Progressive Mobility Research Primer Eric C. Jean RN, BSN

Presentation Content What is progressive mobility? What does previous research show? Why do more research? Purpose of the PM study. Research roles. Research activities. Project elements. Research phase diagram. When we are done. PM FAQ

Objectives The learner will be able to state the purpose of the progressive mobility research. The learner will be able to identify at least two roles associated with the research. The learner will be able to identify at least two activities associated with the research. The learner will be able to define the population to be included in the progressive mobility research.

Definition – Progressive Mobility A systematic method of increasing patient activity based on how they are doing now and what they have shown to be able to do.

Introduction: Progressive Mobility Research Previous Research Moderate number of studies available, fewer in critical care. Decreased mobility during critical illness is associated with: a) decreased quality of life, b) institutionalization, and c) readmission (Bailey et al., 2007) Decreased mobility during hospitalization is associated with hospital acquired delirium (Vasileviskis et al., 2010). Decreased mobility in critically ill patients is associated with increased respiratory complications (Morris et al., 2008). This is just the beginning!

Why do more research? Previous studies have excluded many patients including: Those with decreased mobility prior to admission. Post CPR patients. Cancer patients. Dementia patients. The PM research here at MMC will only exclude:1) quadriplegic patients and 2) those unable to consent. Other studies have called for expanded research (Bassett, Vollman, Brandwene & Murray, 2011). Opportunity for nurses to lead research here at Munson.

Purpose – Progressive Mobility Research The purpose of the PM research is to compare the difference in outcomes between critical care patients who receive usual care and those placed on a systematic mobility protocol.

Research Roles Primary Investigator Research Statistician Department Leads Coordinators Research Nurses & Assistants

Research Activities Literature review Plan the research Process design IRB approval Consent Rounds (This may be changing) Approaching patients/families Barthel scores Data entry Design & build nursing documentation Education

PM Elements Process Flows Barthel Scale PM Continuum

Progress to Better Outcomes Intervention or phase 2 All patients placed on PM continuum Additional 1500 patients Baseline or phase 1 No intervention 500 patient sample There will be a brief break between phase 1 and phase 2.

When its all done Implement changes to practice based on results. Publish findings. Celebrate!

Key Points Phase 1 of the research is near completion. The purpose of the PM research is to compare the difference in outcomes between critical care patients who receive usual care and those placed on a systematic mobility protocol. There are a variety or roles associated with the conduct of research and opportunities for everyone to get involved. Research activities include: literature review, planning, consent rounds, data entry, documentation design/build, process design, and education. Phase 1 of the research is near completion. In phase 2 all critical care patients will have progressive mobility.

Questions? Thank you!

References Bailey, P., Thomsen, G., Spuhler, V., Blair, R., Jewkes, J., Bezdjian, L., Veale, RN, K., Rodriquez, L., & Hopkins, R. (2007). Early activity is feasible and safe in respiratory failure patients. Critical Care Medicine. 35(1), 139-145. Bainbridge, L., Naismith, L., Orchard, C., & Wood, V. (2010). Competencies for interprofessional collaboration. Journal of Physical Therapy Education, 24(1). 6-11. Bassett, R., Vollman, K., Brandwene., & Murray, T. (2011). Integrating a multidisciplinary mobility program into intensive care practice: A multicenter collaborative. Intensive and Critical Care Nursing. 28(2), 88-97. doi: 10.1016/j.iccn.2011.12.001 Morris, P., Goad, A., Thompson, C., Taylor, K., Harry, B., Passmore, L.,…Haponik, E. (2008). Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Critical Care Medicine. 36(8), 1-6. doi: 10.1097/CCM.0b013e318180b90e Pick, A., Liu, A., Drew, V.L., & McCaul, J. (2010, April). The role of the research nurse. Nursingtimes.net, 107. Retrieved from http://www.nursingtimes.net/ Vasilevskis, E., Ely, W., Speroff, T., Pun, B., Boehm, L., & Dittus, R. (2010). Reducing iatrogenic risks: ICU-acquired delirium and weakness-crossing the quality chasm. American College of Chest Physicians. 138(5), 1224-1233. doi: 10.1378/chest.10-0466