Researchers have found that low and moderate levels of mobility are independently associated with greater functional decline in activities of daily living (ADLs) at discharge (Zisberg et al., 2011) and that bedrest promotes declines in muscle mass and muscle strength (Coker et al., 2014; Dirks et al., 2016). The negative effects of low mobility and immobility are recognized by nurses, yet most acute care nurses do not prioritize the mobilization of their patients. Interventions to increase mobilization of hospitalized patients may be more effective if they are barrier targeted. The purpose of this quality improvement project was to identify nurses’ perceived barriers to mobilizing patients on a medical-surgical unit in a community hospital. The project used a 26-item 5-point Likert style survey adapted from the Overall Provider Barriers survey; a validated self-administered survey developed by Hoyer et al. (2015). The survey identified nurses’ perceived barriers in three domains: knowledge, attitudes, and behaviors. A convenience sample of 28 nurses participated in the survey. Results demonstrated that three of the four most reported perceived barriers were in the behaviors domain, which assessed external factors that could influence the respondent’s decision to mobilize or to not mobilize a patient. The highest barriers in the behaviors domain were inadequate staffing, lack of time, and patient resistance to being mobilized. The third highest overall barrier was the perception that increasing patient mobilization would be more work for nurses. This item was in the attitudes domain, which assessed the respondent’s perception of patient safety, needs, and outcomes of mobilization and perception of available time, workload, and ability to mobilize patients. Results were consistent with previous studies that explored barriers to mobilization. Practical implications of the findings are discussed.
Quality improvement project to improve blood test time to results on the acute surgical unit in North Devon District Hospital
