A niche audience: Older adult patients benefit from award-winning mobility initiative
What started as an action plan to get older patients up and moving on the 6th Floor Acute Care Unit is spurring similar efforts throughout Penn State Health Milton S. Hershey Medical Center and gaining national attention.
“We created a mobility team of staff nurses and nursing assistants to champion the work, using a mobility assessment tool in collaboration with our physical therapists,” said Leandra Davis, assistant nurse manager on the floor and coordinator of Nurses Improving Care for Health System Elders, or NICHE, which identifies opportunities to promote age-friendly care.
Their successes caught the eye of the judges in the 2021 NICHE and American Board of Internal Medicine Foundation Choosing Wisely®️ Trailblazer Award, which recognizes clinical teams for improving care for older adults through the use of evidence-based practices.
Formally called proactive ambulation, the action plan involved 75 staff nurses and nursing assistants on the sixth floor who, working with physical therapists, captured individual mobility scores for patients and identified activities to improve their ability to move.
Patients with a high score might walk the hallways three times daily, while patients with a lower score work on range-of-motion exercises in bed.
“Increased mobility prevents functional decline, which is the major risk factor for older adults when hospitalized,” Davis said. “Mobility also decreases the risk for pressure injuries, and it’s good for patients’ cognitive and emotional health as well.”
The proof of success showed up in the numbers. The floor’s ambulation rate was 45 to 50% prior to the program and soared to 65 to 75% within the first year of implementation, Davis said. The staff was also elated to see that the floor had 0% hospital-acquired pressure injuries for four months following implementation of the proactive ambulation project.
“This initiative has really changed the culture of our unit to make mobility a priority,” Davis said. “We’re actively partnering with a group of nurses and physicians to spread these age-friendly initiatives throughout the hospital.”
Success often means home
“I’m extremely excited and proud of our unit,” Davis said. “The service and passion they show for our older adults is so impressive. They have worked tirelessly on this project for the past two years, even throughout COVID-19.”
The staff realizes that older adult patients have unique needs and often specific goals they want to work toward, such as going home.
“If they want to go home, let’s work toward getting them home,” Davis said. “We know we can actually improve their prognosis and help them realize their goals just by helping them improve their mobility, not to mention preventing other health-related problems.”
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