Early Ambulation Is Crucial for Improving Patient Health : AJN The American Journal of Nursing

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Early Ambulation Is Crucial for Improving Patient Health

Halpern, Lucy Wang

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AJN, American Journal of Nursing: June 2017 - Volume 117 - Issue 6 - p 15
doi: 10.1097/01.NAJ.0000520240.29643.e2
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Recent studies demonstrate the health benefits and cost savings of getting hospital patients walking soon after their procedures. Citing this research, the Physician–Patient Alliance for Health and Safety (PPAHS) has issued a position paper (http://bit.ly/2quWobT) calling on hospitals to prioritize early ambulation as a key metric in patient care and recovery.

The benefits of early ambulation are clear. Physical activity strengthens joints and muscles, and movement is associated with shorter hospital stays. A 2014 study linked early mobility to shorter hospitalizations for knee arthroplasty (replacement) patients. These benefits are also evident in patients admitted for conditions and procedures unrelated to mobility. A 2010 study of patients 65 years of age and older admitted for various diagnoses (neurologic, gastrointestinal, cardiopulmonary, infection) found that those who increased their step count by at least 600 steps daily were discharged two days earlier than patients who did not.

Shorter hospital stays also yield significant savings. A 2015 study reported that one day of inpatient care following total hip replacement cost $3,300.

While nurses recognize that patient ambulation can improve outcomes, there are obstacles to achieving this. One is nurses’ increased workloads, which have cut into time spent with patients, including helping them to ambulate. Another obstacle, ironically, is medical technology. Monitoring devices record numerous metrics—heart rate, temperature, oxygen saturation level, carbon dioxide exhalation—but keeping patients connected to these machines restricts their mobility.

Wearable and wireless monitors offer a solution. A 2014 PPAHS survey showed nurses overwhelmingly favor such mobile monitors. Given the evident benefits of early ambulation, the PPAHS urges health institutions and government bodies to establish best practices that prioritize patient ambulation, and urges medical device makers to develop wearable and wireless technology.—Lucy Wang Halpern

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