Implementing a Nurse-Driven Early Ambulation Protocol to Enhance Post-Transcatheter Aortic Valve Replacement Outcomes: A Quality Improvement Initiative.

IF 1.2 4区医学 Q3 NURSING

Journal of nursing care quality Pub Date : 2025-04-01 Epub Date: 2025-01-20 DOI:10.1097/NCQ.0000000000000835

Katie P Worthington, Erin Giannantonio

{"title":"Implementing a Nurse-Driven Early Ambulation Protocol to Enhance Post-Transcatheter Aortic Valve Replacement Outcomes: A Quality Improvement Initiative.","authors":"Katie P Worthington, Erin Giannantonio","doi":"10.1097/NCQ.0000000000000835","DOIUrl":null,"url":null,"abstract":"Background: Immobility in patients undergoing transcatheter aortic valve replacement (TAVR) is linked to adverse outcomes and prolonged length of stay (LOS). Advancements in TAVR procedures allow for early ambulation post-procedure.Local problem: In a large teaching hospital, ambulation occurred at an average of 16.9 hours post-TAVR procedures, higher than the goal of 6 hours.Methods: A pre/post-implementation design was used. Data on ambulation times, LOS, and discharge disposition were collected and analyzed.Results: Time to the first ambulation significantly decreased from a mean of 16.9 (SD = 13.1) to 8.9 hours (SD = 5.3), P < .001. Patients meeting the goal of ambulation 4-6 hours post-procedure had a significantly lower LOS, P < .005. Fewer patients needed a higher level of care at discharge, P = .064.Conclusions: Early ambulation reduced LOS and had a positive impact on patient discharge disposition. A nurse-driven ambulation protocol can improve outcomes after TAVR.","PeriodicalId":16931,"journal":{"name":"Journal of nursing care quality","volume":" ","pages":"187-192"},"PeriodicalIF":1.2000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of nursing care quality","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/NCQ.0000000000000835","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/20 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"NURSING","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Immobility in patients undergoing transcatheter aortic valve replacement (TAVR) is linked to adverse outcomes and prolonged length of stay (LOS). Advancements in TAVR procedures allow for early ambulation post-procedure.

Local problem: In a large teaching hospital, ambulation occurred at an average of 16.9 hours post-TAVR procedures, higher than the goal of 6 hours.

Methods: A pre/post-implementation design was used. Data on ambulation times, LOS, and discharge disposition were collected and analyzed.

Results: Time to the first ambulation significantly decreased from a mean of 16.9 (SD = 13.1) to 8.9 hours (SD = 5.3), P < .001. Patients meeting the goal of ambulation 4-6 hours post-procedure had a significantly lower LOS, P < .005. Fewer patients needed a higher level of care at discharge, P = .064.

Conclusions: Early ambulation reduced LOS and had a positive impact on patient discharge disposition. A nurse-driven ambulation protocol can improve outcomes after TAVR.

查看原文本刊更多论文

实施护士驱动的早期活动方案以提高经导管主动脉瓣置换术后的结果：一项质量改进倡议。

背景：经导管主动脉瓣置换术（TAVR）患者的不活动与不良结局和延长住院时间（LOS）有关。TAVR手术的进步允许术后早期走动。局部问题：在一家大型教学医院，tavr术后平均行走时间为16.9小时，高于6小时的目标。方法：采用实施前/实施后设计。收集并分析了行走时间、LOS和出院处理的数据。结果：患者第一次活动时间由平均16.9小时（SD = 13.1）降至8.9小时（SD = 5.3）， P < 0.001。术后4 ~ 6小时达到活动目标的患者LOS明显降低，P < 0.005。较少的患者在出院时需要更高水平的护理，P = 0.064。结论：早期下床可降低LOS，对患者出院处理有积极影响。护士驱动的行走方案可以改善TAVR后的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of nursing care quality 医学-护理

CiteScore

2.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Journal of Nursing Care Quality (JNCQ) is a peer-reviewed journal that provides practicing nurses as well as nurses who have leadership roles in nursing care quality programs with useful information regarding the application of quality principles and concepts in the practice setting. The journal offers a forum for the scholarly discussion of “real world” implementation of quality activities.