Level of function mobility scale for nurse-driven early mobilisation in people with acute cardiovascular disease

Diana Dima; Julie Valiquette; Joelle Berube-Dufour; Michael Goldfarb

doi:10.1111/jocn.15124

Level of function mobility scale for nurse-driven early mobilisation in people with acute cardiovascular disease

J Clin Nurs. 2020 Mar;29(5-6):778-784. doi: 10.1111/jocn.15124. Epub 2019 Dec 18.

Authors

Diana Dima¹, Julie Valiquette², Joelle Berube-Dufour³, Michael Goldfarb⁴

Affiliations

¹ Department of Nursing, Jewish General Hospital, McGill University, Montreal, QC, Canada.
² Department of Physiotherapy, Jewish General Hospital, McGill University, Montreal, QC, Canada.
³ Department of Occupational Therapy, Jewish General Hospital, McGill University, Montreal, QC, Canada.
⁴ Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC, Canada.

PMID: 31793086
DOI: 10.1111/jocn.15124

Abstract

Background: There are currently no validated tools that are reliable and easy to use for nurses to assess mobility in people with acute cardiovascular disease in the Cardiovascular Intensive Care Unit (CICU).

Methods: A multidisciplinary team at an academic tertiary care centre developed the Level of Function (LOF) Mobility Scale for use in a nurse-driven early progressive mobilisation in the CICU. To determine inter-rater reliability, the prehospital and admission LOF were assessed independently by two CICU nurses. Pairwise comparisons between raters were evaluated using Cohen's kappa statistic. To determine convergence validity, the LOF and Activity Measure for Post-Acute Care 6-Clicks score upon admission were compared with Spearman's correlation. To determine feasibility, a 9-item mobility scale questionnaire was distributed to CICU nurses with and without experience using the LOF Mobility Scale. The STROBE reporting guidelines were used.

Results: The LOF Mobility Scale had good inter-rater reliability for assessment of LOF prior to hospitalisation (N = 131, kappa = 0.66, p < .001) and at the time of CICU admission (N = 131, kappa = 0.71, p < .001). There was a moderate correlation (N = 79 observations; correlation coefficient = 0.525; p < .01) between the bedside nurses LOF and the 6-Clicks score. All nurses surveyed (N = 54; 100%) thought that the LOF Mobility Scale was clear and unambiguous, the LOFs were well-defined and the scale was an appropriate length. Nearly all of the nurses with experience using the scale (N = 22/24; 92%) felt that the scale took less than one minute to complete, compared with about half (N = 14/30; 47%) in the group of nurses without experience using the scale.

Conclusion: The LOF Mobility Scale is reliable and feasible for mobility assessment in a nurse-driven early progressive mobilisation programme in patients with acute cardiovascular disease in the CICU.

Relevance to clinical practice: A nurse-driven EM programme can be implemented in the CICU.

Keywords: Cardiovascular Intensive Care Unit; early mobilisation; functional status; reliability.

MeSH terms

Acute Disease / nursing
Cardiac Rehabilitation / nursing*
Early Ambulation / nursing*
Female
Humans
Intensive Care Units
Male
Middle Aged
Physical Functional Performance*
Practice Patterns, Nurses'*
Reproducibility of Results
Surveys and Questionnaires