Nursing Staff Perceptions and Fall Rates with a Quality Improvement Project for Mobility Screening and Written Bedside Communication: A Pretest-Posttest Design

Communication between healthcare personnel regarding patient mobility status is essential to protect the patient and the healthcare worker. This paper describes the development, implementation, and results of a decision-making algorithm and bedside communication diagram related to patient mobility. A patient mobility assessment and bedside communication diagram was developed and implemented on 4 nursing units. Nurses and nursing assistants participated in a self-efficacy survey before and 6 months after its implementation. Weighted kappa statistics were examined for survey items to assess for differences before and after implementation. Eighteen months of quarterly falls data were descriptively analyzed. A total of 183 presurveys and 110 postsurveys were completed. Weighted kappa statistics (n = 26) suggested participants’ responses changed pre- to postsurvey (κ = 0.07-0.29, 95% CI). A decreasing trend was also noted in the total number of falls and unassisted falls in the units that had implemented the mobility communication tool versus those units that had not (m = -0.0441 vs. 0.0556, m = -0.0101 vs. 0.0503).  By providing a mobility status for patients, nursing staff reported improved self-efficacy related to patient mobility. Quarterly falls data trended toward a difference in total falls and unassisted falls over 18 months. This study reinforces the benefit of standardization of an easily accessible communication method for patient mobility.

Wilson C, Richards N, Slavin B, Siedell J, Jagow D, Gomez S, Perlaki B

Keywords: safe patient handling, mobility, handoff, physical therapy, falls, communication