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Abstract
Problem: A medical-surgical unit has noted a gradual decline in mobilizing patients with congestive heart failure (CHF). CHF patients develop a decline in functional health as a result of declining muscular strength and gait balance. In 2022, 47% CHF patients on this unit did not progress on their highest level of mobility (HLM) scores by the time of discharge. Mobility in CHF patients improves physical function, independence, and overall performance. Purpose: The purpose of this project is to implement a mobility program to improve mobility practices amongst CHF patients by assisting patients out of bed daily, documenting the progress on Johns Hopkins HLM (JH-HLM) tool, and communicating mobility status between staff members. The desire goal is to observe increased and/or sustained JH-HLM mobility scores without resulting in additional falls. Methods: This project utilized PARIHS framework to educate staff on mobility and the CHF Registry in EPIC was used to identify patients and track compliance with HLM score documentation at admission and bi-daily intervals. RNs, PCTs, and other staff assisted patients out of bed at least three times a day, documented mobility status using AM-PAC goal and JH-HLM, and shared updated HLM scores during bedside rounds using a modified handoff tool. The outcome measures were changes in HLM scores from admission to discharge, patients’ ability to meet HLM goal score and associated falls with injury rates. Data on discharged CHF patients was gathered from EPIC and stored in REDCap. Progress was monitored and areas of improvement were identified using descriptive analysis and run charts. Results: The results show improvement in patient outcomes with 70% of patients achieving their goal HLM score compared to only 53% in the baseline. Staff awareness also increased as 42% of patients met or exceeded their highest HLM goal score on discharge, in contrast to only 22% in the baseline period. Lastly, four falls occurred during the intervention period and two of these patients sustained minor injury. Conclusion: Despite the short intervention period of 15 weeks and ongoing staff turnover on the unit, the outcomes indicate a noticeable improvement in mobility scores among CHF patients.Identifier to cite or link to this item
http://hdl.handle.net/10713/22821Collections
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