Published Online:October 23, 2017https://doi.org/10.3928/19404921-20171023-01
Abstract
Hospitalized older adults who do not receive sufficient mobility are more likely to sustain negative health outcomes, including higher rates of mortality and institutionalization. Accordingly, the purpose of the current secondary data analysis was to examine the nurse-promoted mobility of hospitalized older adults and the association between nurses' barriers and nurse-promoted mobility. In addition, the relationship among patient severity of illness, proxy levels for function, and nurse-promoted mobility was examined. The final study sample included 61 nurses working in medical units caring for a total of 77 older adults. Findings suggest nurse knowledge gaps and attitude barriers could potentially influence the type and frequency of mobility they promote in older patients. A relationship was found between older patients with impaired mobility using assistive devices for mobility at home, and those at high risk for falls and nurses promoting more sedentary activity (e.g., chair sitting, walking in the room). Interestingly, nurses promoted significantly more sedentary mobility for patients with physical therapy orders.
[Res Gerontol Nurs. 2018; 11(1):17–27.]
- Allen E., Seaman C.A. (2007). Likert scales and data analyses. Quality Progress, 40, 64–65. Google Scholar
- American Nurses Association. (2015). Policy agenda for nurse-led care coordination. Retrieved from http://www.nursingworld.org/DocumentVault/Health-Policy/ANAs-Policy-Agenda-for-Nurse-Led-Care-Coordination.pdf Google Scholar
- Baggaley A.R., Hull A.L. (1983). The effect of nonlinear transformations on a Likert scale. Evaluation & the Health Professions, 6, 483–491.
10.1177/016327878300600408 Crossref, Google Scholar - Barber E.A., Everard T., Holland A.E., Tipping C., Bradley S.J., Hodgson C.L. (2015). Barriers and facilitators to early mobilisation in intensive care: A qualitative study. Australian Critical Care, 28, 177–182.
10.1016/j.aucc.2014.11.001 Crossref, Google Scholar - Beveridge C., Knutson K., Spampinato L., Flores A., Meltzer D.O., Van Cauter E., Arora V.M. (2015). Daytime physical activity and sleep in hospitalized older adults: Association with demographic characteristics and disease severity. Journal of the American Geriatrics Society, 63, 1391–1400.
10.1111/jgs.13520 Crossref, Google Scholar - Bolker B.M., Brooks M.E., Clark C.J., Geange S.W., Poulsen J.R., Stevens M.H.H., White J.-S.S. (2009). Generalized linear mixed models: A practical guide for ecology and evolution. Trends in Ecology & Evolution, 24, 127–135.
10.1016/j.tree.2008.10.008 Crossref, Google Scholar - Boltz M., Capezuti E., Shabbat N., Hall K. (2010). Going home better not worse: Older adults' views on physical function during hospitalization. International Journal of Nursing Practice, 16, 381–388.
10.1111/j.1440-172X.2010.01855.x Crossref, Google Scholar - Brown C.J., Foley K.T., Lowman J.D., MacLennan P.A., Razjouyan J., Najafi B., Allman R.M. (2016). Comparison of posthospitalization function and community mobility in hospital mobility program and usual care patients: A randomized clinical trial. JAMA Internal Medicine, 176, 921–927.
10.1001/jamainternmed.2016.1870 Crossref Medline, Google Scholar - Brown C.J., Roth D.L., Allman R.M., Sawyer P., Ritchie C.S., Roseman J.M. (2009). Trajectories of life-space mobility after hospitalization. Annals of Internal Medicine, 150, 372–378.
10.7326/0003-4819-150-6-200903170-00005 Crossref Medline, Google Scholar - Burke K.G., Doody O. (2012). Nurses' perceptions of their role in rehabilitation of the older person. Nursing Older People, 24, 33–38.
10.7748/nop2012.03.24.2.33.c8956 Crossref, Google Scholar - Cabana M.D., Rand C.S., Powe N.R., Wu A.W., Wilson M.H., Abboud P.A., Rubin H.R. (1999). Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA, 282, 1458–1465.
10.1001/jama.282.15.1458 Crossref, Google Scholar - Cadogan M., D'Ambruoso S. (2012). Recognizing hospital-acquired disability among older adults. Journal of Gerontological Nursing, 38(12), 12–15.
10.3928/00989134-20121106-06 Link, Google Scholar - Carmines E.C., Zeller R.A. (1979). Reliability and validity assessment (Vol. 17). Beverly Hills, CA: Sage.
10.4135/9781412985642 Crossref, Google Scholar - Catchpole K. (2013). Spreading human factors expertise in health-care: Untangling the knots in people and systems. BMJ Quality & Safety, 22, 793–797.
