University of New Mexico Health Sciences Center

Early Ambulation Project

November 22nd, 2012

/ 1400-1500 / Pink Administrative Conference Room
Physician ProjectLleader / Sheila Modi (A) / Yosef Raskin / Anju Modi / Peggy Beeley
Nursing Leadership / Mari Fraire / Dorte Hartwig
Additional Members
Topic / Discussion /

Recommendations/Actions

/

Follow-up

Call to order / A quorum was established. / Chaired by Peggy Beeley, MD for Sheila Modi
MinuteApproval / 1st Meeting
Project Purpose / This group will develop an early ambulation protocol to be used for all medicine patients, as well as a plan for education and implementation of this protocol.
Statement of the Problem / Medicine patients tend to remain in bed for prolonged periods during hospitalization which results in functional decline and decreased quality of life (and often prevents discharge to home), increased hospital complications, and increased length of stay. We focus on fall prevention which often results in patients being told to remain in bed. Also we rely on PT/OT for basic ambulation needs which can often be provided by nursing and patient care staff.
Scope of Work / This group will develop a protocol, develop a plan for education and implementation of the protocol, and collect before/after data to measure the effect of the initiative, and have ongoing evaluations to continue to reassess needs and potentially refine the protocol in order to reach desired outcomes.
Project Objectives / SMART- specific, measurable, attainable, relevant, targeted to audience
  • Increase mobility in all medicine inpatients and prevent functional decline as a result of hospitalization. *need to make this more specific, measurable*
  • Rates of d/c to home vs rehab/SNF/NH in pts who came from home
  • Decrease hospital complications for medicine inpatients
  • Falls
  • Hospital acquired infections/ CaUTI/HAP
  • Constipation/ileus – unclear how to measure
  • Occurrence of delirium
  • Decreased average length of stay & cost
  • LOS
  • Cost –include inpatient, facility placement or nursing home
  • Improve utilization of PT/OT services
/ -Provider documentation
-Nurse data base
Consider use of Barthel Index
Consider nurse initiated PT/OT evaluation on admission
See if data on time interval from PT consult to evaluation can be determined
Ambulation protocol for Surgery patients
Include list of potentially avoidable tethering processes
Consider adding New Pressure ulcers as a complication. / -Yosef to look to see what information on functional status is available in the chart
– Mari to investigate if PT/OT can be added to nursing orders
–Peggy to email Heidi to see if this time to eval is available
– Mari to contact Nicole for this protocol
– Peggy will bring indications for telemetry, Foleys to next large group
Future Agenda Items /
  • Determine Location
  • Final determination of Key Deliverables
  • Early ambulation protocol
  • Education plan
  • Implementation plan
  • Need for IRB approval
  • Data collection
/ Include both 4 West and 5 West for broader patient polulation and severity of illness
Meeting Logistics / Determine location and time of meetings / Meet monthly, after 2 pm is preferred by staff
Location is TBA
Adjourn at 1500

SUBMITTED: ______APPROVED: ______

Peggy Beeley, MD Sheila Modi, Project Leader

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