Allison Sawyers Cristan Sabio, PhD, MSN, RNSchool of Nursing, College of Health and Human Sciences, Northern Illinois University

Benefits of Early Ambulation: A Literature Review

Method• Database used: CINAHL Complete

• Key words searched: early ambulation, post-operative, mobility, benefits of early ambulation, nursing implications, barriers

• Electronic search criteria:

– English language

– Peer-reviewed articles

– Published within the last five years

• Full articles were reviewed and selected based on the criteria above

• Seven articles were selected

Purpose

The purpose of this study was to review the literature

on the benefits of early ambulation, specifically, for

postoperative patients. Furthermore, the literature

was reviewed to determine the barriers and the

nursing implications as they relate to early

ambulation.

Results Nursing Implications Nurse’s role in successful postoperative ambulation:• Educating patients

– Provide information on early ambulation– Facilitate postoperative ambulation

• Trialling protocol and techniques – Collaborate with a team of nurses to initiate

a quality improvement project on early ambulation • Lipsett & White, 2019

• Collaborating with health care professionals– Work with various members of the patient’s

health care team

Background

Early ambulation is a technique that is used

postoperatively to engage a patient in mild activity.

These activities are meant to be progressive, starting

with sitting in a chair and standing to eventually

walking (Early Ambulation, n.d.).

[Male patient walking with nurse] (n.d.). Retrieved from http://www.oakbendmedcenter.org/why-is-ambulation-important-to-recovery/ References

ConclusionEarly ambulation is a noninvasive technique that can

lower hospital costs, can shorten hospital stays, and

can prevent postoperative complications. Educating

and engaging patients on their plan of care is a key

component to successfully implementing early

ambulation. Nurses can make an impact by

participating and practicing early ambulation

techniques.

Results – Barriers

(Dubb et al., 2016)

Lower Cost• After implementing early ambulation, total hospital costs

decreased by 39.5% (Anderson, Barr, Corbridge, Doerschug, & Sparbel, 2018).

• Ambulation programs decrease hospital costs by $278 per patient per stay (Engelman et al., 2017).

Fewer postoperative complications• Patients who ambulated early were about 7% less likely to

acquire pneumonia postoperatively (Adogwa et al., 2017).

• Before implementing the T-ERAAS protocol, postoperative pneumonia rates were at 6% (Chandy, Fernando, Khandhar, & Mayor, 2018).

• After implementing the T-ERAAS protocol, postoperative pneumonia rates were at 0.7% (Chandy, Fernando, Khandhar, & Mayor, 2018).

Shorter hospital stays• When a day of ambulation

was missed, patients increased their hospital stay by 72 hours (Barnes et al., 2018).

• Patients who ambulated early after surgery decreased their time in the intensive care unit by over 56 hours (Anderson, Barr, Corbridge, Doerschug, & Sparbel, 2018).

Thoracic-Early Recovery with Ambulation After Surgery(T-ERAAS) Protocol

Figure 1. T-ERAAS Ambulation Tool. Adapted from Journal of Thoracic Disease. Retrieved from jtd.amegroups.com

Barriers StrategiesLimited staff, time constraints Additional physical and occupational

therapists, independent ambulation teamLack of patient/family knowledge Media engagement and education

Patient refusal, lack of motivation, pain Adjust plan to personalize treatment, provide patient education, include patient in plan of care, provide pain medication before ambulation