title: Evaluation of a Progressive Mobility Protocol in Postoperative Cardiothoracic Surgical Patients.
abstract: Cardiothoracic surgical patients are at high risk for complications related to immobility, such as increased intensive care and hospital length of stay, intensive care unit readmission, pressure ulcer development, and deep vein thrombosis/pulmonary embolus. A progressive mobility protocol was started in the thoracic cardiovascular intensive care unit in a rural academic medical center. The purpose of the progressive mobility protocol was to increase mobilization of postoperative patients and decrease complications related to immobility in this unique patient population. A matched-pairs design was used to compare a randomly selected sample of the preintervention group (n = 30) to a matched postintervention group (n = 30). The analysis compared outcomes including intensive care unit and hospital length of stay, intensive care unit readmission occurrence, pressure ulcer prevalence, and deep vein thrombosis/pulmonary embolism prevalence between the 2 groups. Although this comparison does not achieve statistical significance (P < .05) for any of the outcomes measured, it does show clinical significance in a reduction in hospital length of stay, intensive care unit days, in intensive care unit readmission rate, and a decline in pressure ulcer prevalence, which is the overall goal of progressive mobility. This study has implications for nursing, hospital administration, and therapy services with regard to staffing and cost savings related to fewer complications of immobility. Future studies with a larger sample size and other populations are warranted.
authors.affiliation: Shawn Floyd, DNP, RN, ACNP, is a nurse practitioner with the Lung Transplant Team at the University of Virginia Health System. Sarah W. Craig, PhD, RN, CNS, is a clinical nurse specialist and an assistant professor of nursing at the University of Virginia School of Nursing. Darla Topley, DNP, RN, CNS, is a clinical nurse specialist working in the Thoracic and Cardiovascular Intensive Care Unit at the University of Virginia Health System. Dorothy Tullmann, PhD, RN, CNL, is an associate professor of nursing and the MSN & DNP Programs and director at the University of Virginia School of Nursing. The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.
authors.forename: Shawn
authors.initials: S
authors.lastname: Floyd
authors.forename: Sarah W
authors.initials: SW
authors.lastname: Craig
authors.forename: Darla
authors.initials: D
authors.lastname: Topley
authors.forename: Dorothy
authors.initials: D
authors.lastname: Tullmann
mesh_terms: D000368:Aged; D013504:Cardiovascular Surgical Procedures / Q000451:nursing*; D003422:Critical Care; D004434:Early Ambulation; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer; D011446:Prospective Studies