Corona Update: SURGE CAPACITY SOLUTIONS – The mobi is a mobile headwall (equipment consolidator) that can be set up in any space that has an electrical outlet: next to a chair, a bed, a cot in a hallway, a cafeteria, or anywhere patients need to be located. Click here for more information.

Tag: early mobility

Preparing For Hospital Overflow

Posted on by Steve Villanueva

Are Hospitals Ready for the Coronavirus?

Preparing for Hospital overflow UPDATE

Preparing for hospital overflow. Hospital overflow crisis. Right now, hospitals in Spain and Italy have become hopelessly overwhelmed. Healthcare workers are releasing video clips that show coronavirus patients packed onto chairs and lying on floors, waiting for medical attention. Resources are so scarce that patients are lying on jackets and using their own bags as pillows. Healthcare facilities have fewer and fewer options for situating patients that desperately need access to multiple pieces of medical equipment, and as conditions in the United States worsen, these scenes may become all too common. Read our article here.

The mobi is a headwall (equipment consolidator) that can be set up in any space that has an electrical outlet: next to a chair, a bed, a cot in the hallway, a cafeteria, or anywhere patients need to be located. The mobi also enables safe early patient mobility improving patient outcomes and decreasing Length of Stay by up to 30%.

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Preparing For Hospital Overflow

Posted on by Steve Villanueva

Are Hospitals Ready for the Coronavirus?

Hospital Overflow Crisis: On January 30, 2020, the World Health Organization declared the outbreak of the coronavirus (“COVID-19”) a “public health emergency of international concern;”1 a few weeks later, the Center for Disease Control & Prevention announced that “at some point, widespread transmission of COVID-19 in the United States will occur,” warning that “public health and healthcare systems may become overloaded, with elevated rates of hospitalizations and deaths,” and that emergency medical services, healthcare providers, and hospitals “may be overwhelmed.”1 Three weeks after the introduction of the coronavirus, hospitals in Italy are operating at 200% patient capacity, and Giulio Gallera, the top health official in Lombardy describes the search for more acute care beds as a “race against time.”2 In the US, the medical director Dr. John Hick echoes this warning, saying that: “People don’t understand how close the health system runs to capacity every day. We just don’t have the trained staff to staff much beyond what we have now. Patients are waiting in the emergency department in many cities on a routine basis. Then you talk about adding a pandemic onto that? There are going to be compromises.” So, what creative options are available for maximizing existing hospital space?

PART I: Preparing for Hospital overflow

Hospital Overflow Solution: The mobi is an equipment consolidator that can be set up in any space that has an electrical outlet: next to a chair, a bed, a cot in the hallway, a cafeteria, or anywhere patients need to be located, allowing for monitors, ventilators, pumps, and IV poles to be continually with the patient.

Key Facts:

  • 10% of the patients who test positive for coronavirus must be admitted to intensive-care units.3
  • According to the American Hospital Association, since 1975, the improvements in medical practice, pharmaceuticals, and outpatient options (as well as pressure from insurance companies) have steadily reduced the number of both hospitals (12%) and hospital beds (16%). This system of consolidation and emphasis on outpatient treatment has limited the hospital system’s ability to accommodate for surges in demand. Many developed countries have 5.4 hospital beds available for every 1,000 patients. In the US, the number is 2.8.7
  • Only a small minority of US states have a formal protocol in place for dealing with a large-scale medical emergency. The existing plans are designed to maximize existing space by putting patients in doubled-up rooms, conference rooms, and any other unused spaces. 4
  • According to the Centers for Medicare and Medicaid Services, coronavirus patients who do not require intubation can be safely isolated in a typical room, rather than a “negative pressure room.” Jane Englebright, CEO of HCA Healthcare Inc. has asked hospital staff to look for any space that might be modified for patient use, including storage closets and previously closed buildings. Cleveland Clinic has responded by planning to shift more than 1,000 non-coronavirus patients to nearby hotel rooms. Crews at Providence hospitals are building new isolation rooms with portable equipment: “It looks like MacGyver has been working in our hospitals…We have fans and filters and holes that have been filled up through any means necessary. Duct tape solves a lot of problems.”7
  • Even severe flu seasons have been known to stretch hospital resources, to the point where tents must be set up in parking lots and patients are held in emergency rooms for days. Dr. James Lawler estimates that coronavirus is likely to cause 5-10 times the burden of influenza, urging hospitals to “get prepared to take care of a heck of a lot of people.” Dr. Lawler estimates that 96 million people could be infected; assuming a 5% hospitalization rate, at least 2 million people would require intensive care and 1 million would require ventilators. 5

Click here for the full article

Learn more about Livengood Medical Mobi Solutions.

