Authors: (including presenting author): :
Lee MK(1), Chen HW(1), Chan YS(1), Mok M(1), Chui KS(1), Ho PC(1), Duong KH(1), Cheng S(1), Li R(1), Cheung CM(1), AuYeung M(1)
Affiliation: :
(1)Department of Medicine, Pamela Youde Nethersole Eastern Hospital
Keyword 1: :
Acute Stroke
Keyword 2: :
Early Mobilization
Keyword 3: :
Patient Safety
Keyword 4: :
Nurse Confidence
Keyword 5: :
NEOM Checklist
Introduction: :
Early mobilization is crucial for acute stroke patients to reduce immobility-related complications such as pneumonia, urinary tract infection (UTI), deep vein thrombosis, and pulmonary embolism. However, there is currently no standardized checklist with criteria, raising concerns regarding potential clinical responses such as hemodynamic instability or neurological deterioration. This study explores whether a nurse-developed NEOM checklist can enhance the safety of out-of-bed mobilization (OM), defined as sitting patients out in a chair, and increase nurses' confidence in implementing NEOM in ASU.
Objectives: :
To evaluate the effectiveness of NEOM checklist on patient safety of acute stroke patients, including acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) in ASU; and ASU nurses’ confidence and acceptability regarding the implementation of checklist.
Methodology: :
A quasi-experimental study with a nonequivalent control group was conducted. 181 ASU patients in the control group (CG; 1 Apr–31 Jul 2025) received standard OM, while 152 in the intervention group (IG; 1 Aug 2025–30 Nov 2025) received the NEOM under checklist, which involved daily progressive sitting, reassessment after 15 minutes, and continuous monitoring during the session, with predefined inclusion and exclusion criteria. 26 ASU nurses completed a self-reported survey using a 5-point Likert scale on confidence and acceptability before and after implementation. Statistical analysis was conducted using Chi-square tests and Mann-Whitney U test.
Result & Outcome: :
No clinically significant hemodynamic or neurological deterioration was observed in AIS or ICH patients in either CG or IG. Among AIS patients with posterior circulation stroke, 5 cases of UTI were reported in the CG (n=26) and none in the IG (n=19) (p< 0.05). In ICH patients, the CG (n=33) had 10 cases of pneumonia, whereas 4 cases were reported in the IG (n=37) (p< 0.05). Nurses’ confidence scores increased from a mean score of 3.08 to 4.35 (p< 0.01).
The NEOM checklist appears safe and beneficial for both AIS and ICH patients, with fewer immobility-related complications and no increase in adverse clinical events. It also significantly enhances nurses’ confidence in performing early OM in ASU.