10.1136/bmjqs-2013-002036 Crossref, Google Scholar - Conn V.S., Rantz M.J., Wipke-Tevis D.D., Maas M.L. (2001). Designing effective nursing interventions. Research in Nursing & Health, 24, 433–442.
10.1002/nur.1043 Crossref, Google Scholar - Cruz-Jentoft A.J., Baeyens J.P., Bauer J.M., Boirie Y., Cederholm T., Landi F., Zamboni M. (2010). Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age and Ageing, 39, 412–423.
10.1093/ageing/afq034 Crossref, Google Scholar - Dermody G., Kovach C.K. (2017). Nurses' experience with and perception of barriers to promoting mobility in hospitalized older adults: A descriptive study. Journal of Gerontological Nursing, 43(11), 22–29.
10.3928/00989134-20170518-01 Link, Google Scholar - Doenges M.E., Moorhouse M.F., Murr A.C. (2014). Nursing care plans: Guidelines for individualizing client care across the life span (9th ed.). Philadelphia, PA: F.A. Davis. Google Scholar
- Doherty-King B., Bowers B. (2011). How nurses decide to ambulate hospitalized older adults: Development of a conceptual model. The Gerontologist, 51, 786–797.
10.1093/geront/gnr044 Crossref Medline, Google Scholar - Doherty-King B., Bowers B.J. (2013). Attributing the responsibility for ambulating patients: A qualitative study. International Journal of Nursing Studies, 50, 1240–1246.
10.1016/j.ijnurstu.2013.02.007 Crossref Medline, Google Scholar - Doherty-King B., Yoon J.Y., Pecanac K., Brown R., Mahoney J. (2014). Frequency and duration of nursing care related to older patient mobility. Journal of Nursing Scholarship, 46, 20–27.
10.1111/jnu.12047 Crossref Medline, Google Scholar - Du W.-J., Tan J.-P., Yi F., Zou Y.-M., Gao Y., Zhao Y.M., Wang L.-N. (2015). Physical activity as a protective factor against depressive symptoms in older Chinese veterans in the community: Result from a national cross-sectional study. Neuropsychiatric Disease and Treatment, 11, 803–813.
10.2147/ndt.s80295 Crossref, Google Scholar - Ebright P.R., Patterson E.S., Chalko B.A., Render M.L. (2003). Understanding the complexity of registered nurse work in acute care settings. Journal of Nursing Administration, 33, 630–638.
10.1097/00005110-200312000-00004 Crossref Medline, Google Scholar - Faul F., Erdfelder E., Buchner A., Lang A.-G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41, 1149–1160.
10.3758/BRM.41.4.1149 Crossref Medline, Google Scholar - Faul F., Erdfelder E., Lang A.-G., Buchner A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175–191.
10.3758/BF03193146 Crossref Medline, Google Scholar - Fisher S.R., Goodwin J.S., Protas E.J., Kuo Y.F., Graham J.E., Ottenbacher K.J., Ostir G.V. (2011). Ambulatory activity of older adults hospitalized with acute medical illness. Journal of the American Geriatrics Society, 59, 91–95.
10.1111/j.1532-5415.2010.03202.x Crossref, Google Scholar - Fisher S.R., Graham J.E., Krishnan S., Ottenbacher K.J. (2016). Predictors of 30-day readmission following inpatient rehabilitation for patients at high risk for hospital readmission. Physical Therapy, 96, 62–70.
10.2522/ptj.20150034 Crossref, Google Scholar - Fisher S.R., Graham J.E., Ottenbacher K.J., Deer R., Ostir G.V. (2016). Inpatient walking activity to predict readmission in older adults. Archives of Physical Medicine and Rehabilitation, 97(Suppl. 9), S226–S231.
10.1016/j.apmr.2015.09.029 Crossref, Google Scholar - Garrison G.M., Mansukhani M.P., Bohn B. (2013). Predictors of thirty-day readmission among hospitalized family medicine patients. Journal of the American Board of Family Medicine, 26, 71–77.
10.3122/jabfm.2013.01.120107 Crossref, Google Scholar - Hoyer E.H., Brotman D.J., Chan K.S., Needham D.M. (2015). Barriers to early mobility of hospitalized general medicine patients: Survey development and results. American Journal of Physical Medicine & Rehabilitation, 94, 304–312.
10.1097/PHM.0000000000000185 Crossref Medline, Google Scholar - Jensen M.D., Ryan D.H., Apovian C.M., Ard J.D., Comuzzie A.G., Donato K.A., Yanovski S.Z. (2014). 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation, 129(Suppl. 2), S102–S138.
