One method of delivering the education and support a shift in practice is to hold a ‘fair’ on the unit.  Held on more than one day, fairs target different shifts and all staff members are expected to attend.  A fair implemented at a MOVE hospital consisted of eight stations.  Staff spent approximately 15 minutes at each of the following eight stations:

1.    Introduction to MOVE

  • Overview of the project
  • Mobility post: “Mobility is Not Lying in Bed”

2.    Documentation

  • What needs to be documented and how do I find mobility information?
  • Discussion of “I thought she could ambulate but I’m not sure” (Covinsky et al., 2011)
  • The shortened algorithm (7 questions) and hand out lanyard cards designed to be worn along with hospital badges documenting the different mobility levels for easy reference for staff (found on portal under Clinical Resources)

3.    Interprofessional Team Functioning/ Mobilize 3x daily/Hazards of bed rest/ Patient & Family Pamphlet

  • Highlight “Team work”
  • Highlight the focus on ADLs as a way to optimize mobility
  • “How could you mobilize this patient 3x/day?” and if they flip over the card, there are some strategies on the back
  • Focus on the patient/family as part of the team and make sure that they are engaged and involved with the program (they will be getting a pamphlet, etc.)
  • “Question the culture of the bed” – hazards of bed rest, patients in “sick role” where the bed legitimizes the admission, etc.

4.    Myth Busters

  • Senior-friendly focused activity using a laptop

5.    Loss of strength station (run by PTs)

  • Demonstrate the loss of muscle strength with bed rest by getting the participant to lift the different weights and “feel/experience” the difference
  • Use a 2.5, 5 and 7.5/10 pound weight to demonstrate the loss of muscle strength, loss of 5%/day, so 10 days of bed rest results in 50% decrease in strength. Age-related body composition changes result in seniors have less muscle strength at baseline, which makes them at risk for functional decline and disability.
  • Loss of muscle strength greatest in legs
  • Loss of quadriceps strength makes the patient vulnerable to functional decline and dependence

6.    Sit at the side of the bed station

  • Set up bed
  • Teach people how to get someone to sit at the side of the bed safely

7.    Reflection, Feedback & Evaluation, and Food & Hydration Station

  • Provide Post-it notes, so that participants can provide comments with respect to usefulness, what worked well, what could be improved
  • May also be an opportunity to further explore barriers about the project which could be used to inform the Knowledge-to-Practice coaching and/or brought to the unit champions for further exploration and feedback