Early Mobilization

Posted on by Steve Villanueva

MINIMIZING HOSPITAL-ACQUIRED Complications

Early Mobilization. Recovering from a major illness or injury can be a slow and difficult process. But when patients are bed-bound, simply being in the hospital can add further complications. In the United States alone, 600,000 patients acquire healthcare-associated infections every year, resulting in nearly 100,000 preventable fatalities (Vaughn 2020). Further complications can include constipation, blood clots, bed sores, delirium, and ICU-acquired weakness, all of which increase the risk of readmission and death. However, early mobilization reduces these risks by activating the body’s own defense mechanisms: improving circulation, decreasing fluid retention, and stimulating the lymphatic, digestive, and nervous systems. Early mobilization keeps patients safe, improves recovery times, and lowers healthcare costs for both the patient and the hospital.

Key Facts:

  • A systematic review of medical studies found that early mobilization reduces both costs and the risk of secondary complications. On average, patients who achieved early mobilization experienced two fewer days of delirium, fewer central line and catheter infections, lowered risk of ventilator-assisted pneumonia, and reduced risk of readmission and death. (Hunter 2014)
  • For patients who have undergone coronary artery bypass surgery grafting (CABG), mobilization within six hours after surgery significantly reduces the risk of secondary pneumonia. (Strobel 2020)
  • An extensive study of patients with traumatic spine injuries revealed that patients who were immobilized for more than 72 hours after surgery were 14% more likely to acquire serious secondary complications (pneumonia, urinary tract infection, deep vein thrombosis, and/or pulmonary embolism). (MacCallum 2020)
  • A survey of more than 23,000 lumbar surgery patients showed that mobilization on the day of surgery resulted in a shorter length of stay and significantly decreased risk of bowel obstruction, urinary tract infection, and readmission. (Zakaria 2019)
  • For cancer patients who have had part of the lung surgically removed, standard early mobilization (within 24 hours) and physiotherapy is recommended to improve lung volume, clear excess fluid from the lungs, and reduce postoperative pulmonary complications. (Agostini 2020)
  • Standardized early mobility protocols can improve outcomes for patients with deep vein thrombosis, decrease length of stay for patients with community-acquired pneumonia, and help elderly patients recovering from major surgery to achieve or maintain independent functionality. (Pashikanti 2012)

Click here for full article

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Known Benefits to Early Patient Mobility

Posted on by Steve Villanueva

Neurological Benefits with Patient Ambulation

There are many known neurological benefits of early patient mobility. The fact that immobility causes muscle stiffness and weakness is familiar to anyone who sits in a chair for too long, but can immobility actually cause permanent nerve damage? Recent studies reveal that immobility during hospital stays can cause damage to the peripheral nervous system, increase the likelihood and severity of delirium, and slow recovery for patients with neurological problems. To resolve this, neurological intensive care units have been developing specialized early mobility protocols that make it safe to mobilize patients with severe conditions like stroke, aneurysm, and severe acquired brain injury.

Key Facts:

  • Patients who experience in-hospital immobilization are at high risk for intensive care unit-acquired weakness (ICUAW), which contributes to long-term disability, including permanent damage to the peripheral nervous system. (Kramer 2017)
  • Patients who have experienced treatment for critical illness often acquire secondary, long-term neuropsychiatric problems like delirium. Exercise is associated with increased cerebral blood flow, normal nerve repair, and nerve health, and early mobilization may reduce delirium and improve neuropsychiatric outcomes. (Hopkins 2012)
  • Specialized early mobility activities have been developed specifically for patients admitted to the neurological intensive care unit (NICU) to maximize safety and minimize complications from immobility, even for patients with complications like an external ventricular drain. (Yataco 2019, Shah 2018, Olkowski 2017, Moyer 2017)
  • Movement is so important to nerve health that new nursing guidelines call for patients undergoing spinal surgery to be mobilized on the day of surgery, within six hours of arrival at the medical-surgical unit. (Rupich 2018)
  • Early mobilization assists in the clinical and functional recovery of patients who have severe acquired brain injuries. (Bartolo 2017)

Click here for full article

Learn more about Livengood Medical Mobi Solutions.

