GET UP Campaign: Continued! Mobility Team Strategies June 11, 2018 - - PowerPoint PPT Presentation

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Feb 26, 2024 245 likes •660 views

GET UP Campaign: Continued! Mobility Team Strategies June 11, 2018 Fun on the Road PROGRESSIVE MOBILITY reduces harm in EIGHT focus areas Worker Falls PrU VAE VTE Delirium CAUTI Readmissions Safety G E T - U P Sharing Successes:

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GET UP Campaign: Continued! Mobility Team Strategies June 11, 2018

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Fun on the Road

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PROGRESSIVE MOBILITY reduces harm in EIGHT focus areas

Falls PrU

Delirium

CAUTI VAE VTE

Readmissions

Worker Safety

G E T - U P

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Sharing Successes: Implementation of a Mobility Team

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Deployment of a Mobility Team in the Acute Care Setting: Programmatic Success Through Collaboration

Leslie Pollart, RN, OCN, MSN, MBA Director of Nursing, Memorial Regional Hospital lpollart@mhs.net | 954-265-5250 Office

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History

Opened in 1953 with 100 beds
Three campuses, one license, 1,057 total beds:

– Memorial Regional Hospital (553 beds) – Joe DiMaggio Children’s Hospital (224 beds) – Memorial Regional Hospital South (280 beds)

Regional Tertiary and Quaternary Care Hospital
One of only 7 state-approved Level 1 trauma centers (adults and

pediatrics)

Largest provider of emergency services in Broward County1
Largest provider of acute care inpatient services in Broward

County1

Comprehensive Stroke Center
Adult Heart Transplants & Adult Renal Transplants

1 Source: Broward Regional Health Planning Council, One Year Ending December 2014

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Services

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The Effects of Immobility

Patients who walk outside their room at least once a day left

the hospital 1.5 days earlier than those who stayed inside their room.

Muscle fatigue decreases by as much as 20-30% after just a

week of bed rest.

65% of older patients experience a decline in mobility by day

2 of hospitalization.

Immobility is a risk factor for adverse outcomes related to

DVT’s, pressure ulcers, and respiratory distress.

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Consensus Within the Interdisciplinary Team RN

“I wish I had more time to ensure my patients ambulate.”
“While I know it is very important, competing priorities and

workload are impediments for me to ensure timely patient mobility.”

Many patients require increased manpower and time to provide safe

transfers & ambulation.”

PT

“I frequently get pulled from doing consults to assist nurses with

putting patients back to bed.”

“Some PT consults are ordered as a means to assist with ambulation.”

MD

“I write activity orders, but they are not carried out consistently.”
“Patients would get out of the hospital sooner and more frequently

back to home if they were ambulated regularly.”

“I often find myself ordering a PT consult to ensure my patients get

OOB.”

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10 20 30 40 50 60 70 HHS JDC MHM MHP MHW MMA MRH RSC UCC

HHS JDC MHM MHP MHW MMA MRH RSC UCC 2015 7 7 10 39 4 53 17 1 2014 2 3 11 13 52 4 63 19 1 2013 1 5 10 32 4 56 19 2012 6 11 14 46 1 60 15 2011 4 17 27 32 3 70 19 1

Patient Handling Injuries by Location 2011-2015

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Project Mission Statement: “ Prevention of hospital acquired functional decline and

ther adverse outcomes to facilitate the earliest

discharge to the most independent setting.”

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Job Description

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Training in Motion

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Mobility Team EPIC Referral Tool

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Mobility Decision Tool

1) Is patient able to lift both legs off the bed independently or with the assistance of

ne person?

Yes, go to #2 No – refer to mobility team 2) Is patient able to move from supine to sit independently or with the assistance of

ne person?

Yes, go to #3 No – refer to mobility team 3) Is patient able to move from sit to stand independently or with the assistance of one

person?

Yes, go to #4 No – refer to mobility team 4) Is patient able to take a step forward independently or with the assistance of one

person, with or without a device?

Yes, ambulate patient No – refer to mobility team

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Coverage Model

Telemetry
Telemetry
Telemetry
Telemetry
Telemetry
IMCU -1 RN/PCA with

Mobility Tech

Telemetry
Telemetry
Ortho/Neuro- 1 RN/PCA with

Mobility Tech

Team I Team II

Team III

Each Couplet can see approximately 32 patients per day

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Patient Mobility Initiatives

Representation from all MHS campuses to discuss what initiatives

could be rolled out in lieu of a mobility team

Universal agreement in the need to implement a patient mobility

initiative:

The consensus initiatives include:

– Heels for Meals Campaign – Develop a way to track distance walked & use enhanced documentation within the EMR – Patient Education on the risks of decreased mobility – Promote Use of Patient Handling Equipment

Ambulation is the for Wellness!

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Distance Markers

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Tent Cards

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Meaningful Ambulation Documentation

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Mobility Journal

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Lift Smart: Patient Handling Device Roll Out

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Patient Handling Equipment

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Pace Carts: Early Mobility

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Patient Handling Equipment Assessment

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Revision to Post-Fall DeBrief

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Ongoing Education

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Inpatient Fall Rates: 2016-2018 YTD

1st Quarter 2nd Quarter 3rd Quarter 4th Quarter 2016 1.37 2.03 2.11 2.70 2017 2.44 2.50 1.83 1.34 2018 1.49 1.00 1.50 2.00 2.50 3.00 3.50 Fall Rates

Patient Handling Equipment Go Live

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Hospital Improvement Innovation Network

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Hospital Acquired LE DVT: 1st Quarter 2018

January February March DVT's 7 1 4 1 2 3 4 5 6 7 8

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MRH: Musculosk skeletal al I Injuries 2016 016

9 7 5 10 14 8 10 15 16 19 13 9

Musculoskeletal Disorder - injuries requiring treatment

MRH Musculoskeletal disorder injuries with treatment pt related Linear (MRH Musculoskeletal disorder injuries with treatment pt related)

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MR MRH: Mu Muscu culos

skele

letal I Injuri ries 2 2017

7 12 22 5 15 6 6 3 3 1 1 2

JAN-17 FEB-17 MAR-17 APR-17 MAY-17 JUN-17 JUL-17 AUG-17 SEP-17 OCT-17 NOV-17 DEC-17

Musculoskeletal Disorder - injuries requiring treatment patient related