTRACT
CONTACT
Sandy Gandee RN, ACNS-BC [email protected] Phone: 404-851-6309 Cristiane Fukuda, MSN,ANP-BC [email protected] Phone: 404-851-6914
The implementation of the nurse driven mobility protocol resulted in substantial improvements in all of the outcomes that were measured. We compared 6 months of outcomes for the same time period in the previous year. The protocol resulted in a reduction in: • Fall rate from 18 falls /1000 patient days to a low of 4 falls/1000 patient days. • Readmission rate by 30%. • Hospital length of stay by 0.27 days. • Functional decline - measure by the difference between MBI on admission and discharge.
Out of 300 patients, 70% did not have a decline in functional status and 21% had an improvement in their functional status.
An interdisciplinary team developed a nurse driven mobility protocol for patients on a medical unit. The team created a protocol that incorporated assessment of functional status using the Modified Barthel Index and the Get up and Go test. An algorithm was created to implement three different mobility levels based on the assessment: A four hour course curriculum was designed for nurses and patient care technicians. Education content included: complications of immobility, how to assess patient mobility using the Modified Barthel Index, how to determine level of mobility, how to use “mobility communication sheet”, patient education material, common tips for mobilizing and demonstration of safe patient mobilization and use of lifting equipment. We also created a “Mobility Protocol Implementation Guide” to help unit leadership get prepared for the mobility protocol implementation.
Even though our results are encouraging, we had and still have challenges. The greatest of all has been to create a shift in the unit culture from relying on Physical therapy (PT) to “walk” our patients to take ownership of mobility and prevention of functional decline. Not all patients meet criteria for PT referral but all of them need to be mobilized. Even for the patients being treated by a physical therapist, the care should be continued beyond the 30 minute session they are able to provide. Some other barriers identified were: • Nurses delegating mobility to the patient care
technician. • Staff’s fear that mobilization will increase fall rate. • Suboptimal documentation of mobilization by nursing
staff. • Bed rest orders on admission without further
reassessment , even though patient condition changed. • Bed rest orders without a justification or a timeframe for
discontinuation if appropriate. • Electronic generated reports that were not concurrent
and accurate. • Leadership not holding staff accountable if mobilization
did not improve. • Leadership sub estimating complexity of program
implementation and resources needed. • Lack of resources to collect and monitor data
concurrently. • Competing priorities .
Bed rest in hospitalized patients leads to an increase in hospital acquired complications such as venous thrombosis, falls and hospital acquired pneumonia. Between 30-60% of patients experience functional decline after hospitalization which results in a decline in quality of health and increases the risk for falls and readmissions. There is a plethora of literature written about the benefits of an early mobility protocol for ICU patients but comparably little has been published regarding the benefits of mobility for the med-surgical population. A review of the literature revealed that early mobilization may improve patient outcomes in medical patients as well. Literature also supports early mobilization through standardized mobility protocols or programs. We believe that bedside nurses and patient care techs are in the best position to impact patient mobility, an important nurse-sensitive outcome.
1. Hoogerdujn,Jita et al. The Prediction of functional decline in older hospitalized patients. Age and Ageing 2012: 41:381-387
2. Needham, Dale, Mobilizing Patients in the Intensive Care Unit; Improving Neuromuscualr Weakness and Physical Function
Documentation Compliance Fall Rate/1000 Patient Days
Readmission Rate Length of Stay Reduction
Functional Status
Implementing a nurse driven protocol can be challenging but the benefits of reducing fall rates, readmission rates and length of stay far exceeded our goals. Mobilization is an intervention that is basic to nursing but not always seen as a priority in all of the tasks that nurses are required today. The data reveals that mobilization is as important and potentially more so than any other intervention that we provide. Staff buy in , leadership support and multidisciplinary collaboration are vital for the success of a nurse driven mobility program.
CONCLUSION
