College of Allied Health Professions
UNMC_Acronym_Vert_sm_4c
University of Nebraska Medical Center

Supervised Mobility and/or Activities of Daily Living

Supervision during mobility and/or ADLs allows staff to verbally or physically assist a patient to help keep them safe during these tasks. Patients may need help for a variety of reasons: pain, injury, deconditioning, cognitive impairment, medication side effects, etc. Physical and occupational therapists are well-trained in strategies to appropriately assist patients with these tasks and can serve as a resource to other hospital staff for this issue.

Supervised Mobility and/or ADLs Education

Audio/Visual Resources

  • Safe Transfers and Mobility Webinar: The webinar Best Practices in Safe Transfers and Mobility to Decrease Fall Risk created by the UNMC CAPTURE Falls team describes principles of balance, strategies to reduce patient fall risk during transfers and ambulation, and strategies to improve a patient’s balance in sitting. It could be used as an educational tool for staff training on this topic.

Print Resources

  • Tension Between Promoting Mobility and Preventing Falls: An editorial published in JAMA Internal Medicine discusses how too strong of a focus on reducing all falls may lead to unintended consequences of reduced patient mobility. The article promotes the concept that assisted falls are a “good” thing because it means that staff were assisting the patient with mobility at the time and were able to control the fall.

Supervised Mobility and/or ADLs Tools

Sixteen stand-alone training videos were created by the CAPTURE Falls Team demonstrate safe strategies for assisting patients with a variety of movement tasks ranging from rolling in bed to assisting a fall. These videos can be used as tools for staff education on this topic.
The Safe Transfers and Mobility Gap Analysis created by the UNMC CAPTURE Falls Team can be used to assess topics included in staff training in safe patient transfers and mobility.
The Safe Transfers and Mobility Action Plan created by the UNMC CAPTURE Falls Team can be used to set priorities and document progress towards improving your facility’s approach to promote safe patient transfers and mobility.
The tool, Transitioning to Independent Patient Mobility, was created and shared by a hospital that has participated in the CAPTURE Falls program. It can guide staff decision-making about when to allow a hospitalized patient to engage in independent mobility, as well as a patient education tool for when this transition occurs.
The Mobility Change Package and Toolkit created by Sharon Inouye, MD, MPH is a rich evidence-based resource to help your organization implement a mobility program. Example resources within this toolkit include staff training protocols for how to safely mobilize patients, a progressive mobility protocol for patients, assessments that nursing staff can use to determine a patient’s appropriateness for mobility, and suggestions of measures to assess your organization’s progress with a mobility program.
The Safe Patient Handling App from the U.S. Department of Veterans Affairs can be used to support nurse clinical-decision making regarding how to safely assist patients with mobility.
Tool 3K: Algorithm for Mobilizing Patients in the Agency for Healthcare Research and Quality Fall Prevention Toolkit can be used to support nurse clinical-decision making regarding when to initiate patient mobilization and when to refer to physical and/or occupational therapy.
The ICU Mobilization Test, originally intended to assess the potential for safe mobility of patients on mechanical ventilation, could be used to assess any patient’s potential for safe mobility.
The Banner Mobility Assessment can be used by nurses to guide decision-making for patient mobility, including the need for safe patient handling equipment and physical therapy referral.
A variety of tools from the Clinical Excellence Commission of the New South Wales (Australia) Ministry of Health provide guidance on terminology used to describe assistance levels, an algorithm and tip sheet for how to mobilize patients, and videos of various assistive devices.