10.1161/01.cir.0000437739.71477.ee Crossref Medline, Google Scholar - Jolley S.E., Regan-Baggs J., Dickson R.P., Hough C.L. (2014). Medical intensive care unit clinician attitudes and perceived barriers towards early mobilization of critically ill patients: A cross-sectional survey study. BMC Anesthesiology, 14, 84.
10.1186/1471-2253-14-84 Crossref Medline, Google Scholar - Knowles S., Lam L.T., McInnes E., Elliott D., Hardy J., Middleton S. (2015). Knowledge, attitudes, beliefs and behaviour intentions for three bowel management practices in intensive care: Effects of a targeted protocol implementation for nursing and medical staff. BMC Nursing, 14, 6.
10.1186/s12912-015-0056-z Crossref Medline, Google Scholar - Lamb G., Newhouse R., Beverly C., Toney D.A., Cropley S., Weaver C.A., Peterson C. (2015). Policy agenda for nurse-led care coordination. Nursing Outlook, 63, 521–530.
10.1016/j.outlook.2015.06.003 Crossref, Google Scholar - Leditschke I.A., Green M., Irvine J., Bissett B., Mitchell I.A. (2012). What are the barriers to mobilizing intensive care patients?Cardiopulmonary Physical Therapy Journal, 23, 26–29. Crossref Medline, Google Scholar
- Lee C.M., Fan E. (2012). ICU-acquired weakness: What is preventing its rehabilitation in critically ill patients?BMC Medicine, 10, 115.
10.1186/1741-7015-10-115 Crossref Medline, Google Scholar - Lehman C.A. (2009). Practical issues in conducting hospital-based research. Perioperative Nursing Clinics, 4, 269–276.
10.1016/j.cpen.2009.05.008 Crossref, Google Scholar - Little R.J.A. (1988). A test of missing completely at random for multivariate data with missing values. Journal of the American Statistical Association, 83, 1198–1202.
10.1080/01621459.1988.10478722 Crossref, Google Scholar - Liu S.K., Montgomery J., Yan Y., Mecchella J.N., Bartels S.J., Masutani R., Batsis J.A. (2016). Association between hospital admission risk profile score and skilled nursing or acute rehabilitation facility discharges in hospitalized older adults. Journal of the American Geriatrics Society, 64, 2095–2100.
10.1111/jgs.14345 Crossref, Google Scholar - Moore J.E., Mascarenhas A., Marquez C., Almaawiy U., Chan W.H., D'Souza J., Straus S.E. (2014). Mapping barriers and intervention activities to behaviour change theory for Mobilization of Vulnerable Elders in Ontario (MOVE ON), a multi-site implementation intervention in acute care hospitals. Implementation Science, 9, 160.
10.1186/s13012-014-0160-6 Crossref Medline, Google Scholar - Pedersen M.M., Bodilsen A.C., Petersen J., Beyer N., Andersen O., Lawson-Smith L., Bandholm T. (2013). Twenty-four-hour mobility during acute hospitalization in older medical patients. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 68, 331–337.
10.1093/gerona/gls165 Crossref Medline, Google Scholar - Peterson S.J., Braunschweig C.A. (2016). Prevalence of sarcopenia and associated outcomes in the clinical setting. Nutrition in Clinical Practice, 31, 40–48.
10.1177/0884533615622537 Crossref, Google Scholar - Pilotto A., Franceschi M., DiBara M., Rengo F., Berabei R., Lorenzoni L., Greco A. (2011). The ability of the all patient refined (APR) and Centers for Medicare (CMS) diagnosis related groups (DRG) systems to evaluate clinical and functional outcomes of hospitalized elderly patients: A multicenter, prospective study. Journal of Public Health and Epidemiology, 3, 248–253. Google Scholar
- Sollecito W.A., Johnson J.K. (2011). McLaughlin and Kaluzynsky's continuous quality improvement in health care (4th ed.). Burlington, MA: Jones & Bartlett. Google Scholar
- Woolf S.H. (1993). Practice guidelines: A new reality in medicine. III. Impact on patient care. Archives of Internal Medicine, 153, 2646–2655.
10.1001/archinte.1993.00410230060008 Crossref Medline, Google Scholar - Zisberg A., Syn-Hershko A. (2016). Factors related to the mobility of hospitalized older adults: A prospective cohort study. Geriatric Nursing, 37, 96–100.
10.1016/j.gerinurse.2015.10.012 Crossref, Google Scholar
