Running head: EARLY MOBILITY IN PATIENTS 1

Cost of Early Mobilization in Trauma Patients

Stefany A. Ramirez

James Madison University

NURSING STAFF SHORTAGE 2

Cost of Early Mobilization in Trauma Patients

Traumatic injuries are very common in the healthcare world. The patients who survive

traumatic injuries often have to go through multiple surgeries and procedures in order to get

better. Often times, patients will need to spend their hospitalization in a critical care unit and will

be on a mechanical ventilator. A patient who has had a traumatic injury is at risk for many other

complications during their hospitalization. “Complications such as venous thromboembolism

(VTE), pneumonia, and delirium are common and increase mortality, length of stay (LOS), and

cost,” (Falkenstein, Skalkowski, Lodise, Moore, & et al., 2020). In a study published by the

Journal of Trauma Nursing, it determines the results of early mobilization in trauma patients.

The study looked at ventilator days, length of stay, utilization of rehabilitation services, and cost

(Falkenstein et al., 2020).

In order to determine who would qualify for the study, the ABCDEF bundle was utilized

(Falkenstein et al., 2020). “The ABCDEF bundle (Assess, prevent, and manage pain; Both

spontaneous awakening trials and spontaneous breathing trials; Choice of analgesia and sedation;

Delirium, assess, prevent, and manage; Early mobility and exercise; and Family engagement and

empowerment) reduces the complications associated with critical illness and improves the

outcomes of patients admitted to the ICU,” (Falkenstein, et al., 2020). According to the study,

patients who have experienced a traumatic injury have had fewer complications when early

mobilization took place (Falkenstein et al., 2020). The study was performed in a level II trauma

hospital that contained a 14-bed trauma/surgical intensive care unit (Falkenstein et al., 2020).

There were eighty-seven patients who were admitted to the intensive care unit that had sustained

a traumatic injury that qualified to be in the improvement project (Falkenstein et al., 2020).
NURSING STAFF SHORTAGE 3

The study worked with a great team. “A multidisciplinary early mobility

committee consisting of a trauma surgeon, a trauma nurse, a clinical nurse specialist, a

respiratory therapist, a physical therapist, an occupational therapist, and a clinical

pharmacist convened to develop an early mobility program for patients in the trauma

ICU,” (Falkenstein et al., 2020). The results of the study showed that there was no

difference in length of stay and the amount of time a patient was on the ventilator

(Falkenstein et al., 2020). However, it did show an improvement in cost. “The direct

variable cost to care for patients in the early mobility group was $354,277 less than the

cost to care before the early mobility resulting in an average direct variable cost savings

of $8,239 per patient. The direct variable cost saving projection is $2,352,744 annually,”

(Falkenstein et al., 2020).

The authors learned that the early mobility program required collaboration

between all of the staff in the critical care unit. They learned that it was important for the

unit to work together in order to help the patients out. It was important for the team to

assess the patients together in order to see if they qualified for the program as well. In

conclusion, early mobilization in patients that have traumatic injuries reduced cost in

their hospitalization.

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NURSING STAFF SHORTAGE 4

Reference

Falkenstein, Beth A., Skalkowski, C. K., Lodise, K. D., Moore, M., Olkowski, B. F., & Roiavin,

Y. (2020).The Economic and Clinical Impact of an Early Mobility Program in the

Trauma Intensive Care Unit. Journal of Trauma Nursing, 27(1), 29-36. doi:

10.1097/jtn.0000000000000479