Emotional Benefits of Early Patient Mobility

Posted on by Steve Villanueva

Emotion & Early PATIENT MOBILITY

There are many emotional benefits of early patient mobility. One critical factor in determining a patient’s capacity for early mobility is their mental state, which nurses judge on a case-by-case basis. But it turns out that early mobility can actually stimulate patients’ mental well-being and improve their emotional well-being, which immediately improves the patients’ quality of life, while reducing the serious risk of delirium and decreasing overall recovery time.    

Physical & Mental Benefits Linked

Key Facts:

ABCDEF Protocol

To improve patient outcomes and reduce hospital costs, the Society of Critical Care Medicine officially recommends that all intensive care units adopt the “ABCDEF” Protocol:

  • Assess, Prevent, and Manage Pain
  • Both Spontaneous Awakening Trials & Spontaneous Breathing Trials
  • Choice of Painkillers and Sedatives
  • Delirium: Assess, Prevent, and Manage
  • Early Mobility & Exercise
  • Family Engagement and Empowerment

Reducing Delirium in Patients

  • To decrease the incidence and duration of delirium, it is recommended that intensive care unit (ICU) staff perform early mobilization of adult patients whenever it is feasible. (Barr 2013)
  • To limit the incidence of physical, cognitive, and psychological disabilities that can result from critical illness, the Agency for Healthcare Research and Quality strongly endorses early mobilization for all patients, whenever it is feasible.
  • Early mobility decreases the occurrence, severity, and duration of delirium in patients. (Dirkes 2019, Krupp 2019, Taito 2016, Banerjee 2011, Schweickert 2009)
  • There is a very strong correlation between delirium, increased length of hospital stay, and increased chance of death in adult ICU patients. Delirium is also associated with a development of cognitive impairment after discharge from the ICU. (Barr 2013)
  • For patients who have experienced an acute stroke, early mobilization decreases the risk of depression and anxiety. (Cumming 2008)
  • While early mobility studies in pediatric units are still new, pediatrician Kristina Betters M.D. has gone on record to say: “Anecdotally, medical staff members are seeing their patients improve. Patients are less sedated and more interactive, and families are also engaging more with their children. Oftentimes parents feel helpless in the ICU, and this is one way they can help their child get better.”

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Barriers to Patient Mobility

Posted on by Steve Villanueva

Patient Ambulation

Barriers to patient mobility. Most medical practitioners are keenly aware of the benefits of early mobility—it improves patient recovery times, lowers the risk of complications, and shortens overall length of stay. So why has it been so difficult to implement? Why have there been so many barriers to patient mobility? The most common barriers to patient mobility can be grouped in four categories: equipment, patient availability, staff availability, and unit planning.

Why Aren’t Patients Being Mobilized

Key Facts:

Barriers to patient mobility include:

EQUIPMENT

  • In a survey of 500 U.S. ICUs, the number one listed barrier to early mobility was a lack of appropriate equipment. (Bakhru 2015)
  • If key pieces of mobility equipment (mobility platforms, ceiling lifts, etc.) are not readily available, multiple assistants will be required to support the patient, and mobility may be deferred due to staff unavailability. (Krupp 2019)

PATIENT AVAILABILITY

  • Patients who are called away for unscheduled procedures and tests aren’t present in the ward where nurses and physical therapists can implement early mobility.

STAFF AVAILABILITY

  • Understaffing physical therapists decreases the frequency and length of early patient mobilization. (Johnson 2019)
  • In an extensive study of community and academic hospitals, researchers determined that the greatest barrier to early patient mobility was the fear that “increasing mobilization of my inpatients will be more work for nurses.” Nurses directly reported that “they did not have enough time” to meet unit early mobilization goals (Hoyer 2015; Fontela 2018; Jolley 2014)

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Patient Ambulation and Staff Safety

Posted on by Sean Bryant

Helping Hospitals Reduce Costs With Patient Ambulation

Patient Ambulation and staff safety. Early mobility (patient ambulation) protocols are first implemented, there is an increased cost in time for both the nursing and support staff. However, when early mobility protocols are implemented systemically, the overall improvement in patient independence, reduction in secondary complications (including delirium), and reduced patient length of stay actually save time and reduce the burden for hospital staff. There are many sustainable benefits to implementing patient ambulation protocols.

