Twenty-plus years in nursing have given Ann Hendrickson, RN, BSN a lot of perspective on health care—not just the needs of individual patients, but of society in general.
Knowing that people are living longer, but often in greater need of care, Ann wanted to develop a program to help older patients get back on their feet—and out of the hospital quicker and healthier.
“Patients can lose up to 5% of their muscle strength every day on bed rest,” Ann said. “We need to increase their mobility, especially older patients.”
For her capstone project in the Clinical Nurse Specialist master’s degree program, Ann developed a “mobility protocol” for older adult patients that she is currently piloting on a medical unit at Upstate University Hospital.
“Let’s Get Moving: Making Strides Toward Wellness” is a four-month project involving approximately 300 patients.
At the onset of the project, Ann collected first quarter 2012 unit data on patient hospital length of stay, as well as data on patients’ functional abilities (eating, bathing, dressing, walking) when they were admitted and when they were discharged.
After introducing the mobility protocol to nurses on the pilot unit, she began collecting functional abilities data on patients — who are getting up and moving, independently or with help, at least 25 feet three times a day. After her project ends in December, she plans to present her findings to hospital administrators.
Besides losing strength by the day, older patients who don’t get up and move around are at greater risk for pressure ulcers (bedsores) and infections, Ann said. Then there’s the fall paradox. The less that patients walk, the more they’re at risk of falling when they do get up and start moving, she said. So, there’s all the more reason for increasing patients’ mobility from day one of admission.
Ann said her mobility protocol is designed to reinforce what a lot of nurses have been doing all along, although it wasn’t practiced consistently. “We need a system to improve what we’re already doing,” she said.
Significant change can be difficult and slow, but with positive reinforcement it can become contagious, Ann said. That’s why she uses footprint stickers as a whimsical way to encourage patients to walk and to emphasize mobility as a key to wellness. She has also enlisted hospital volunteers to encourage patients to increase their mobility through getting out of bed for meals and walking in the halls.
This kind of health care culture shift, where increasing mobility in older adults becomes a priority, not only will help individual patients, Ann said, but it will help hospitals save money (better care translates to better reimbursements) and will help the economy as a whole.
Seniors 65 and older—and there will be 90 million of them by 2050—will be healthier, live independently longer and stay out of hospitals and nursing homes.
“Mobility does help,” Ann said. “We do need a health care culture shift toward older adults, and this is the crux of it. Increasing mobility in older adults can lead to healthier seniors for years to come.”