IMPLEMENTATION OF AN EARLY AMBULATION PROGRAM FOR ORTHOPEDIC PATIENTS TO PROMOTE ENHANCED RECOVERY AFTER SURGERY (ERAS)

Abstract

AbstractProblem Statement: ERAS protocols function as a recommended method for practice and are tailored to every institution’s need. From the literature, despite strong emphasis on its importance, there is great ambiguity regarding the definition of early ambulation. This ambiguity provides flexibility in care planning but has ultimately led to poor standardization of ERAS protocol. This lack of standardized protocol combined with limited data on distance and timing of early ambulation has resulted in unmet early ambulation goals and poor patient mobility outcomes. This lack of measurability is a major barrier to care, further demonstrating the need for standardized ERAS protocol parameters and robust nursing education on ERAS protocols. Purpose: The purpose of this project was to determine if nurse education of safe early ambulation and defining a goal of postoperative joint arthroplasty patient’s ambulation distance of greater than or equal to ten feet on postoperative day zero (POD0) would improve nursing practice that contributes to increased rates of early ambulation. Methods: A facility specific rapid ERAS early ambulation training was created by the DNP student and delivered to nurses in five to seven minutes. A pre-test survey and post-test survey were designed to assess nurses’ knowledge of ERAS, attitudes, and currents practices regarding early ambulation for postoperative joint arthroplasty patients. Results: 17 Registered Nurses (RNs) participated in the rapid ERAS early ambulation education. 29.4% reported receiving prior education on ERAS and were able to correctly define ERAS prior to the intervention. 35.5% reported they knew how far and within what time frame to ambulate their patients post-op. After the educational intervention, 100% of respondents could identify the early mobility goals of ERAS for the unit and identify the goals of ERAS care. There was an increase in nurse knowledge as evidenced in the pre-test and post-test scores. Discussion: This project highlighted the importance of continual nursing education on ERAS early ambulation protocol to promote patient mobilization in the first 24 hours post-operatively. The findings from this project indicate that training eliminates gaps in knowledge among nurses and have a positive impact on patient recovery. It is essential for facilities to clearly define early ambulation in time and distance for nursing staff to assist patients in reaching these recovery goals.