Outcomes of Implementation
Protocol Implemented
August 5th, 2014
 The protocol was implemented with the 1st 25
patients ordered the protocol in each age group
(age 60-69, age 70-79, age 80-89, and age 90-99)
who meet inclusion criteria were included:
 Exclusion criteria
-
Comfort measures only
Bedridden prior to admission
Surgical procedure
Control Group
 Was chosen from patients discharged within 4 months
prior to protocol implementation.
 Patients chosen matched protocol patients by:
- Discharge diagnosis
- Gender
- Mobility prior to admission
- Age within 1 year.
The matches were very close
AGE
GENDER
The following outcomes were
measured:
 Length of stay
 Presence of a Pressure Ulcer
 Occurrence of a Fall
 New placement in Skilled Nursing Faciltiy or Rehab
setting
 Mobility on Day 2 of Admission
 Mobility at Discharge
 Compliance with Protocol recommended goals
Length of Stay (Mean and SD)
Hospital Acquired Pressure Ulcers
Braden Scores
Occurrence of a Fall
New Discharge Destination
Admission to Discharge Location for patients on the
Nursing Mobility Protocol vs Control Group
45
40
37
35
33
30
25
Protocol
20
Control
15
10
7
7
5
5
1.9
1.9
0
1.9
0
1.9
0
0
Home to VNA to SNF to AL to AL Home to
Home
VNA
SNF
Hospice
Home to Home to Home to VNA to
VNA
SNF Rehab Rehab
AL to
SNF
Home to Rehab
VA
to SNF
Hosp
Mobility Scale
Mobility rating over time
What does this mean?
 Favorable outcomes although within a standard
deviation so did not reach significance
 Difficult to determine if the effects seen were from
the protocol or the education about mobility that
occurred with protocol implementation. Time will tell
 There was not big changes in mobility overall,
however the small changes showed great outcomes
What now?
•
Audit proper leveling on patients on the protocol
• Retrain and reinforce the use of safe patient lifting
devices to support mobilization of patients
• Discuss possibility of inform physical therapy
consults to help nurses determine a mobility plan
for patients if not OOOB by Day 2