- All post-operative major surgical patients.
- Patients requiring two I.V. poles.
- Patients requiring a walking frame and any other equipment such as drains or I.V.
- Patients needing Oxygen and other equipment while mobilizing.
- Any patient having stability problems with available equipment.
- Any patient with or without equipment who requires upper body support.
Effective use of the Moose
Moose Remains with Patient
The Moose should remain with the patient at the bedside with equipment and pumps remaining on the unit. This includes redivacs, urinary drainage containers and Naso-gastric (NG) drainage collection bags.
Use Onboard Power board
The volumetric and syringe drive pumps should be connected to the onboard power board. The power board is then connected to the patient protected wall outlet.
Assist Patient
Good assistance by physiotherapist or nurse in the first mobilizing will build confidence in the patient who within a day or two should be able to mobilize solo.
To Mobilize
This should take one minute, not seven to eight without the Moose.
Unplug the power board from the wall outlet. Pumps will continue to function on their own battery backup systems.
If patient is on oxygen therapy or requires oxygen for mobilizing, connect wall oxygen tubing to the on-board oxygen cylinder after setting the regulator to desired rate.
Assist the patient to stand out of bed then to take the Moose handles. Release the back wheel brakes when the patient is stable and ready to move.
Mobilize Solo
The patient will require assistance to setup if still having oxygen treatment. If not, then the patient can be taught to first switch off the wall outlet then remove the plug and store the power-board cord in the front basket. On return, and moving to the other side of the bed, plug into then switch on the wall outlet. Patient should be given the opportunity to become involved by documenting each mobilizing, time and distance.
Frequent Mobilizing
The more frequent the mobilizing the better. Ensure the patient is adequately trained in the use of the Patient Controlled Analgesia (PCA).Mobilize when pain is minimal with stability maintained. With minimal pain and comfortably supported by the Moose the patient will be less reluctant to mobilize.
The surgeons who advocate frequent mobilizing do so because it accelerates healing and diminishes bed-rest induced complications.
Patients can cease using Heparin or Clexane when mobilizing more than six times per day.
Aim to have patients mobilize assisted or solo six to eight times per day by the end of day three.
A gentle reminder, with offer of assistance, should be all that is required on day three and onwards.
To Reposition Patient
Unplug the power board cord from the wall outlet. Maneuver the Moose around the foot of the bed to the other side. Plug the power board into an available outlet, and then assist the patient to roll over.
Alternative Method:
The better way to reposition a patient is to have the patient stand out of bed on the Moose side. Walk with the Moose to the other side of the bed then reenter the bed or chair as preferred. If you teach this style then to reposition = to mobilize. Even these short distances have a bearing on speeding up recovery.
Weaning Off
An important part of using the Moose effectively is the weaning off process.
The main benefit of the Moose is in the first few days post-op. It allows for early and frequent mobilizing, returning the body’s processes back to normal quicker.
When the patient has gone from Total Parental Nutrition (TPN) through naso-gastric feeding and is on clear or nutritional fluids then the time is right. Depending on many variables, this could be as little as three or four, to six or more days.
At this stage they should have less reliance on oxygen, urinary catheter removed, no NG tube and only one I.V. live for maintenance I.V. or drugs.
When the pumps and oxygen are no longer required then they need to be told that the Moose is required elsewhere.
It is important they understand that they need to continue to mobilize at least eight times per day.
Efficient Use of Staff
One of the most effective aspects of using the Moose is that it frees up highly trained staff to work more efficiently.
On many occasions the physiotherapist or nurse buddy is summonsed in the early days to be equipment carriers. The patient and one nurse cannot move two I.V. poles, an oxygen cylinder and the required walking frame.
If the patient experiences difficulty then the nurse or physiotherapist are not “hands free” to immediately assist.
In the time it takes to go to the office, call the physiotherapist to arrange a time, and then return to the patient, the task could have been accomplished twice over. Either the nurse or the visiting physiotherapist can easily assist the patient without calling on another trained staff.
