UNM Early Ambulation Protocol :

1. UNM Early Ambulation Protocol: • Protocol should be initiated on all inpatients on the first day of admission or transfer. • Goal of the protocol is for patients to ambulate (walk) early and often during their hospital stay. • Mobility activity per protocol to be performed ≥ 3 times per day and documented in PowerChart. • If a patient walks downstairs or around the unit often, can just document ambulation distance as 2000 feet. • Meals should be served out of bed whenever possible. • Once a step is mastered, advance to the next step at the next session. • If intolerance develops, discontinue activity and return to bed for rest. During next session, may decrease activity level until patient able to tolerate. • Help is defined as either hand held OR use of assistive device. • Continue ambulation protocol (≥ 3 times per day) until patient is discharged. Start here with assessment (ask + observe): • Walk. • Initial goal: distance ≥ 200 feet. • Secondary goal: to increase distance each time patient walks. • Decrease level of assistance and/or supervision as tolerated. YES Can patient walk (with OR without help)? NO Can patient sit at the edge of the bed with HOB flat (with OR without help)? YES Stand/pivot/step to chair. Goal: ≥ 60 minutes in chair. NO YES Patient to sit at the edge of the bed. Goal: ≥ 10 minutes at edge of bed. Can patient sit at the edge of the bed with HOB↑ to 45°-65° (with OR without help)? Patient to chair position with HOB↑ to 65° and feet in dependent position. Goal: ≥ 60 minutes in chair position. NO