Abstract：
BACKGROUND:Immobility contributes to many adverse effects in critically ill patients. Early progressive mobility can mitigate these negative sequelae but is not widely implemented. Appreciative inquiry is a quality improvement method/change philosophy that builds on what works well in an organization. OBJECTIVES:To explore whether appreciative inquiry would reinvigorate an early progressive mobility initiative in a medical intensive care unit and improve and sustain staff commitment to providing regular mobility therapy at the bedside. Secondary goals were to add to the literature about appreciative inquiry in health care and to determine whether it can be adapted to critical care. METHODS:Staff participated in appreciative inquiry workshops, which were conducted by a trained facilitator and structured with the appreciative inquiry 4-D cycle. Staff members' attitudes toward and knowledge of early progressive mobility were evaluated before and after the workshops. Performance of early progressive mobility activities was recorded before and 3 and 10 months after the workshops. RESULTS:Sixty-seven participants completed the program. They rated the workshops as successfully helping them to understand the importance of early progressive mobility (98%), explain their responsibility to improve patient outcomes (98%), and engender a greater commitment to patients and the organization (96%). Regarding mobility treatments, at 3 months orders had improved from 62% to 88%; documentation, from 52% to 89%; and observation, from 39% to 87%. These improvements were maintained at 10 months. CONCLUSION:Participation in the workshops improved the staff's attitude toward and performance of mobility treatments. Appreciative inquiry may provide an adjunct to problem-based quality improvement techniques.
journal_name
Crit Care Nursejournal_title
Critical care nurseauthors
Fernald MM,Smyrnios NA,Vitello Jdoi
10.4037/ccn2020251subject
Has Abstractpub_date
2020-08-01 00:00:00pages
66-72issue
4eissn
0279-5442issn
1940-8250pii
31094journal_volume
40pub_type
杂志文章abstract：:This 6-month retrospective study provided our medical center with a profile of the population of patients readmitted within 31 days of discharge. We found that chronic illness and age greater than 65 years were the high risk factors related to patient readmissions. These 2 attributes are common in critical care patien...
journal_title：Critical care nurse
pub_type： 杂志文章
doi：
更新日期：2001-04-01 00:00:00
abstract：:As surgery for complex congenital heart disease is becoming more advanced, an increasing number of patients are surviving into adulthood, yet many of these adult patients remain in the pediatric hospital system. Caring for adult patients is often a challenge for pediatric nurses, because the nurses have less experienc...
journal_title：Critical care nurse
pub_type： 杂志文章,评审
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journal_title：Critical care nurse
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journal_title：Critical care nurse
pub_type： 杂志文章
doi：
更新日期：1989-05-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章
doi：
更新日期：1992-06-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章,评审
doi：
更新日期：1996-06-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章
doi：10.4037/ccn2011552
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journal_title：Critical care nurse
pub_type： 杂志文章
doi：
更新日期：1990-07-01 00:00:00
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journal_title：Critical care nurse
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doi：10.4037/ccn2013290
更新日期：2013-06-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章,评审
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更新日期：2015-06-01 00:00:00
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journal_title：Critical care nurse
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更新日期：2018-08-01 00:00:00
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journal_title：Critical care nurse
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更新日期：2013-08-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章
doi：10.4037/ccn2019647
更新日期：2019-10-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章
doi：
更新日期：1989-07-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章,评审
doi：
更新日期：2003-02-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章
doi：10.4037/ccn2012596
更新日期：2012-10-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章
doi：
更新日期：1995-02-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章,评审
doi：
更新日期：1998-02-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章
doi：10.4037/ccn2011470
更新日期：2011-12-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章,评审
doi：
更新日期：1996-12-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章,评审
doi：
更新日期：2001-08-01 00:00:00
abstract：:This article discusses congenital heart defects that are marginal candidates for biventricular repair and highlights the anatomic considerations upon which the surgical decision is based. Specifically, the article reviews the importance of capacitance and compliance of the ventricles and their associated atrioventricu...
journal_title：Critical care nurse
pub_type： 杂志文章
doi：10.4037/ccn2018679
更新日期：2018-10-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章
doi：10.4037/ccn2018669
更新日期：2018-10-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章,评审
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journal_title：Critical care nurse
pub_type： 杂志文章
doi：
更新日期：1989-11-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章
doi：10.4037/ccn2020681
更新日期：2020-06-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章
doi：
更新日期：1991-09-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章
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更新日期：2020-04-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章
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更新日期：2020-10-01 00:00:00
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journal_title：Critical care nurse
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更新日期：2017-06-01 00:00:00
