RNCohortJournal of the American Medical Directors Association2025

An Observational Study of Nursing Delivery of Mobility Assistance in Acute Care.

Sandra F Simmons, Emily K Hollingsworth, Jason M Slagle and 4 others

PMID 40789336

WHAT IT FOUND

Nurses documented mobility help for most patients, but observed care often exceeded the chart: 46% received more assistance than recorded.

Repositioning was the most common observed mobility task, and walking took the longest staff time.

Key findings

01Nurses rated 68% to 88% of patients as requiring 1 or 2 staff for mobility assistance, and typical mobility goals were 2 to 3 times per patient per day.

02Observed mobility assistance was most often repositioning in bed (59.7%), and walking assistance required the most staff time (8.51 minutes per episode).

03Observed nursing assistance matched documentation 53.4% of the time, and nearly half (46%) of patients received a higher level of assistance than documented.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

Results come from 1 hospital, so they may not apply to other settings. Observations were not continuous for each patient, so some mobility episodes may have been missed. Patients who could walk independently may have been out of bed without staff, so those episodes would not appear in the data. The study did not track length of stay or how mobility needs changed during hospitalization, so repositioning may have been appropriate early in care. Only 13.8% (n = 232) of patients were identified as cognitively impaired, and the study had no patient-level data on changes in cognition or its causes. Patient preferences may have influenced the timing and type of assistance provided. The study describes care delivery and does not test whether any mobility assistance model improves outcomes.

Declared interests

The authors declare no conflicts of interest. The article is listed as supported by NIH extramural research, but the supplied text does not state that a funder designed or wrote the study.

The easy way to misread this

Do not conclude that repositioning in bed is a good substitute for walking or transfers because it took less time. The study observed routine nursing care and did not compare mobility outcomes, so it cannot show whether repositioning, transfers, or walking is better for patients.

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