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Impact of Early Mobilization Protocol on the Medical-Surgical Inpatient Population: An Integrated Review of Literature

Pashikanti, Lavanya MSN, RN; Von Ah, Diane PhD, RN

doi: 10.1097/NUR.0b013e31824590e6
Feature Article

Purpose/Objectives: The purpose of this review article was to examine the efficacy of an early mobilization protocol in hospitalized medical-surgical inpatient population.

Background/Rationale: Prolonged immobilization can result in functional decline and heighten the risk for hospital-associated complications such as falls and pressure ulcers. Early mobilization, on the other hand, has been shown to prevent functional decline and hospital-associated complications. However, currently no evidence-based guidelines exist with regard to an early mobilization protocol for the medical-surgical inpatient population. Therefore, the purpose of this review was to provide a thorough analysis of current evidence pertaining to an early mobilization protocol for the medical-surgical inpatient population.

Methods: A comprehensive search of the literature was conducted using Ovid, MEDLINE, and PubMed databases using the following search terms: early ambulation, postoperative care, and length of stay.

Outcome: We found a total of 9 empirical studies that met the inclusion criteria. Studies revealed that using the basic tenets of an early mobilization protocol was associated with improved outcomes for patients with deep vein thrombosis, reduced length of stay in patients with community-acquired pneumonia, and maintained or improved functional status from admission to discharge of hospitalized older adults and patients recovering from major surgery.

Interpretation/Conclusion: Overall, our review found that early mobilization (especially early ambulation) of the medical-surgical inpatient population may improve patient outcomes.

Implications: Our review indicated that the greatest impact of early mobilization is through standardized mobility protocols or programs. Clinical nurse specialists are experts in leading and sustaining standardized protocols or programs pertaining to a nurse-sensitive outcome such as mobility.

Author Affiliations: Medical-Surgical Clinical Nurse Specialist, Indiana University Health Bloomington (Ms Pashikanti), and Assistant Professor and Robert Wood Johnson Nurse Faculty Scholar, School of Nursing, Indiana University (Dr Von Ah), Indianapolis, Indiana.

Support for this publication was provided in part by a grant from the Robert Wood Johnson Foundation (Nurse Faculty Scholar Award [principal investigator Dr Von Ah 64194]).

The authors report no conflicts of interest.

Correspondence: Lavanya Pashikanti, MSN, RN, 1063 S Colchester Ct, Bloomington, IN 47401 (

© 2012 Lippincott Williams & Wilkins, Inc.