Patient Ambulation and Staff Safety. Improved patient coordination and the reduction of ICU-acquired weakness also reduces the risk of falls, which are both dangerous and costly events. Ambulation platforms are an important part of this process because they help patients to help themselves, reducing the risk of injury for both patients and hospital staff. More importantly during a pandemic, mobility platforms dramatically increase patient independence, which limits risky interactions between patient and staff. The net improvement in staff efficiency, staff safety, and patient turnover all contribute toward greater hospital efficiency and significant cost savings associated with early and safe patient ambulation.

See the full article here.

Beneficial Reading

ICU Nurses and Patient Mobility

Fall Prevention Intervention

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Improving Patient Outcomes and COVID-19

Posted on by Steve Villanueva

Early Mobility & COVID-19

IMPROVING PATIENT OUTCOMES

Improving patient outcomes and COVID-19. Covid-19 primarily attacks the lungs, and, although the virus itself is new, doctors are relying heavily on standard respiratory treatments (including early mobility) for the alleviation of COVID-19 symptoms (WHO 2020). In the initial surge and amid the attempts to quarantine, early mobilization of COVID-19 patients was impossible to implement, but it has long been established that early mobilization of patients with severe respiratory infections activates the body’s own defenses, shortens length of stay, and significantly improves both short-and long-term patient outcomes.

The benefits of early mobilization for improving patient outcomes has been particularly well-documented for geriatric patients, who are at highest risk from COVID-19, and pediatric patients, who represent an increasingly significant percentage of COVID-19 patients. Now that there are dedicated COVID-19 wards and facilities, mobilization within a quarantined area is increasingly feasible and offers an immediate, proven, cost-saving option for saving lives and minimizing the burden for hospital staff.

See the full article here.

Beneficial Reading

Management of Acute Respiratory Infection

Early Mobility and Pneumonia

Learn more about Livengood Medical solutions here.

Early Mobility-Length of Stay

Posted on by Sean Bryant

Early Mobility and Length of Stay

Helping Hospitals Reduce Costs

Early mobility-length of stay. For hospitals, especially ICUs, reducing patient length of stay results in dramatic cost savings for both the individual patient and the hospital itself. Surveys done in both ICUs and across different units universally found that early mobilization dramatically contributed to improved patient turnover, improved patient outcomes, and millions of dollars in savings for the hospital.

Key Facts:

  • When nurses and rehabilitation therapists were able to increase mobility by approximately 1 hour per ICU patient (for patients on ventilators and patients who were not), the average ICU length of stay decreased by almost 20%, floor bed average length of stay lowered by almost 40%, and twice as many patients were discharged without home services. Average cost per day in the ICU and floor bed decreased, resulting in an annualized net cost savings of $1.5 million. (Corcoran 2017)
  • Danish hospitals recently performed a comprehensive national cost-savings survey and found that conforming to best-practice protocols reduced hospital costs by reducing patient length of stay and the need for secondary treatment; early mobilization resulted in one of the largest adjusted cost differences ($3,300 per patient). (Kristensen 2019)
  • One hospital introduced a systematic schedule for their pediatric unit and found that patients experienced: shorter periods of bed rest, reduced pressure sores, fewer falls, decreased length of stay, improved family satisfaction, and improved staff satisfaction. Overall, early mobilization resulted in cost savings for both the patient and hospital. (Letzkus 2013)
  • A study conducted at a community acute care hospital found that patients who received mobility intervention had fewer falls, ventilator-associated events, pressure ulcers, CAUTIs, delirium days. They also had lower sedation levels, improved functional independence, and lower hospital costs. (Fraser, 2015)
  • A comprehensive review of studies regarding post-operative knee surgery found that early mobilization (“fast-track rehabilitation”) resulted in shortened hospital stays and significant cost saving. (Quack 2015)
  • For patients hospitalized with Parkinson’s Disease, early mobilization is critical for improving both cost savings and improve outcomes. (Aminoff 2010)
  • Patients who achieved full mobilization within four days of coronary bypass surgery were able to be safely discharged from the hospital, without increased health risks, maximizing hospital resources and reducing hospital costs by over $900/patient. (Loubani 2000)

Click her for full article.

