1. Mobilization Of Vulnerable Elders Interprofessional Education (Quick Summary)

2. Standard of Care for Mobilization

3. Complications of Immobility
Circulatory System
• Loss of plasma volume
• Loss of orthostatic compensation
• Increased heart rate
• Development of DVT
Respiratory System
• Decreased lung volume
• Pooling of mucous
• Cilia less effective
• Decreased oxygen saturation
• Aspiration atelectasis
Gastrointestinal System
• Increased risk of aspiration
• Loss of appetite
• Decreased peristalsis
• Constipation
Musculoskeletal System
• Weakness
• Muscle atrophy
• Loss of muscle strength by 3-5%
• Calcium loss from bones
• Increased risk of falls due to weakness
Psychological
• Anxiety
• Depression
• Sensory deprivation
• Learned helplessness
• Delirium
Genitourinary System
• Incomplete bladder emptying
• Formation of calculi in kidneys and infection
Available as a printed resource

4. Standard of Care for Mobilization - Summary
Assess mobility A,B,C within 24 hours
Design plan of care
Monitor progress, update targets to support OPTIMAL mobilization
Interprofessional team collaboration
Goal: Progressive, scaled mobilization, at least three times daily

5. Assessment Algorithm

6. Mobility Assessment Algorithm
Available as a printed resource

7. Simplified Mobility Assessment Algorithm
Can they respond to verbal stimuli?
Can they roll side to side?
Can they sit at edge of bed?
Can they straighten one or both legs?
Can they stand?
Can they transfer to a chair?
Can they walk a short distance?
Mobility Level
Corporate Standard of Practice C B A
Available as a printed resource

8. A B C Mobility level (A,B,C) Staff Role Able to Ambulate
Ambulate 3x/day or more B
Transfer
Bed to Chair
Ensure up to chair 3x/day
Up to commode chair
Active ROM C
Cannot stand to transfer
Encourage to participate in care
Upright for meals
Active/passive ROM 3x/day
Assist with turns
Hoyer to chair 1x/day
Available as a printed resource

9. Patients who can Ambulate will be encouraged to:
Ambulate 3 times per day
Participate in personal care to greatest extent possible
Use the bathroom for toileting
Eat meals sitting in a chair

10. Patients who can transfer from Bed to chair will be encouraged to:
Get up to chair 3x/day preferably at meals
Commode for toileting
Active Range of Motion 3x per day
Participate in care to the greatest extent possible

11. Patients who Cannot stand to transfer:
Hoyer to Chair at least 1x daily
Upright or side of bed for meals, dangle legs
Active Range of Motion 3x per day
Encourage patient to be as active as possible in bed (personal hygiene, turning, self-feeding)
Turn every 2 hours when unable to participate in care

12. A Review of the ABC’s of Mobility
Ambulates with or without assistance A
Bed to chair transfers B
Cannot stand to transfer C

13. Staff Roles and Responsibilities
Daily assessment of mobility
Determine mobility level (A, B, C)
Set individual goals for patient
Ensure activity at least TID

14. Interprofessional Collaboration
A Case Study
Interprofessional Collaboration
From E Module