Implementation of the Bedside Mobility Assessment Tool (BMAT) in the Ambulatory Care Settings (Spotlight Poster)

Purpose: Falls are a common occurrence in the ambulatory care setting and can lead to unintended patient harm and work-related injury. Fall rates at the site remained a concern. An evidence-based approach was sought. The purpose of this quantitative, quasi-experimental quality improvement project in two ambulatory care departments was to determine if or to what degree the bedside mobility assessment tool (BMAT) used in conjunction with current fall practices would impact fall rates in the ambulatory setting in Southern California over four weeks.
Description: The safety of patients is threatened by the possibility of falls when receiving ambulatory care services. This issue impacts patients’ health and outcomes, but there is also a substantial financial impact on the healthcare community. This project used nursing mobility assessment and safe patient handling and mobilization (SPHM) technology based on the patient’s mobility level. The BMAT instructs nurses to guide patients through a four-step functional task list to identify the level of mobility patients can successfully perform. The tool takes both patient and the nursing staff to determine mobility level based on a pass or fail score. The nurses use the patient’s level of mobility and the unique technology needed to lift safely, transfer, and mobilize the patient.
Evaluation/outcome: Emergency department results: The total sample population of N=10,469, n= 5,456 in the comparative group, and n= 5,013 in the implementation group. The fall rate in the comparison group was 0.05% (n=3), and .02% (n=1) in the implementation group. The p-value of .359 showed no statistically significant difference in fall rates. There was, however, a clinical significance as the fall rate was reduced by 0.3% over the project timeline.
Gastroenterology department results: A chi-square test showed a clinical and statistically significant improvement in fall rates X 2 (1, N= 90) = 8.39, p = .004. The results indicate that implementing the BMAT and current fall practices may reduce fall rates in this population and setting.
Summary statistics on the number of work-related injuries were collected. There were four injuries during the comparative period and no injuries during the implementation period. Summary statistics were computed for SPHM technology use within the comparative and implementation group. There was an increase of 10% use of the SPHM technology in the implementation group. Summary statistics were computed for the use of BMAT. Of the 45 patients, 43 (93.3%) were assessed using the BMAT.