Abstract

Problem: When geriatric patients are immobilized or placed on bedrest, loss of function and decreased activity levels are common. Prolonged immobility is associated with a decline in muscle strength and mass, as well as physical and cognitive function, thereby leading to delays in functional recovery as well as delays in hospital discharge. The purpose of this project was to address the consequences of prolonged immobility in hip fracture patients and evaluate a potential solution to improve patient outcomes.

Intervention: Nursing staff initiated an early mobility intervention that comprised of mobilization of hip fracture patients on the day of surgical repair. The early mobility intervention included dangling the patient on the side of bed and performing range of motion exercises to the upper extremities within 8 hours of patient returning from surgery. The intervention was repeated on post-operative day one.

Measures: Hospital length of stay and prevalence of hospital acquired delirium was evaluated in the pre and post intervention group. Delirium was assessed by nurses utilizing the Nurse Delirium Screening Scale (NuDESC). The prevalence of positive delirium scores at discharge were compared in the pre and post intervention group.

Results: Results of the study were clinically significant (length of stay decreased by 0.7 days and hospital acquired delirium at discharge decreased from 20% to 0%); however, not statistically significant (Hospital Length of Stay: t(19.579)= (-0.92572), p = 0.3659, Presence of hospital acquired delirium: χ2(1) = 0.11324, p = .7365).

Conclusion: Early mobilization on the day of surgery decreased hospital LOS and the prevalence of hospital acquired delirium. Additionally, the study found that initial mobilization of hip fracture patients can safely and effectively be performed by bedside nursing staff.

Description

Tool(s) Used: Nurse Delirium Screening Scale and The Institute for Healthcare Improvement's Age Friendly Health Systems 4M's Framework

Author Details

Christina Vejnovich, DNP, RN, AGCNS-BC, PCCN-K

Sigma Membership

Tau Tau

Lead Author Affiliation

Nebraska Methodist College, Omaha, Nebraska, USA

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Early Mobilization of Hip Fractures, Early Mobility, Hip Fractures, Geriatric Patients, Hip Fragility, Early Mobility Protocols

Advisor

Kinney, Meg

Second Advisor

Hall, Lyndsi

Degree

DNP

Degree Grantor

Nebraska Methodist College

Degree Year

2021

Creative Commons License

Creative Commons Attribution-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-No Derivative Works 3.0 License.

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Review Type

Faculty Approved: Degree-based Submission

Acquisition

Self-submission

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