2025 National Teaching Institute Evidence-Based Solutions Abstracts

Purpose/Rationale: Early patient-mobility programs (EPMPs) have been recognized for improving patient outcomes and decreasing use of hospital resources.The purpose of an EPMP is to promote early mobilization and decrease adverse outcomes for patients.Adverse outcomes associated with prolonged immobility include prolonged length of stay (LOS), hospital-acquired pressure injuries (HAPIs), and falls.Synthesis of Evidence: A literature search was conducted in the CINAHL, PubMed, and Google databases using the following terms: early patient mobility, patient mobility programs, and telemetry units.Articles published between 2018 and 2023 were included.Research suggests low mobility is prevalent in the hospitalized adult population and places patients at high risk for adverse health outcomes.An increasing amount of evidence shows that early mobilization is a safe and cost-effective initiative for decreasing adverse outcomes.Practice Change: The EPMP setting was a single 22-bed telemetry unit in New Jersey.The Bedside Mobility Assessment Tool (BMAT) was used to assess patient mobility levels and determine which patients were appropriate for the EPMP.The BMAT defines 4 levels of mobility, each assessing the patient's ability to perform a physical task.Patients with a BMAT score of 3 or greater were selected for our EPMP.Implementation Strategies: Starting in August 2023, the nurse leader reviewed the patient's charts.A magnet in the image of a walking shoe was placed by the room number of patients with a BMAT score of 3 or greater.The registered nurses (RNs) and patient care technicians (PCTs) ensured these patients were taken on supervised walks throughout the day.The interprofessional team was supported by physical therapists (PTs), who specifically focused on walking patients who had orders for physical therapy.Evaluation: The 24-month data collection before and after implementation of the EPMP ranged from August 2022 to July 2023 and August 2023 to July 2024.Primary outcomes for both patients and staff included fall rates, incidence of HAPIs, and LOS.Fall rates declined from 2.1 falls per 1000 days to 1.7 per 1000 days.Fall rates with injuries declined from 0.5 falls per 1000 days to 0.16 per 1000 days.HAPIs declined from 1.19 per 1000 occupied beds to 0.27 per 1000 occupied beds.LOS stayed relatively unchanged from 5.3 median days to 5.02 median days.Implications for Practice: EPMPs are effective interventions for improving strength and physical function, as well as decreasing fall rates and HAPIs.One of the major barriers was the additional burden on staff, which was relieved by using an interprofessional approach involving RNs, PCTs, and PTs.Our findings indicate the EPMP decreased adverse outcomes and improved patient safety.