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Learning Objective 1: The learner will be able to utilize an interprofessional team to improve outcomes.
Learning Objective 2: The learner will be able to identify interventions to improve mobility in the hospitalized older adult.
The Geriatric Nursing Leadership Academy (GNLA) focuses on individual leadership development, advancing nursing practice, and expanding scope of influence within an organization, the nursing profession and the community. Individual goals of developing an effective team and maximizing collaboration between disciplines were achieved by utilizing the three domains.
Research shows that deconditioning occurs within two days of a hospitalization. Patients who increase their walking day one and two of admission have better outcomes than those who remain bedridden. Implementing a mobility program and changing the culture within an organization begins with educating staff on mobility and functional decline, sharing accountability, and utilizing data to demonstrate success. Therefore, a mobility initiative was implemented for geriatric patients within the acute care setting.
The early mobility initiative began on two nursing units. The staff was required to get patients out of bed for meals starting on the day of admission. The goals of this program were to decrease functional decline, falls, length of stay, readmission rates, and for patients return to their original living situation. To achieve this, an interprofessional team was formed that included a physician, physical therapist, nursing, patient care technicians, patient transporters, nursing education, volunteer services, and a nurse manager. Since implementation, improved mobility has been shown in patients who are out of bed for meals. As a result, the program will be implemented hospital wide starting September 2013. The next step for the mobility program is to introduce early and frequent ambulation during the hospital stay for those patients who meet criteria. Initial data has shown a increase in the percentage of patients out of bed for meals, decrease in the fall rate, and improvement in patient satisfaction as indicated by our Press Ganey scores.
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