January 2011

Collaboration Promotes Ambulation for Isolation Patients

Northwest Community Hospital's efforts to reduce length of stay (LOS) have led to a number of new initiatives, which now include new guidelines for ambulation of patients in certain types of isolation.

"Frequent and early ambulation of older adult patients is recognized as a key intervention for improving clinical outcomes, decreasing LOS and increasing patient satisfaction," says Dina Lipowich, RN, director of Medical Nursing and Inpatient Geriatrics. "And, with a significant percentage of Northwest Community's patient population requiring isolation measures during the course of hospitalization; promoting ambulation, while imperative, has been very challenging for clinical staff."

To address the challenges of ambulation, NCH's Geriatric Best Practice Team assembled an interdisciplinary subgroup, "Focus on Function," led Donna Boyd, RN, geriatric clinical nurse specialist, and Lipowich. After conducting an extensive literary review, this team collaborated with infectious disease specialists, Susan Bleasdale, MD, and Vern Kerchberger, MD, to establish specific guidelines for promoting safe ambulation of patients in certain types of isolation. This collaboration has led to the development of new "Ambulation Guidelines for Patients in Isolation." With the recent approval of these guidelines by the Infection Prevention Committee, patients who were previously confined to their room environment may now be safely ambulated by clinical staff in the hallway, but with very clear and specific precautions taken.

"We anticipate that this new practice will have a tremendously positive impact on patients' expected recovery time, as well as their satisfaction with the overall hospital experience," Lipowich says. She explains that with the implementation of the ambulation guidelines, the most notable change in clinical practice will involve the requirement of staff to wear a clean isolation gown and gloves outside the patient's room during the ambulation session. "Our staff education on the necessary precautions for ambulating patients in isolation is robust, including discussion, as well as the publication of a formal Nursing Practice Update."

The approved ambulation guidelines have been posted on the Intranet in the Infection Prevention Manual. For more information, please contact Dina Lipowich, RN, at 847.618.5610.