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Decreased mobility in hospitalized patients can lead to various health consequences, including increased morbidity and mortality. In the Intensive Care Unit (ICU), patients are not mobilized as frequently or as often as possible. Barriers to mobilization include limited resources such as time and staffing, perceived risk, and insufficient training in safe patient handling. This quality improvement initiative aimed to increase out-of-bed mobility in ICU patients, address activity orders at interdisciplinary rounds, and trial a designated mobility champion. The America Association of Critical-Care Nurses (AACN) Early Progressive Mobility (EPM) protocol and Bedside Mobility Assessment Tool (BMAT) were adopted and used to discuss patients’ mobility during interdisciplinary rounds. During these rounds, a mobility champion who received additional training from physical therapy in safe patient handling attended these rounds. The mobility champion then coordinated with nursing staff and other care team members throughout the day to mobilize patients.

Increased numbers of patients with COVID-19 did not fit the eligibility criteria during the implementation period, and increased mobility was not seen. However, the ICU team members felt the interventions, especially the use of a mobility champion, were beneficial and decided to extend the new practice for continuing review. The mobility champion is now utilized on all inpatient units. All inpatient units have seen an increase in patients mobilized. Nurse-driven early mobility tools are safe and feasible and give nurses greater autonomy in planning mobility interventions. The use of a dedicated mobility champion compliments these tools and helps reduce barriers to early mobilization.

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Intensive Care Unit Team Members, Newark-Wayne Community Hospital

Nurse Driven Early Mobility in the Intensive Care Unit: Mobility Protocol and a Designated Mobility Champion