Audrey M Johnson1, Dana M Howell2. 1. Department of Rehabilitation Science, College of Health Sciences, University of Kentucky, Lexington, Kentucky. 2. Department of Occupational Science and Occupational Therapy, Eastern Kentucky University, Richmond, Kentucky.
Abstract
AIMS AND OBJECTIVES: To qualitatively evaluate an early mobilisation quality improvement project implemented on a general medicine unit. BACKGROUND: Early mobility quality improvement projects show promising quantitative results yet have failed to collect data from patient and staff experience associated with physical activity during illness and the impact of this change in clinical practice. DESIGN: A mixed methods case study was used to evaluate a mobility quality improvement project. Quantitative results will be published separately. The qualitative evaluation used a phenomenological lens to explore the patient and staff experience. METHODS: Semi-structured interviews with twelve participants (four patients and eight staff) were performed during the project. Data were analysed using open coding, direct interpretation and then categorised into an overarching and four supporting themes. Findings are reported per the Standards for Reporting Qualitative Research. RESULTS: Participants reported that early mobilisation bridged a gap in care. Staff understood the benefits of early mobility. Patients expressed how mobility aligned with personal preferences and their need to prepare for hospital discharge. Greater functional independence and higher mobility levels in patients on the unit reduced staff level of care. When patients were consistently presented with opportunities to be mobile and active, they expected mobility to be a part of their daily care plan. CONCLUSIONS: Findings suggest that early mobility quality improvement projects have the potential to transform clinical practice and improve the quality of care for patients in acute care. RELEVANCE TO CLINICAL PRACTICE: All members of the healthcare team, including the patient, recognise the importance of maintaining mobility and function during hospitalisation yet focus on these needs are often delayed or missed. Early mobility quality improvement projects help to set patient expectations and build a culture that promotes patient mobility and function during acute illness.
AIMS AND OBJECTIVES: To qualitatively evaluate an early mobilisation quality improvement project implemented on a general medicine unit. BACKGROUND: Early mobility quality improvement projects show promising quantitative results yet have failed to collect data from patient and staff experience associated with physical activity during illness and the impact of this change in clinical practice. DESIGN: A mixed methods case study was used to evaluate a mobility quality improvement project. Quantitative results will be published separately. The qualitative evaluation used a phenomenological lens to explore the patient and staff experience. METHODS: Semi-structured interviews with twelve participants (four patients and eight staff) were performed during the project. Data were analysed using open coding, direct interpretation and then categorised into an overarching and four supporting themes. Findings are reported per the Standards for Reporting Qualitative Research. RESULTS:Participants reported that early mobilisation bridged a gap in care. Staff understood the benefits of early mobility. Patients expressed how mobility aligned with personal preferences and their need to prepare for hospital discharge. Greater functional independence and higher mobility levels in patients on the unit reduced staff level of care. When patients were consistently presented with opportunities to be mobile and active, they expected mobility to be a part of their daily care plan. CONCLUSIONS: Findings suggest that early mobility quality improvement projects have the potential to transform clinical practice and improve the quality of care for patients in acute care. RELEVANCE TO CLINICAL PRACTICE: All members of the healthcare team, including the patient, recognise the importance of maintaining mobility and function during hospitalisation yet focus on these needs are often delayed or missed. Early mobility quality improvement projects help to set patient expectations and build a culture that promotes patient mobility and function during acute illness.
Authors: Marco Maciel-Monteon; Jorge Limon-Romero; Carlos Gastelum-Acosta; Yolanda Baez-Lopez; Diego Tlapa; Manuel Iván Rodríguez Borbón Journal: PLoS One Date: 2020-01-03 Impact factor: 3.240