Improving the assessment and documentation of patient mobility using a quality improvement framework

Geriatr Nurs. 2021 Mar-Apr;42(2):325-330. doi: 10.1016/j.gerinurse.2021.01.002. Epub 2021 Feb 6.


Objective: To implement a system for assessing and documenting patient mobility in an inpatient geriatric unit using a quality improvement framework.

Methods: Whiteboards incorporating the Johns Hopkins Highest Level of Mobility scale were placed on each door of the unit. Staff were trained to assess and document patient mobility, and documentation compliance was measured. Nurses were surveyed to assess perceived burden of the system. Fall rates were calculated and analyzed for change from baseline.

Results: Median daily documentation rates reached 79% by the end of the project. Surveys indicated a low perceived burden of the system. Fall rates did not increase when compared to the previous year baseline (p = 0.80) and the analogous time frames during the previous two years (p = 0.84).

Conclusion: A quality improvement framework may be used to improve mobility assessment and documentation in a geriatric unit without increasing patient falls or nursing burden.

Keywords: Acute care; Ambulation; Assessment; Documentation; Elderly; Falling; Falls; Geriatrics; Harm; Immobility; Mobility; Mobilization; Older adults; Quality improvement.

MeSH terms

  • Accidental Falls / prevention & control
  • Aged
  • Documentation
  • Humans
  • Inpatients
  • Nursing Care*
  • Quality Improvement*