Evaluation of a Progressive Mobility Program in Cardiothoracic Surgery Patients

Cardiothoracic surgical patients are at high risk for complications related to immobility such as increased intensive care unit, hospital length of stay, intensive care unit readmission, pressure ulcers, and deep vein thrombosis/pulmonary embolus. A progressive mobility protocol was started in the thoracic cardiovascular intensive care unit in a rural academic medical center. The purpose of the progressive mobility protocol was to increase mobilization of post-operative patients and decrease complications related to immobility in this unique patient population. To evaluate this progressive mobility protocol a retrospective analysis was conducted. Using Pender’s Health Promotion Model to help us understand implications of immobility in the cardiothoracic surgical patients. A matched pairs design was used to compare a randomly-selected sample of the pre intervention group (n=30) to a matched post intervention group (n=30). The analysis compared outcomes including, intensive care unit and hospital length of stay, intensive care unit readmission, pressure ulcer prevalence, and deep vein thrombosis /pulmonary embolism prevalence between the two groups. Although this comparison does not achieve statistical significance (p<0.05) for any of the outcomes measured it does show a reduction in hospital length of stay hospital, intensive care unit days, a decline in intensive care unit readmission rate, and a decline in pressure ulcer prevalence which is the overall goal of progressive mobility. This study can lead to a larger study to try and achieve statically significant results in a larger group of cardiothoracic patients. This study does have implications for nursing, hospital administration, and therapy services in regards to staffing and cost savings due to complications of immobility.