Early Mobility for Critically Ill Patients: Building Staff Commitment Through Appreciative Inquiry
| Autor: | Nicholas A. Smyrnios, Joan Vitello, Michelle M Fernald |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Quality management Appreciative inquiry Critical Care Attitude of Health Personnel Critical Illness MEDLINE Nursing Staff Hospital Critical Care Nursing law.invention 03 medical and health sciences 0302 clinical medicine Documentation Nursing law Health care Medicine Humans 030212 general & internal medicine Early Ambulation Quality of Health Care Progressive mobility business.industry 030208 emergency & critical care medicine General Medicine Middle Aged Intensive care unit United States Facilitator Practice Guidelines as Topic Female business |
| Zdroj: | Critical care nurse. 40(4) |
| ISSN: | 1940-8250 |
| Popis: | Background Immobility contributes to many adverse effects in critically ill patients. Early progressive mobility can mitigate these negative sequelae but is not widely implemented. Appreciative inquiry is a quality improvement method/change philosophy that builds on what works well in an organization. Objectives To explore whether appreciative inquiry would reinvigorate an early progressive mobility initiative in a medical intensive care unit and improve and sustain staff commitment to providing regular mobility therapy at the bedside. Secondary goals were to add to the literature about appreciative inquiry in health care and to determine whether it can be adapted to critical care. Methods Staff participated in appreciative inquiry workshops, which were conducted by a trained facilitator and structured with the appreciative inquiry 4-D cycle. Staff members’ attitudes toward and knowledge of early progressive mobility were evaluated before and after the workshops. Performance of early progressive mobility activities was recorded before and 3 and 10 months after the workshops. Results Sixty-seven participants completed the program. They rated the workshops as successfully helping them to understand the importance of early progressive mobility (98%), explain their responsibility to improve patient outcomes (98%), and engender a greater commitment to patients and the organization (96%). Regarding mobility treatments, at 3 months orders had improved from 62% to 88%; documentation, from 52% to 89%; and observation, from 39% to 87%. These improvements were maintained at 10 months. Conclusion Participation in the workshops improved the staff’s attitude toward and performance of mobility treatments. Appreciative inquiry may provide an adjunct to problem-based quality improvement techniques. |
| Databáze: | OpenAIRE |
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