Ambulation Case

Increasing patient mobility, through ambulation, will decrease patient's length of hospitalization, and decrease organizational costs.

Check list for Discharge teaching material collection by the UAP

o UAP is familiar with client's usual care and needs.

o UAP understands instructions and direction on how to collect teaching materials.

o UAP validates with RN the right materials have been collected.

o UAP has teaching materials ready as needed by the patient or at the time of discharge of the patient.

GROUP 4 DELEGATION PROJECT

Our setting is an acute care facility, specifically dealing with restorative processes for clients with mobility issues.

After an annual review and evaluation of our patient outcomes, the nursing department found that they had lower than expected government reimbursements due to noncompliance with DRGs and a higher than expected readmission of clients.

The committee gathered a team including staff from:

Nurse Education, Physical Therapy, Policy and Protocol/Standards and Actions, Nurse Manager, Head UAP, Safety Office, Home Health, _______________, _____________________, etc.

(Other members?)

To problem solve, the committee read current literature and research, and compared protocols followed in other facilities. They found that patient outcomes would be improved by more regular periods of ambulation. This would both raise the level of reimbursement and lower the rate of readmission.

The team found that client reasons for non-compliance were lack of regular assistance and direction to ambulate. They also found that the staff nurses had a high ratio of patients so they were unable to provide the frequent assistance with ambul

(We have to identify two potential barriers to our plan's successful implementation...)

Solutions to potential barriers are...

(and their solutions!)

1) Staff education department will develop an appropriate teaching and certification class with the input of the RNs.

2) UAPs will get a pay raise or bonus for acquiring new skills that help both the clients and the staff.

3) Nurses and UAP are required to build rapport when throughout completing this task.

(Ideas?)

STUDY:

The nurse is present with the UAP the first time skill is completed or until UAP completes the skill successfully.

Or until the UAP feels confident enough to perform task independently

RN evaluated the effectiveness of the intervention by 1) client feedback, 2) monitoring whether or not compliance with care plan increased, 3) client demonstrating return knowledge/skill

(Others?)

PT monitored improvement by assessing percentage of return to function.

(Others?)

The nursing department monitored effectiveness by measuring changes in 1) length of stay and 2) number of readmissions.

(Others?)