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: improving patient outcomes

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

Learn more about Livengood Medical Mobi Solutions.

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)

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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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Learn more about Livengood Medical Mobi Solutions.

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.

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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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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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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See the mobilite here

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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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