Nurturing the seeds of evidence-based practice: Early ambulation among cardiac surgery patients
- Author:
RAINIER C. MORENO-LACALLE
- Publication Type:Journal Article
- MeSH:
Early Ambulation;
Cardiac Surgical Procedures
- From:
Philippine Journal of Nursing
2016;86(1):56-65
- CountryPhilippines
- Language:English
-
Abstract:
Background:Cardiovascular disorders continue to be the most prevalent cause of
morbidity and mortality in the Philippines and worldwide. Surgical treatments used to
manage cardiovascular disorders (unfortunately) have multiple complications. As part of
the health care team, nurses need to develop interventions that are safe, scientifically
grounded, and cost-effective in order to counteract these complications. One of the nursing
interventions that can be implemented is early ambulation.
Aim:To search, appraise, and synthesize the best evidence surrounding early ambulation
among cardiac surgery patients.
Methods:This study employed an evidence-based review method suggested by Melnyk
and Fineout-Overholt (2005). Systematic literature search was done to the following
databases: Cochrane, Cumulative Index of Nursing and Allied Health Literature (CINAHL),
Joana Briggs Institute (JBI), MEDLINE, National Guideline Clearinghouse (NGC), and
Nursing/Academic edition. Post-operative patients who have undergone coronary artery
bypass surgery (CABG), percutaneous coronary intervention (PCI), and transfemoral
cardiac catheterization (TCC) are included in this study. The final review also included six
articles.
Results and Discussion:Findings show that early ambulation among patients who
underwent coronary artery bypass surgery (CABG), percutaneous coronary intervention
(PCI), and transfemoral cardiac catheterization (TCC) improves patient care outcomes
(i.e., reduce complications such back pain, puncture bleeding, and urinary discomfort,
improves general well-being, and decrease health care costs). Parameters for early
ambulation (ranges from 3 hours to 24 hours) and late ambulation (ranges from 12 hours to
48 hours) are used in the study reviewed. The non-randomized comparative study found
that the complication rate in the early ambulation group is not increased compared to the
late ambulation group (test for non-inferiority p= 0.002). Randomized controlled trial found
out that early ambulation among cardiac surgery patients could reduce back pain
(OR=0.19, 95% CI: 0.08-0.45, p<0.001), decrease urinary discomfort (OR=0.35, 95%
CI:0.14-0.90, p=0.03) for very or unbearable urinary discomfort, and general-well being
(p=0.0005 for vitality scale and p=0.014 for the total general well-being). Furthermore,
early ambulation group reported decrease in hospitalization costs (less charge of $105 or
Php 5,040).
- Full text:pjn 102.pdf
