Nurse-Led Protocol Improves Early Progressive Mobility for Patients with Heart Failure

An analysis presented at the 2026 Annual Meeting of the American Association of Heart Failure Nurses (AAHFN 2026) in San Diego, California, showed that mobility rounding led by inpatient nurses promoted early mobility and decreased length of stay for patients hospitalized for acute heart failure episodes. 
 
Clinical practice guidelines recommend early mobilization and progressive ambulation for patients hospitalized for acute cardiac episodes. Once hemodynamic and respiratory stability is achieved, getting patients to move three times daily at their highest level of mobility can prevent functional decline and reduce duration of hospital stays. Nevertheless, daily mobility goals are not always achieved in inpatient settings. A review conducted in 2024 at Duke University Hospital in Durham, North Carolina revealed that more than half of the hospitalized patients failed to achieve guideline-recommended mobility goals. In response to those concerns, a project was designed to promote progressive mobility for patients with heart failure by performing nurse-led weekly mobility rounds and identifying barriers that prevent patients from achieving their daily mobility goals. The intervention targeted adults hospitalized with primary or secondary heart failure, including those with acute on chronic exacerbations, cardiogenic shock, and advanced heart failure requiring mechanical circulatory support or heart transplantation, with a 4 to 1 nurse-to-patient ratio. A validated, nurse-driven mobility assessment was conducted daily at the bedside to determine the highest level of mobility for each patient, with the aim to initiate progressive mobility. 

The analysis showed that the mobility rounding intervention, which ran from October 2024 through November 2025, increased daily mobility from 49% at baseline to 80% among participants hospitalized with heart failure. This increase translated into a lower number of falls with injuries and a decreased number of referrals to rehabilitation services post-discharge. While there was only a modest decrease in the total length of stay in the hospital (3%) among patients participating in nurse-led mobility rounding, the authors noted that the program increased visibility and accountability through daily tracking, setting the stage for increased patient engagement and improved mobility. Moreover, the nurse-led initiative provided support to the frontline clinical staff and improved real-time decision-making at the bedside, marking a significant step toward improved patient mobility and clinical outcomes after discharge from the hospital. Ultimately, integrating early and progressive mobility into nurse-led care protocols has the potential to accelerate recovery and reduce hospital length of stay for patients with heart failure in a cost-effective manner that benefits patients and their families.