# Preventing Hospital-Acquired Disability: An Intervention to Improve Older Adult Patient Ambulation - Supplement

> **NIH AHRQ R01** · UNIVERSITY OF WISCONSIN-MADISON · 2022 · $51,638

## Abstract

Project Summary/Abstract: NO CHANGE FROM ORIGINAL SUBMISSION
Up to 65% of adults aged 65 and over will lose their ability to independently ambulate during hospitalization
primarily because they were not engaged in walking during their stay. Loss of independent ambulation is now
identified as a hospital acquired disability and a significant patient safety concern. Older adults spend greater
than 80% of the time in bed during hospitalization and only engage in ambulation 4% of the time. Costs for new
onset disability in the United States are estimated to be 26 billion dollars annually to cover increased medical
and long term care needs. Having a recent hospitalization and restricted activity were strongly associated with
development of a new functional impairment in older persons. Although patient ambulation may fall within the
domain of multiple healthcare providers (nurses, physical and occupational therapy, and physicians), nurses
have traditionally been responsible for promoting and maintaining patients’ functional mobility. But nurses
infrequently ambulate patients due to multiple personal and organizational barriers that prevent them from
getting patients up to walk. Asking nurses to do more will not fix the harm that is being caused to hospitalized
older adults or mounting costs due to increased need for health care resources post discharge. Innovative
models of care are needed that address and overcome barriers that prevent nurses from walking older
patients. Pilot study results of our model of care, Mobilizing Older adults Via a systems-based INtervention
(MOVIN) have demonstrated statistically significant increases in patient ambulation and change in nursing
practice and unit culture, which have been sustained on the study unit for over 3 years. Our next step is to
conduct an RCT using an incomplete stepped wedge cluster randomization design across four adult medical
inpatient units in two hospitals. The overarching hypothesis of this project is that MOVIN will improve functional
outcomes for older adult patients by producing a change in nursing practice and culture of ambulation on
inpatient units. Specific aims are to: 1) test the effectiveness of MOVIN to improve functional ability of older
adult patients at discharge, and 1, 3, and 6 months post discharge; 2) test the effectiveness of MOVIN to
reduce healthcare utilization of older adults at discharge, and 1, 3, and 6 months post discharge; 2a) analyze a
return on investment of MOVIN based on program costs and health utilization measures across different
hospitals; and 3) measure change in nurse behaviors and unit culture and identify ongoing systems barriers
that impact translation of MOVIN across inpatient units and different hospitals. We propose to accomplish
these aims with the overarching goal of eliminating loss of independent ambulation in hospitalized older adults.
This proposed project has the potential to prevent development of physical disability (loss of independent
ambul...

## Key facts

- **NIH application ID:** 10652832
- **Project number:** 3R01HS026733-03S1
- **Recipient organization:** UNIVERSITY OF WISCONSIN-MADISON
- **Principal Investigator:** Barbara King
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2022
- **Award amount:** $51,638
- **Award type:** 3
- **Project period:** 2022-09-01 → 2023-08-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10652832

## Citation

> US National Institutes of Health, RePORTER application 10652832, Preventing Hospital-Acquired Disability: An Intervention to Improve Older Adult Patient Ambulation - Supplement (3R01HS026733-03S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10652832. Licensed CC0.

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