1. Baumhover, Lisa A. MS, GCNS-BC
  2. Lillegraven, Cheryl MSN, ACNS-BC
  3. Pandullo, Sarah MSN, CCNS-BC

Article Content


The purpose of this project was to help patients hospitalized at Iowa Health-Des Moines maintain the strength and ability to function while in the hospital.



Patients hospitalized in an acute care setting are oftentimes immobilized, increasing the patient's risk for experiencing iatrogenic complications. Three clinical nurse specialists at Iowa Health-Des Moines have developed a nurse-driven mobility protocol with a goal to decrease deconditioning, which can lead to falls and hospital-acquired pressure ulcers.



Three units at Iowa Health-Des Moines will implement a nurse-driven mobility protocol. These include a general medical unit, a neurology/neurosurgery unit, and a critical care unit. Each unit will form an interdisciplinary team to develop, implement, and evaluate an evidence-based protocol.



Triggers will be developed for patient enrollment into the mobility protocol, and the actual nursing protocol will be developed and piloted on the three units. This will essentially be an independent nursing function.



The primary goals of the nurse-driven mobility protocol at Iowa Health-Des Moines are to maintain the patient's functional status, decrease length of stay, and decrease iatrogenic complications as measured by HAPU rates, VAP rates, CAUTIs, and injurious falls. Secondary goals include decreased fall rates, decreased sitter rates, and decreased restraint rates. Tertiary goals include improvement in pain management, improved nurse-to-nurse handoffs and improved nursing documentation.



It is anticipated that the 3 units implementing the mobility protocol at Iowa Health-Des Moines will achieve the mentioned goals to improve patient outcomes.


Implications for Practice:

Hospitalized patients can experience functional decline in a matter of days. This occurs most rapidly in the geriatric patient. Something as simple as establishing a mobility protocol can prevent this decline, which can lead to poor patient outcomes and increased costs on the system.


Section Description

The 2010 National Association of Clinical Nurse Specialists (NACNS) Annual National Conference is planned for Portland, Oregon, on March 3 to 6. More than 375 clinical nurse specialists (CNSs), graduate faculty, nurse administrators, nurse researchers, and graduate students are expected to attend. This year's theme, "CNS as Internal Consultant: Influencing Local to Global Systems," demonstrates the breadth and depth of CNS practice and leadership at multiple levels in organizations and on healthcare.


A total of 142 abstracts were submitted for review, and 58 (not including student posters) were selected for either podium or poster presentations. Again, this year, there is a CNS student poster session; student abstracts will appear in a later issue of the journal. The abstracts addressed CNS practice in all 3 practice domains as described in the Spheres of Influence Framework for CNS Practice. Abstracts emphasized patient safety and quality care outcomes, leadership, CNS education, evidence-based practice, and new ways to shape CNS practice. Topics include CNS work activities incorporated into the 3 Spheres of Influence, the role of the CNS in developing clinical inquiry skills among staff nurses, use of simulation technology, strategies to maintain clinical excellence, the role of the CNS in National Database for Nursing Quality Indicators (NDNQI) activities, and many new and thoughtful ideas to support CNS education, practice, and research. Collectively, the abstracts represent the breadth, depth, and richness of the CNS's contribution to the well-being of individuals, families, and communities, as well as contributing to the advancement of the nursing profession.


The conference abstracts are published to share new knowledge with those unable to attend the conference. As you read each abstract, appreciate the intellectual talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to the health of society through improved outcomes for patients and healthcare organizations. We encourage you to contact individual presenters to network, collaborate, consult, or share your thoughts and ideas on the conference topics.


Watch for next year's call for abstracts and consider submitting for presentation at the next NACNS annual conference scheduled for March 9-12, 2011, in Baltimore, Maryland.