Beneficial Reading

Implementation of an Early Mobility Program

Early Discharge after Coronary Bypass Surgery

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Livengood Helps to Streamline Early Mobility Post Stem Cell Replacement

Posted on by Philip Crumpton

On a recent trip to Arizona I met Woody, a patient at the Banner Gateway/ MD Anderson hospital. Woody is a 72 year old, retired long distance truck driver who has been battling leukemia for over a year. When we met, Woody had already been in the Oncology ICU for over a week after undergoing stem cell transplant, and he was quite frustrated. Whenever he wanted to get up and walk he had to put on his call light, wait for staff who then had to get his walker and get an extra helper to pull along his IV pole and oxygen caddy while he ambulated. He often waited for up to thirty minutes and sometimes by the time enough staff was available he had “run out of steam.” Woody trialed the LIVENGOOD mobi for five days and by the second day he was deemed safe to be up walking independently with the mobi. He would unplug the mobi cord from the wall and he was good to go. He would often do 5 laps around the unit with his iPAD on the mobi playing music while he walked. Having a handy place to plug in his iPAD meant a lot to him and hearing the upbeat music made him, and everyone around him smile. Woody would stop any nurse who was available and tell them all about the mobi and how great it felt to be independent.

The mobi is designed to simplify ambulation by keeping all of the patient’s equipment with them wherever they go. The increase in mobility ease and efficiency makes the hospital experience significantly better for both patient and staff. Everything changed after Woody had his hands on the mobi.

It is no secret patient mobility is tied to results. A Johns Hopkins study found that early mobility in the ICU vastly improves patient outcomes and can save hospitals up to $1,300 per patient by decreasing their stay up to 22 percent.

The fact is, it is impossible for staff to meet the mobility needs of every patient, so tools like the LIVENGOOD mobi prove invaluable in increasing the frequency of mobilization; increasing patient mobility and decreasing length of stay; increasing staff efficiency and patient satisfaction, and helping hospitals save money.

June JONA

Posted on by Philip Crumpton

June JONA.

2015 Journal of Nursing Administration (JONA)

June Jona. We are pleased to announce that LIVENGOOD will be highlighted in an article being published in the June 2015 issue of JONA (The Journal of Nursing Administration). The article titled “Use of an Ambulation Platform Apparatus” addresses our joint study done with Medical Center of the Rockies discussing how The mobi reduced LOS and the number of Care Givers needed in each mobility event. We are very excited to be part of the solution for mobilizing patients.

Ambulation has proven to be an important part of recovery for medical-surgical patients. This study provides original research on the use of a platform apparatus for ambulation of patients on a medical-surgical unit. Outcomes included number of ambulation attempts, distance of ambulation, length of hospital stay, number of staff necessary to ambulate, and discharge destination. Compared with a control group, patients who had access to the ambulation platform apparatus had a shorter length of stay with fewer nurses and other staff needed to ambulate. Staff rated ambulation with the apparatus as easier than without and noted that patients were more willing to ambulate on their own with the ambulation platform apparatus.

Updated Information

Here is the link to the abstract.

Here is the link to the full study

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Early Mobility Programs Focus on “Best Practices” Maintenance

Posted on by Philip Crumpton

The hardest part about losing weight isn’t always losing it, it can often be maintaining the loss. The same is true with most big changes, especially when the change involves multiple people.

Many ICU departments are starting early mobility programs because it has proven to be ” best practice” for their patients. Starting a mobility program is tough and takes a lot of planning, discipline and enthusiasm from the staff. The trend I see is that programs start out strong and then often fizzle out.

Maintaining a strong early mobility program takes continuous effort and I would like to offer some suggestions on how to be successful. It is important to have champions both when a program starts and while it is maintained. Champions should be available on each shift and should serve as a point of education and guidance. ICU rounds should always have a line item for mobility and even if a patient isn’t being mobilized yet, there should be a discussion about mobility and when it might be appropriate. Mobility should be on a pre-printed order sheet which will act as a stimulus for doctors when writing and checking off orders. Equipment which makes mobility more efficient should be readily available and easy to use. P.T. should have a daily presence in the ICU. Programs should have a clear exclusion criteria and if a patient isn’t mobilizing the only excuse should be that they meet these criteria. The programs I see succeed are those with a constant driving force from management. Mobility becomes an expectation for patients and not a choice made by staff.

