Doctor of Nursing Practice Program

• Committee Chair Name & Credentials:
  Ken Nelson, DNP, RN, NE-BC, CPHQ
• Committee Member Name & Credentials:
  Carol Callaway-Lane, DNP

DNP Project Abstract

Implementing a Nurse-Driven Mobilization Protocol for Patients on Mechanical Ventilation

Purpose
Mobilization of patients on mechanical ventilation is an aspect of the Intensive Care Unit liberation bundle established by the Society of Critical Care Medicine that is overlooked in many Critical Care settings. A lack of protocol for early mobilization is a common problem in many facilities. The purpose of this project is to evaluate the impact of implementing a nurse-driven early mobilization protocol on reducing ventilator days and the rate of re-intubation for patients on MV.

Methods
The method utilized in this project is retrospective chart reviews for 50 adult patients in the Medical ICU with acute respiratory failure who received any level of early mobilization while on MV. EM was associated with a reduction in overall ventilator days, reduced sedation and vasopressor needs, and a reduction in preventable complications.

Results
Subjective results obtained from staff through pre- and post- surveys revealed a positive change in staff attitudes and engagement. Objective results demonstrated reduced ventilator days and sedation needs, earlier extubation, reduced need for tracheostomy, improved sepsis survival, mortality index, and rate of readmission in patients who received mobilization compared to the prior practice of posponing mobilization until extubation.

Implications for Practice
Early mobilization of patients on mechanical ventilation is beneficial in improving patient outcomes and in reducing  healthcare cost through the prevention of complications and decreasing overall hospital days. Improvement in patient outcomes also led to increased job satisfaction for nurses and other members of the multidisciplinary critical care team.