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Improving Ambulation Rates for Adult Oncology Patients Using an Evidence-based Framework

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Daily, Stephen
Date
2025-05
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DNP Project
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IMPROVING AMBULATION FOR ADULT ONCOLOGY PATIENTS
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Abstract

Problem & Purpose: Hospitalized oncology patients at a large urban academic hospital spend most of their time in bed. Only about 50% of ambulatory patients have documented mobility interventions and out-of-bed (OOB) activities in their electronic health record (EHR). Research shows that enacting nurse-driven mobility protocols or toolkits successfully improves patient outcomes. The purpose of this quality improvement (QI) project was to increase documented mobility interventions and ambulation rates among adult patients on an oncology unit by instituting the Mobilizing Older adults Via a systems-based Intervention (MOVIN) framework. Methods: Eligible patients were those that could ambulate with little to no assistance. The unit was measured in feet, distance markers were established, and an ambulation pathway was created. Physical therapy offered a three-hour psychomotor skills training. Whiteboards in patients’ rooms were utilized to communicate patients’ mobility goals. The unit culture was supported by encouraging staff and motivating patients to track the distance walked, with small prizes and staff recognition used as incentives. Results: Sixty percent of eligible staff received psychomotor training. Fifty percent of staff utilized the in-room whiteboards for goal setting. An average of 61% of patients had documented mobility interventions in their EHR, an increase of 11% from baseline, with a median ambulation count of one per day. The average daily distance walked per day increased by 253 feet. Conclusions: Enacting interdisciplinary, evidence-based mobility toolkits successfully improves patient mobility. Unit budgets, staffing, and the patient population must be considered when implementing new quality initiatives.

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