ICU Delirium

Posted on by Philip Crumpton

ICU Delirium

Preventing ICU Delirium with Safe Early Mobility Protocols

ICU Delirium. 80% of the sickest patients in the ICU will suffer from delirium. They have multiple risk factors that include immobility, medications for pain and sedation, and interrupted circadian rhythms, just to name a few. Delirium in the ICU will complicate the patients stay and can lead to many adverse outcomes. Patients who suffer from delirium will often be combative, pull out catheters, be unable to participate in therapy, and they may even self-extubate. These adverse outcomes can be hard on patients, families and ICU staff. Education about delirium should be provided to family members when applicable. Delirium in the ICU will also increase the total cost of a patient’s stay.

ICU staff should have a system in place for assessing delirium such as the CAM-ICU. Their CAM-ICU score should be reported regularly in the EHR and during rounds. If staff is consistently reporting on delirium they can aim their interventions towards minimizing any adverse outcomes. Interventions will range from reducing certain medications, increasing mobility during the day, reducing stimulation at night, and to introducing cognitive therapy with an Occupation Therapist. Increasing patient  mobility continues to be a safe and viable way of reducing all manner of secondary infections.

Early Mobility Protocols

Delirium in the ICU is prevalent and also often preventable with the implementation of safe early mobility protocols. By tracking and addressing the following six risk factors our patients will have less complications: sleep deprivation, immobility, visual impairment, hearing impairment, cognitive impairment and dehydration. Livengood’s mobility solutions are designed for ease of patient mobility, so they can safely ambulate and limit the effects of secondary infections.

Click to read Article on Reducing Secondary Infections

Beneficial Reading

Implementation of a Mobility Program

 

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ICU Physical Therapy

Posted on by Philip Crumpton

ICU Physical Therapy

Benefits of Physical Therapy in the ICU

Benefits of physical therapy in the ICU. You might ask yourself what a physical therapist does in the ICU. That is a great question. The role of a P.T. in the ICU will vary from facility to facility. Some facilities have a dedicated P.T. who spends the day mobilizing patients, doing progressive resistance exercises and acting as the expert for positioning and prevention of contractions. Other facilities order a P.T. consult only when a patient is extubated and active.

There are some important things that a P.T. needs to be knowledgeable about when working in the ICU. I would recommend brushing up on the following; cardiopulmonary physiology, ventilator and respiratory equipment, medications commonly used in the ICU, exclusion criteria for mobility, clinical implications of lab values, and monitoring systems. It is also beneficial to take 2-4 hours to shadow an ICU nurse and a respiratory therapist if your facility allows for this.

There are many P.T. activities that can be done while the patient is sitting edge of bed such as; PREs for lower extremities, therapeutic exercises, deep breathing, ADLs, trunk control and seated balance activities.

The ultimate goal of ICU P.T. is to get patients mobile which will inevitably help them wean off of a ventilator, become more independent and eventually transfer out of the ICU.

As a P.T. who has worked in the ICU I can tell you that it is rewarding, exciting and important. The evidence for early mobility is strong and it is “Best Practice” for ICU patients. I encourage you to get trained, get involved and get your patients moving.

Beneficial Reading

Implementation of an Early Mobility Program

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Implementing ICU Mobility Program

Posted on by Philip Crumpton

Implementing ICU Mobility Program

Safe Early Patient Mobility in the ICU

Implementing ICU mobility program. Are you looking to start an ICU early mobility program? If so, there are many factors that you’ll need to consider. One thing you need to think about is the current culture in your ICU. Is the culture to sedate all ICU patients, for patients to stay in bed? Is the staff ready for and supportive of a change? How well do the different departments work together? Are P.T.’s and O.T’s actively involved in the treatment of your ICU patients?

The next thing that I would advise would be to create a multi-disciplinary early mobility team, decide on a time frame, a start date, and start planning. You’ll need to create protocols, exclusion criteria and, add an early mobility line item to your pre-printed order sets.

It is important to have super-users or champions from each department who can then start training their coworkers and prepare them for your start date.

It is helpful to agree on the way that you will define mobility. I recommend using a system of 5 mobility stages. Stage1- bed in chair position, Stage 2- sitting edge of bed/dangling, Stage 3- Sitting in a chair, Stage 4- Standing/marching at bedside, Stage 5- Ambulation >10′. When documenting or discussing mobility in rounds, be sure that all team members are using the same grading system and language.

