Featured Story 24 October 2023
Ivinson's World-Class Mobility Program
Written by Angelis Medina
Ivinson’s new Comprehensive Mobility Program is creating mobility plans for inpatients, new moms and critical care patients to improve patient outcomes.
Physical Therapist, Tennille Nelson has been in the rehabilitation department at Ivinson since 2008. Tennille works with patients admitted to inpatient units at Ivinson and works to help them regain and maintain mobility while being cared for in the hospital.
“Over the last several years, I’ve been able to promote mobility in three specific areas at Ivinson in an effort to provide world-class healthcare,” Tennille said.
These three areas include:
- C‑section patients in Labor and Delivery.
- Patients in the ICU including patients on ventilators.
- Patients on Medical/Surgical unit.
Tennille has worked to create three new mobility initiatives to make up the new Comprehensive Mobility Program at Ivinson. The Comprehensive Mobility Program helps a wide variety of different patients with mobility concerns.
Labor and Delivery Mobility Program (OB PT Program)
Labor and Delivery is one of the areas that was focused on in the Comprehensive Mobility Program to help limit concerns, issues and immobility mothers can experience after having a C‑section.
“After having a C‑section, it can be difficult and painful to perform basic tasks like getting out of bed and walking. For a long time, mothers who had a C‑section did not receive physical therapy services to help learn strategies and techniques to make caring for themselves and their baby easier and less painful after such a major surgery. At Ivinson, now they do. And I’m proud to say we are on the cutting edge for labor and delivery patients with only a handful of other hospitals providing this valuable service to our mothers,” states Tennille.
To satisfy this long awaited need for labor and delivery patients, Ivinson created a labor and delivery program that offers post-partum physical therapy through an acute Obstetrics Physical Therapy (OB PT) Program. This allows labor and delivery patients to be seen by physical therapist to address mobility issues, concerns and fears after having major abdominal surgery. The goal of this program is to address mothers as holistically as possible and provide access to services appropriate to address their wellbeing and recovery after pregnancy and delivery.
Ivinson is pleased to provide a supportive and holistic environment to mothers after pregnancy (post-partum), with options and education through the Comprehensive Mobility Program.
ICU Early Mobility Program
The second aspect of the Comprehensive Mobility Program includes mobilization of patients that are critically ill. Mobilizing patients that are critically ill is known to be safe and beneficial in a variety of ways.
“Early mobilization does not help save the life of critically ill patients but it does significantly increase the chances of an optimal recovery if one does survive critical illness,” states Tennille.
Even though the pandemic was extremely difficult to manage, COVID allowed the opportunity for implementation of the ICU Early Mobility Program through the Comprehensive Mobility Program, in 2020.
“During the pandemic we had the opportunity to introduce an early mobility program in the ICU due to the large volume of patients on ventilators,” Tennille said of rolling out the ICU program.
Although patient/ICU levels have decreased back to pre-COVID levels, this program will continue to help mobilize critically ill patients.
“Credit for training, implementing, and sustaining the Early Mobility Program goes to Dr. Kristin Lane PT, DPT. She provides the expertise and experience needed to safely provide physical therapy services to our critically ill and ventilated patients,” states Tennille.
Med/ Surg Mobility Cultural Change
The medical/surgical unit mobility cultural change is about changing the culture around fall prevention procedures and policies, to create a program that no longer limits mobility in an effort to prevent falls
“Starting in 2008, hospitals all across the country implemented fall prevention policies and programs in an effort to keep patients from falling while hospitalized. Although very well intended, these efforts resulted in an “epidemic of immobility” in hospitals which actually causes more harm to all hospitalized patients,” Tennille said.
As fall prevention policies and practices were evaluated, bed rest was shown not to decrease falls with injuries.
“Each body system is negatively affected by remaining in bed day-after-day while hospitalized,” Tennille said. “Negative effects include increased risk for blood clots, pneumonia, muscle atrophy, and skin breakdown leading to wounds. There is also an increased risk of delirium as well as other psychological effects. For our older adult population, if enough strength is lost due to bedrest while hospitalized, they may not be able to return home living independently. The consequences of immobility are very real and can be harmful to our patients,” states Tennille
Since fall prevention and policies were causing more harm to all hospitalized patients, rehabilitation professionals across the country understood the importance of leading the effort to reverse the culture of immobility. The rehab team is leading this cultural change at Ivinson focusing on educating medical and surgical staff members to integrate more movement for patients.
Current program training includes:
- Education on how the “epidemic of immobility” started and the harm caused by bedrest.
- Training on how to increase mobility opportunities for patients and processes to support this.
- Reference materials to build confidence.
- Changes to documentation standards to promote more opportunities for mobility.
The goal of this medical/surgical units’ mobility cultural change project is to increase education, provide mobility opportunity and to create confidence in staff members so that they provide more opportunities for movement for our hospitalized patients.
comprehensive mobility services
Comprehensive Mobility is a new program at Ivinson that has been successfully implemented to provide inpatients services to patients in Labor and Delivery, ICU, and Med/Surg.
For more information about these inpatient services please call (307) 755‑4728.
Angelis is a student at the University of Wyoming. Currently a junior, Angelis is pursuing a degree in entrepreneurship with minors in pre-law and in accounting.