PostOperative Early Ambulation Jessica Eynatian University of New

Post-Operative Early Ambulation Jessica Eynatian- University of New Hampshire Nursing, Senior Practicum Nursing Practice PRH provides extensive education to patients regarding the benefits of ambulation in the hospital and follows its Progressive Mobility Protocol, which requires nurses to perform a mobility assessment every shift and encourages patients to be out of bed for meals, when using the bathroom, and for 3 walks in the hall daily. However, at PRH there is currently no protocol in place that addresses early ambulation after surgery or the time frame in which initial ambulation should be attempted. Ambulation is a crucial nursing intervention. Yet according to The Journal of Clinical Nursing, ambulation of patients is the most frequently missed element of patient care by nurses (Kalisch, 2013). P I C O In adult post-op patients, does ambulation within 12 hours of surgery (day 0) improve patient outcomes compared to ambulation post-op day 1? 1. a. b. Evidence-Based Research “Early ambulation after surgery is safe and feasible. It can reduce the patient's pain and economic burden, increase the patient's comfort, reduce the nursing workload, achieve rapid recovery, and improve 2. patient satisfaction” (Wang, 2018). c. “Early ambulation is associated with a statistically significant reduction in the average length of stay and average total hospitalization costs” (Pua, 2014) “Immediate postoperative ambulation may be the most significant prophylaxis against thromboembolic complications” (Gorecki, 2008). “Early ambulation yields decreased post- op complications such as pneumonia” (Kazaure, 2014). Recommendations Develop a clinical practice guideline for early ambulation after surgery where: Patients sit at the edge of bed and dangle their feet within 6 hours of PACU discharge (Morris, 2010) Patients ambulate within 12 hours of surgery (Morris 2010) Nursing staff and patients are educated on the benefits of early ambulation (< 12 hours) after surgery Develop a system to prevent “missed” ambulation care by nursing staff