There are many resources out there and the evidence is strong in support of early mobility. The mobility will lead to better outcomes, improved cognitive status and improved patient satisfaction. Take the first step and get those patients moving!!

Beneficial Reading

Implementation of an Early Mobility Program

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Get Up and Pee

Posted on by Philip Crumpton

Get Up and Pee

Mobility – A Patient’s Basic Need

Get up and pee. We’ve all woken up early in the morning really needing to pee, but are so tired that we try to just lie there a little longer. We all know that the second we finally commit to getting out of bed we can rush to the bathroom. I bet you’ve never thought of that as a luxury. For millions of people who are in the hospital every day, it’s just that.

Imagine being in a hospital bed: you’re tethered to oxygen, an IV pole, and maybe even a chest tube. It wouldn’t be an easy feat to get up, let alone go to the bathroom. Often, the solutions available to you are to have a catheter, use a bedpan, or, god forbid, pee in your bed. They’re all so embarrassing. When I was in the hospital after an appendectomy and the nurse slid a bedpan under me and told me to “go ahead and pee,” I could’ve died. I was 17 and I really wanted to get up to use the regular bathroom. The nurse said that would be too much trouble with my IV and oxygen running. While using the bedpan, I couldn’t help but think that it was going to spill over onto the bed.

I joke about getting up to pee, but there are so many serious complications of bed rest. Immobility while one is hospitalized can lead to serious complications: urinary tract infections, bed sores, pneumonia, and blood clots, just to name a few. The benefits of mobility are numerous, including improved digestion, increased strength, increased independence, improved pulmonary function, and improved blood flow.

There is a better way! You have to insist on getting up and out of bed when you are in the hospital! It’s good for you to move your legs, and you certainly don’t want to pee in your bed now, do you?

 

Beneficial Reading

Implementation of an Early Mobility Program

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Basic Needs – Mobility

Posted on by Philip Crumpton

Basic Needs – Mobility

A Basic Need for Recovery

Basic Needs – Mobility. On a recent trip to trial the LIVENGOOD mobi at Tulane Medical Center I had the pleasure of meeting Sarah. Sarah was a patient in the neurological ICU who had been on a ventilator for 3 weeks. During the placement of cervical traction she experienced heart failure. After being resuscitated she had to be intubated. The staff had good intentions of getting Sarah out of bed but equipment management was difficult. Consequently, she stayed in bed most days and occasionally, at best, made it to a chair. The staff agreed at an attempt to walk with Sarah on a portable ventilator, while mounting all of her equipment on the mobi. She sat at the edge of the bed and slowly regained her ability to sit unsupported with her feet on the floor. We all held our breath as she transitioned from sitting to standing and cheered as she stood there smiling. Sarah was able to walk 16 feet to the door of her room and then after sitting in her chair we wheeled her to the picture window where she sat basking in the warm Louisiana sun, the sun she had not seen in 21 days, as her hospital room did not have an exterior window. This session of mobility worked her muscles, her lungs, her cardiovascular system and it gave her an emotional boost. From this day forward mobility became part of her care plan and helped her progress towards a transfer out of the ICU. To thrive as humans we need to feed our basic needs. We need nourishment, sunlight, mobility and community. The sense of accomplishment Sarah felt that day was truly palpable in that room and I think we all slept better that night. *Patient’s name has been changed to protect her identity.

Beneficial Reading

Implementation of an Early Mobility Program

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Safe Patient Mobility

Posted on by Philip Crumpton

Safe Patient Mobility

Shaking up Hospital Practices with Safe Patient Mobility

Safe Patient Mobility. Please take a moment and read this article by InnovatioNews. Read Article

FORT COLLINS – Most people don’t want to stay in a hospital any longer than they absolutely have to. And while that’s primarily based on a person’s desire simply to be well again and get back home, there are other factors that weigh in favor of getting out of that hospital bed as soon as possible. Read Article

Overview

Faster recovery is one factor associated with early patient mobility, with patients who are able to get up and walk again after a treatment or surgery leaving the hospital sooner than those who remain bedridden. And there’s the reduced cost of a shorter hospital stay, which is actually good for both the patient and hospitals that receive a higher reimbursement from insurers for shorter stays.

