Early Mobility for Critically Ill Patients: Building Staff Commitment Through Appreciative Inquiry
UMass Chan Affiliations
Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Graduate School of NursingUMass Memorial Medical Center
Document Type
Journal ArticlePublication Date
2020-08-01
Metadata
Show full item recordAbstract
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.Source
Fernald MM, Smyrnios NA, Vitello J. Early Mobility for Critically Ill Patients: Building Staff Commitment Through Appreciative Inquiry. Crit Care Nurse. 2020 Aug 1;40(4):66-72. doi: 10.4037/ccn2020251. PMID: 32737490. Link to article on publisher's site
DOI
10.4037/ccn2020251Permanent Link to this Item
http://hdl.handle.net/20.500.14038/34473PubMed ID
32737490Related Resources
ae974a485f413a2113503eed53cd6c53
10.4037/ccn2020251