As evidence shows, immobility can have devastating effects on patients, especially those who are already medically compromised. These negative effects include respiratory complications, development of pressure ulcers, muscle wasting and atrophy, development of contractures, and decreased functional endurance.
UCLA Health's "U Move" program was developed to create a "culture of mobility" for patients, making mobility a high priority for their recovery. The goal is for every inpatient in the health system to be on some sort of mobility program, ranging from exercise in bed to ambulating in the hallway. Development of the program was a highly collaborative team effort, including representatives from nursing, rehab, lift team, and safe patient handling across the health system.
At the core of the U Move program is an evidence-based mobility assessment called the BMAT: Banner Mobility Assessment Tool. This simple assessment, performed by the RN every shift, places the patient on one of four mobility levels. The mobility level is communicated to all team members through development of a corresponding care plan, patient story, and placement on the white board in the patient's room. Use of Safe Patient Handling equipment is incorporated into each mobility level. This way, a mobility goal can be set daily for each patient, with involvement of the patient, family, and other team members, and the daily goal can be reinforced by all who interact with the patient. As the patient progresses, the mobility level will change.
In addition to the BMAT, the U Move program includes UCLA "branding", such as educational posters, special gait belts and storage bags, screen savers, and distance markers to be placed in the hallways on every inpatient unit. These branding efforts will help to sustain the culture of mobility. Also included is streamlining of physician activity orders, to emphasize mobility and require a reason for a bed rest order. Measurements of success will include number of bed rest orders overall, % of patients with a mobility care plan, % of patients out of bed at least daily, pressure ulcer rate, CAUTI rate, length of stay, and others.
For questions, contact:
Jill Scherrey, MSN, RN-BC
Nursing Professional Development Specialist
Center for Nursing Excellence