• Kate E Klein, James F Bena, Malissa Mulkey, and Nancy M Albert.
• Cleveland Clinic, 9500 Euclid Avenue, Mail Code G20, Cleveland, OH 44195, USA. Electronic address: keklein@novanthealth.org.
• Intensive Crit Care Nurs. 2018 Apr 1; 45: 11-17.

ObjectivesTo determine sustainable impact of an early progressive mobility protocol on mobility level and clinical outcomes.Design/MethodsProspective, longitudinal, comparative study using three time points (pre-, immediate post-intervention and 12-month post-intervention sustainability). Analyses included comparative statistics and multivariable modelling. Data were collected by clinical nurses, from administrative databases. Psychological health data were collected using a valid, reliable tool.SettingPatients treated in a 22-bed Neurological Intensive Care Unit of a quaternary-care medical centre.Outcome MeasuresHighest mobility level, length of stay, mortality, discharge disposition, quality metrics and psychological profile including depression, anxiety, and hostility.ResultsAmongst 260 pre-intervention, 377 post-implementation, and 480 twelve-month post-implementation patients (N = 1117) walking increased post-implementation and was sustained at the eight-month assessment, p < .001. After multivariable adjustment, unit and hospital length of stay and psychological distress were reduced compared to the pre-early mobility programmes (all p < .001). There were no differences in discharge disposition (i.e., home vs skilled nursing facility), mortality or quality metrics.ConclusionOngoing implementation of an early mobility programme in a neurological intensive care environment led to sustained improvement in patients' level of mobility, length of unit and hospital stay, depression, anxiety and hostility levels.Copyright © 2018 Elsevier Ltd. All rights reserved.

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