Promoting Collegial Relationships
Patients gain strength in Project Walk
Keep moving – it’s the 21st century mantra for staying healthy. A team of nurses and physical therapists (PTs) have taken that mantra to heart by creating and implementing an innovative, interprofessional program called “Project Walk.”
Drawing from evidence-based literature, the Project Walk team focused on early, progressive mobilization as a way to decrease length of stay and prevent hospital-acquired conditions while providing patients with a “world tour” during their stay at the hospital.
“The most compelling aspect of Project Walk is the shared responsibility across the two disciplines [nursing and physical therapy] to assess each patient and get an individualized mobility plan in place. Together, we found a way to quickly and efficiently provide individualized care to our patients,” said Clinical Nurse Leader Meghan Conroy Sweis, MSN, RN, who was involved in the pilot and expansion of Project Walk.
Beginning with small steps in a surgical unit in 2014, nurses and PTs quickly saw results by getting patients up and out of bed and taking strolls across the unit.
“The key is to reduce the incidents of deconditioning that happens because of immobility,” said Marla Robinson MSc, OTR/L, BCPR, FAOTA, Assistant Director of Inpatient Therapy Services. When patients’ muscles become weak from being confined to a hospital bed, “they are at higher risk for falls and pressure sores and blood clots,” said Robinson, who helped spearhead the program. “We wanted the project to look at all those data points and ask, ‘How can we make this better?’”
From the onset, nurses and PTs monitored patient outcomes, including falls, pressure injuries, blood clots and length of stay. Siting early successes, nurses, physical therapists and physicians implemented an evidence-based program that motivates patients to get up and move more quickly after surgery or other hospital stays.
Nurses provided education sessions to other nurses and therapists about the program and expectations, she said.
“The message was: It’s everybody’s responsibility to move our patients,” Robinson said.
Project Walk expanded into the Big Walk in February 2016 in all adult inpatient units.
Through a partnership with the Healing Arts Program, units have different types of artwork, from footprints to modern art photography and images of Italy, France, Dubai and Rome to make for a “world tour.”
“This helps us to measure how far a patient moved based on how much of the world tour they walked,” Sweis said. “What’s most exciting to the Project Walk team is how physical therapists and nurses are sharing the way they evaluate patients.”
Before Project Walk, nurses scheduled evaluations with physical therapists who determined what type of therapy the patient needed. Through Project Walk and the Big Walk, nurses learned to evaluate patients via a physical therapy protocol and determine their mobility needs.
“The routine evaluation of patient mobility by nurses helps the physical therapists prioritize their consults and see high priority patients first,” Sweis said. “Nursing staff is empowered by this process to help lower acuity patients start moving sooner.”
The process has been invigorating, Sweis said. “The collaborative efforts between nursing, therapists and clinicians across the hospital to promote early mobility is inspiring to us all. And in the long-term, we look forward to taking a team approach to pave the way for more strides at UCM.”
The professional nursing staff has many opportunities to collaborate with interprofessional teams in leading organizational change to support excellent clinical outcomes for our patients. We are able to work with the interprofessional teams through our commitment to utilize respectful and professional communications.