Nurse-driven Mobility Progression for the Liver Transplant Population in an Intensive Care Unit

Background: Patients with cirrhosis requiring liver transplant often suffer from frailty, sarcopenia, and malnutrition. As their disease progresses, their complex and acute pretransplant state usually leads to longer, more complicated recoveries in the posttransplant setting. Objective: Standard care for mobilizing high-acuity intensive care unit (ICU) patients before and after liver transplantation is mobilization at least twice daily. This quality improvement initiative sought to increase adherence to this standard. Methods: The mobility champion role was established to support early mobilization efforts. Mobility champions consist of a multidisciplinary team of registered nurses (RNs) and restorative care assistants (RCAs) who provide staff education and led the implementation of an early mobilization program. Team-based mobility initiatives have been shown to be effective in improving mobilization among high-acuity patient populations. Results: Following the implementation of the mobility champions, more than 88% of patients were mobilized at least twice per day; additional analysis correlated mobility frequency with improved disposition after hospitalization. Using mobility champions led to increased compliance with patient mobilization standards. Conclusion: Although this quality improvement initiative demonstrated promising early results, additional study is needed to assess the effectiveness and sustainability of mobility champions in the liver transplant population.