NR 631- Nurse Executive Concluding Graduate Experience

Abstract Summary of Project Topic At my organization, the average percent for compliance of mobility documentation is 69%. The goal of the practicum project is to increase mobility and mobility documentation compliance to 82% organization wide. The barriers that have prevented nursing staff from documenting mobility includes staffing shortage issues, lack of ability to document in real time, and lack of education regarding the importance of mobility and the documentation requirements. Mobility can decrease the number of falls in a hospital setting because it decreases the patient’s risk of becoming deconditioned and weak. Patient’s who are admitted to the hospital are less likely to ambulate and become more deconditioned which can lead to a longer length of stay and an increased chance of having to go to a skilled nursing facility for continued rehab, which can delay discharge and further patient deconditioning. Evidenced- based practice has suggested that when patients are offered mobility during purposefully rounding, they are less likely to attempt to get out of bed without assistance and therefor decreases the chance of the falls. My practicum project will be implementing a work flowsheet on our mobile EMR system called the ROVER and will allow nursing staff the opportunity to document mobility when mobilization occurs. By implementing a way to document in real time will assist with increasing compliance with mobility documentation. For the CGE project, I have worked with my organizations Fall’s Prevention Committee, my mentor, nursing informatics, education department, and a nurse analyst to create an education piece that will be shared to all nursing staff to educate staff regarding the new workflow sheet that allows staff to document mobility on the Rover device. After the education is approved by the education committee, it will be assigned to all nursing staff to complete the online education. This project will run until November 2022. The education piece is currently in the process of 4 being approved by the education committee at the June monthly meeting. After the education is officially approved, the education department will assign each nursing staff the education module. As the project manager, I will look at the monthly unit report cards for each unit to see if the metrics have had an increase in mobility compliance. Currently, my unit is at 42% for mobility compliance and the organizations’ goal is 83%. For the month of May, my unit had a total of five falls and two of those falls were with injury. When looking at monthly metrics, I will look at the number of falls per month and the percentage of mobility compliance to see if there is an increase in mobility documentation compliance and a decrease in falls. By looking at these metrics monthly, it will allow me to discuss with staff any barriers they see are preventing them from utilizing the new intervention from the project. 5 Literature Review: Mobile EMR to Increase Compliance for Mobility Documentation According to the Agency for Healthcare Research and Quality, between 700,000 and 1,000,000 people in the United States fall in the hospital resulting in fractures, lacerations, or internal bleeding, leading to increased health care utilization (Agency for Healthcare Research and Quality, 2021). Falls are an issue healthcare organization all over have been working to prevent and a review of evidence-based literature has suggested that there are current interventions in practice to assist with preventing falls. Healthcare organizations look at quality metrics regarding mobilization and currently documentation compliance for mobility at my organization is 69%. In this paper I will discuss the current evidence- based literature regarding falls, mobility, mobility documentation, and the current interventions for all, how the current evidence- based literature relates to my practicum project, and an analysis of the literature. Review of Evidence Based Literature Mobility is an important aspect of nursing that can contribute to patient healing and decrease the length of stay for patients. Immobility in the hospital can lead to the development of hospital acquired conditions including pressure ulcers, pneumonia, blood clots, and physical deconditioning. According to Dewitt et al., ambulation of patients remains one of the most ignored patient care activities (Dewitt et al., 2019). There could be many different things attributing to mobility being one of the most ignored patient care activities including lack of time, fear of patient falling, and lack of knowledge of proper mobility techniques. Many nurses look to the physical therapist for their input and rely on the physical therapist to mobilize their patients. Although it is good to have input from the physical therapist regarding the patient’s assistance level, the physical therapist is not used to solely mobilize the patient but instead are there to evaluate the patients in an acute care setting to make recommendations for further