A Multidisciplinary Approach to Improve Mobility in Acute Stroke Patients

Abstract

Stroke is a seriously debilitating condition that occurs suddenly and affects individuals' activities of daily living. Guidelines for stroke rehabilitation provide clear treatment recommendations for improving overall mobility and are often recommended as soon as 24 hours after a stroke event (Winstein et al., 2016). There is sufficient evidence to support mobility practices in an in-patient setting, and it is critical to screen acute stroke patients for early mobilization and provide daily mobility goals. At an academic hospital in Southern California, acute stroke patients are often observed to be sedentary or lying in a bed during a hospital stay. The project setting took place in a 32-bed neurology progressive care unit over a period of six months. The quality improvement project aimed to impact outcomes in acute stroke patients by using a multidisciplinary approach to care by providing daily mobility goals and increasing the mobilization provided by nursing staff. The Plan Do Study Act model was used to conduct the project, and, with permission from the Johns Hopkins Mobility Team, a mobility tool was used as an effective strategy to improve communication among interdisciplinary staff (Johns Hopkins Physical Medicine and Rehabilitation, 2022). The project’s primary objective was to standardize mobility practices and decrease the silos to improve multi-disciplinary communication concerning mobility, and increase staff comfort and participation in safe patient mobility. The project objectives focused on staff education on the designated unit, improvement in mobility scores within the stroke population, and impact on the nursing culture in patient mobilization. The project demonstrated that in-patient mobility practices are feasible as a part of hospital workflow and showed statistically significant improvements in outcomes. Improvements in outcomes included using a standardized process for early mobility, providing daily mobility goals for stroke patients, and improving outcomes by limiting the variation in acute stroke rehabilitation.