Livengood, a Fort Collins company that’s developed a simple yet revolutionary bedside product, is helping get patients up and around sooner and cutting hospital stay expenses. Livengood’s PACE (PAtient Care Environment)–rebranded as mobi–is an evolution of the IV pole ambulatory patients push to get exercise and go to the bathroom while still attached to feeding tubes, pumps  and other hospital care paraphernalia.

Patients love it

And patients are loving the mobi.

Beneficial Reading

Implementation of an Early Mobility Program

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What Customers Say

Testimonials

“6 months ago we implemented 12 mobis into our early mobility program. We have a very diverse population on our ICU and having the option of mobilizing them in a way that is helpful and assistive to staff while instilling confidence in the patient and family is great. We’re still working to figure out our ideal workflow but it’s given us concrete examples of how even our sicker vented patients can get mobilized safely and efficiently.”

Mark Rohlfing
RN, BSN Clinical Operations Manager Intensive Care Unit
Indiana University Health Ball Memorial Hospital - Muncie, IN

“After completing a research study with the LIVENGOOD mobi on our post trauma/surgical floor, I realized its potential to decrease length of stay, help with staff efficiency and empower patients to be independent.”

Lorrie Henecke
MS, APRN, ACNS-BC, CNRN Clinical Nurse Specialist
Medical Center of the Rockies, Loveland, CO

“We are so excited that the mobi helped us ambulate our very first vented patient.”

Esther Vandermeulen
R.N.
University Health System - San Antonio, TX

“The LIVENGOOD mobi is very user friendly, safe and a great solution to use minimal staff and be able to contain all of the patient’s equipment.”

Michael Saccone
P.T.
Saint Joseph's Hospital - Syracuse, NY

“I think the LIVENGOOD mobi will revolutionize the way we mobilize patients in the ICU. I saw patients mobilize sooner and with less anxiety with the mobi. One young patient was even able to walk outside with the mobi and her portable vent. Having the mobi made mobility a real team effort, not just a P.T. activity.”

Terra Terwilliger
PT, DPT - Adult Inpatient Physical Therapist
Rehab Services University of Minnesota Medical Center, Fairview Health System

“The LIVENGOOD platform allows my patients to be active and independent without attention being diverted to multiple lines, an oxygen tank, and other medically necessary devices. It allows patients to have hope and a sense of “normalcy”, which so often is lost after trauma or surgery.”

Jessica Gilbert
DPT
Staff Physical Therapist - Medical Center of The Rockies -Loveland, CO

“Six years ago I was introduced to the LIVENGOOD mobi. This piece of equipment has been life changing for my patients. I am now able to consolidate all of the patient’s medical devices onto an easy to push mobile platform, therefore freeing up both of my hands to safely assist my patient.”

Tanya Kensley
P.T.
Poudre Valley Hospital -Fort Collins, CO

“Mobility is Life, the mobi platform will help patients move again.”

Blas Villa
CCRN
University Health System - San Antonio, TX

“I was at NTI in Boston (2013) and, during the exhibit portion, I wandered across the LIVENGOOD booth. At that moment, I knew our hospital needed this mobi for our open heart recovery program. I worked with a Clinical Nurse Specialist to write a grant for this product. I am so excited to bring the mobi to our program.”

Celina Adams
RN, MSN, CCRN (CVICU)
John C. Lincoln - Phoenix, AZ

“We walked a vented patient with the mobi and it was awesome! This helped her physically and emotionally.”

Natalie Hariel
R.N.
Tulane Medical Center - New Orleans, LA

“I am a nurse in a cardiovascular ICU… Our goal for patients is to ambulate to the chair 2 hours after extubation, often the evening of surgery day. Our patients are up and walking with central venous catheters, swan ganz catheters, chest tubes, foley catheters, and with IV medications infusing. The ambulation of these patients would not be possible without the mobi walker. Every bit of equipment that these patients need can be carried on the walker while providing the stability of a standard walker… It is an essential piece of equipment for us and we couldn’t provide the care and therapies we do without it.”

Katherine Whitfield
RN CCRN
Athens Regional Medical Center - Athens, GA

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Mobi Ambulation Specialist

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+1 (970) 797-4938
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1001-A East Harmony Rd.
#502
Fort Collins, Co 80525
United States
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mobi Patient Mobility

sales@livengoodmed.com
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