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The purpose of this research study is to decide if using a nurse-led mobility protocol affects teamwork perceptions, when mobilizing ventilated neurosurgery patients. Participants will mobilize ventilated neurosurgery patients according to either facility standard procedures or a piloted nurse-led mobility protocol. Each selected patient will be mobilized once during his/her hospitalization for the purposes of this study. Patient mobility may take up to 1 hour. Following this, participating staff will be asked to complete a survey used to measure teamwork perceptions. Participants will be given up to 30 minutes to complete the survey. Total study duration is 3 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control/non-experimental group | Active Comparator | The control/nonexperimental group will consist of multidisciplinary teams, who will not be given the nurse-led protocol and will be asked to mobilize the assigned ventilated neurosurgery patient according the facility's standard mobility procedures. |
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| Experimental/interventional group | Experimental | The experimental/interventional group will consist of multidisciplinary teams who will use a given nurse-led protocol (intervention) to mobilize the assigned patient. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nurse-led progressive mobility protocol | Other | The nurse-led mobility progression protocol incorporates a checklist for four primary team members belonging to each discipline to follow before, during, and after providing mobility for each patient. It outlines steps to progress patient mobility from in-bed mobility activities to out-of-bed activities as tolerated. This protocol intervention was created and designed based upon a review of previously conducted studies' interventions and findings, as well as expert guidelines established in the literature. Furthermore, multidisciplinary experts at the medical center who work with ventilated neurosurgery patients were consulted to form the protocol to further establish hemodynamic, neurological, respiratory, and physiological patient safety parameters. This intervention has not been implemented in previous studies and will be piloted for this study. |
| Measure | Description | Time Frame |
|---|---|---|
| Teamwork perceptions | Will be measured using the reliable and valid Nursing Teamwork Survey (NTS) established by Beatrice Kalisch, PhD. The NTS is composed of items with Likert-type scale ranging from 1-5. Higher scores indicate more positive perceptions of teamwork, while lower scores indicate more negative perceptions of teamwork. This scale has been tested and has good psychometric properties including adequate validity and reliability. The minimum total score is 33, while the highest possible score is 165 per participant. | Will take each participant no more than 30 minutes to complete. Each participant will take this once following each patient mobility instance. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Adrianna Lall | University of Texas at Arlington | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Texas Southwestern Medical Center | Dallas | Texas | 75088 | United States |
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| ID | Term |
|---|---|
| D059039 | Standard of Care |
| ID | Term |
|---|---|
| D019984 | Quality Indicators, Health Care |
| D011787 | Quality of Health Care |
| D006298 | Health Services Administration |
| D017530 | Health Care Quality, Access, and Evaluation |
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This study will consist of a quasi-experimental research design to examine causality between two or more variables by comparing groups following an intervention. Although the intervention itself will be randomly assigned/administered to each of the multidisciplinary groups for this proposed research study, true randomization of participants cannot be achieved. This is primarily due to each patient having a pre-assigned multidisciplinary care team for each shift. Changing this patient assignment would compromise patient safety while interfering with continuity of care and workflow, which hospital units strive to achieve. By applying the purpose and elements of a quasi-experimental approach to this proposed research study, researchers can determine if an intervention/active independent variable consisting of a nurse-led mobility protocol, has an effect on the outcome measure of teamwork perceptions , which will serve as dependent variables.
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All teams will be asked to progressively mobilize the ventilated neurosurgery patient they are assigned to during the shift. Each team will be blinded to whether or not they will be utilizing the nurse-led mobility protocol or standard mobility procedures until arrival at the patient's room during the assigned mobility time.
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| Standard of Care | Other | For the purposes of the current study, the control group of multidisciplinary teams requested to mobilize the ventilated neurosurgery patient, may also consist of the primary nurse, RT, PT, and PCT. They will be asked to progressively mobilize the patient to the best of their ability according to standard of care procedures, incorporating any resources the medical center provides including, but not limited to, written information, equipment, ThinkLift, etc. |
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