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Affiliations

Aurora Sinai Medical Center

Presentation Notes

Quality Improvement poster presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.

Abstract

Background: Patients admitted to the adult intensive care unit (ICU) often experience ICU-acquired weakness (ICU-AW) consequential to their acute illness. Benefits of mobilization have been shown to decrease associated risks to the patient during hospitalization while limiting long-term effects.

Local Problem: Chart review suggested inconsistent activities for patients in the ICU and a need to focus attention on early and frequent mobilization, with opportunities to partner with the interdisciplinary team. Mobilization standards of practice were identified as a need to be included into the unit culture.

Methods: Gamification was used to promote mobilization of patients in the ICU, increase interdisciplinary collaboration, and encourage team engagement. Using a track and field Olympic theme, team members were challenged and updated weekly on the cumulative distance ambulated by all patients in the unit, team member who ambulated their patient the furthest, and team members who completed the most activities with their patients. “Brunch and learns” were utilized to enhance team member learning about the benefits of mobilization during admissions.

Results/Conclusions: Six months from the start of the Mobility Olympics, the average time from admission to first time out of bed decreased by 24%, the number of patients ambulating in the hall increased 37%, total distance ambulated by patients increased 132%, documented abnormal response to activity decreased by 50%, and the average length of stay decreased by 1.4 days. An unexpected finding was the enthusiasm and patients’ willingness to be active participants in their care.

Implications for Practice: Team members became highly engaged in mobility through friendly competition created by gamification, which can be used in other quality improvement initiatives. Sustainability includes recognition and celebration of milestones achieved, updates of continued progress, and unit standards of mobilization included in the orientation process. Interdisciplinary collaboration will be beneficial to support the needs of the patient during mobilization.

References

Bass, G., Chang, C., Sorce, L., Subramanian, S., Laytin, A., Somodi, R., Gray, J., Lane-Fall, M. & Kaplan, L. (2024). Gamification in critical care education and practice. Critical Care Explorations, 6 (1), e1034. doi: 10.1097/CCE.0000000000001034.

Bonn, J., Mulkey, D., & Goers, J. (2022). Using gamification to engage clinical nurses in quality improvement. Journal for Nurses in Professional Development, 39(5). https://doi.org/10.1097/nnd.0000000000000898

Dayton, K., Hudson, M., & Lindroth, H. (2023). Stopping delirium using the awake-and-walking intensive care unit approach: True mastery of critical thinking and the ABCDEF bundle. AACN Advanced Critical Care, 34(4), 359–366. https://doi.org/10.4037/aacnacc2023159

Rosa, D., Negro, A., Marcomini, I., Pendoni, R., Albabesi, B., Pennino, G., Terzoni, S., Destrebecq, A., & Villa, G. (2023). The effects of early mobilization on acquired weakness in Intensive Care Units. Dimensions of Critical Care Nursing, 42(3), 146–152. https://doi.org/10.1097/dcc.0000000000000575

Document Type

Poster

Publication Date

11-13-2024


 

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Nov 13th, 12:00 AM

ICU Mobility Olympics: Using gamification to go for gold

Background: Patients admitted to the adult intensive care unit (ICU) often experience ICU-acquired weakness (ICU-AW) consequential to their acute illness. Benefits of mobilization have been shown to decrease associated risks to the patient during hospitalization while limiting long-term effects.

Local Problem: Chart review suggested inconsistent activities for patients in the ICU and a need to focus attention on early and frequent mobilization, with opportunities to partner with the interdisciplinary team. Mobilization standards of practice were identified as a need to be included into the unit culture.

Methods: Gamification was used to promote mobilization of patients in the ICU, increase interdisciplinary collaboration, and encourage team engagement. Using a track and field Olympic theme, team members were challenged and updated weekly on the cumulative distance ambulated by all patients in the unit, team member who ambulated their patient the furthest, and team members who completed the most activities with their patients. “Brunch and learns” were utilized to enhance team member learning about the benefits of mobilization during admissions.

Results/Conclusions: Six months from the start of the Mobility Olympics, the average time from admission to first time out of bed decreased by 24%, the number of patients ambulating in the hall increased 37%, total distance ambulated by patients increased 132%, documented abnormal response to activity decreased by 50%, and the average length of stay decreased by 1.4 days. An unexpected finding was the enthusiasm and patients’ willingness to be active participants in their care.

Implications for Practice: Team members became highly engaged in mobility through friendly competition created by gamification, which can be used in other quality improvement initiatives. Sustainability includes recognition and celebration of milestones achieved, updates of continued progress, and unit standards of mobilization included in the orientation process. Interdisciplinary collaboration will be beneficial to support the needs of the patient during mobilization.

References

Bass, G., Chang, C., Sorce, L., Subramanian, S., Laytin, A., Somodi, R., Gray, J., Lane-Fall, M. & Kaplan, L. (2024). Gamification in critical care education and practice. Critical Care Explorations, 6 (1), e1034. doi: 10.1097/CCE.0000000000001034.

Bonn, J., Mulkey, D., & Goers, J. (2022). Using gamification to engage clinical nurses in quality improvement. Journal for Nurses in Professional Development, 39(5). https://doi.org/10.1097/nnd.0000000000000898

Dayton, K., Hudson, M., & Lindroth, H. (2023). Stopping delirium using the awake-and-walking intensive care unit approach: True mastery of critical thinking and the ABCDEF bundle. AACN Advanced Critical Care, 34(4), 359–366. https://doi.org/10.4037/aacnacc2023159

Rosa, D., Negro, A., Marcomini, I., Pendoni, R., Albabesi, B., Pennino, G., Terzoni, S., Destrebecq, A., & Villa, G. (2023). The effects of early mobilization on acquired weakness in Intensive Care Units. Dimensions of Critical Care Nursing, 42(3), 146–152. https://doi.org/10.1097/dcc.0000000000000575

 

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