{"title":"实施护士驱动的早期活动方案以提高经导管主动脉瓣置换术后的结果：一项质量改进倡议。","authors":"Katie P Worthington, Erin Giannantonio","doi":"10.1097/NCQ.0000000000000835","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Immobility in patients undergoing transcatheter aortic valve replacement (TAVR) is linked to adverse outcomes and prolonged length of stay (LOS). Advancements in TAVR procedures allow for early ambulation post-procedure.</p><p><strong>Local problem: </strong>In a large teaching hospital, ambulation occurred at an average of 16.9 hours post-TAVR procedures, higher than the goal of 6 hours.</p><p><strong>Methods: </strong>A pre/post-implementation design was used. Data on ambulation times, LOS, and discharge disposition were collected and analyzed.</p><p><strong>Results: </strong>Time to the first ambulation significantly decreased from a mean of 16.9 (SD = 13.1) to 8.9 hours (SD = 5.3), P < .001. Patients meeting the goal of ambulation 4-6 hours post-procedure had a significantly lower LOS, P < .005. Fewer patients needed a higher level of care at discharge, P = .064.</p><p><strong>Conclusions: </strong>Early ambulation reduced LOS and had a positive impact on patient discharge disposition. A nurse-driven ambulation protocol can improve outcomes after TAVR.</p>","PeriodicalId":16931,"journal":{"name":"Journal of nursing care quality","volume":" ","pages":"187-192"},"PeriodicalIF":1.2000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Implementing a Nurse-Driven Early Ambulation Protocol to Enhance Post-Transcatheter Aortic Valve Replacement Outcomes: A Quality Improvement Initiative.\",\"authors\":\"Katie P Worthington, Erin Giannantonio\",\"doi\":\"10.1097/NCQ.0000000000000835\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Immobility in patients undergoing transcatheter aortic valve replacement (TAVR) is linked to adverse outcomes and prolonged length of stay (LOS). Advancements in TAVR procedures allow for early ambulation post-procedure.</p><p><strong>Local problem: </strong>In a large teaching hospital, ambulation occurred at an average of 16.9 hours post-TAVR procedures, higher than the goal of 6 hours.</p><p><strong>Methods: </strong>A pre/post-implementation design was used. Data on ambulation times, LOS, and discharge disposition were collected and analyzed.</p><p><strong>Results: </strong>Time to the first ambulation significantly decreased from a mean of 16.9 (SD = 13.1) to 8.9 hours (SD = 5.3), P < .001. Patients meeting the goal of ambulation 4-6 hours post-procedure had a significantly lower LOS, P < .005. Fewer patients needed a higher level of care at discharge, P = .064.</p><p><strong>Conclusions: </strong>Early ambulation reduced LOS and had a positive impact on patient discharge disposition. A nurse-driven ambulation protocol can improve outcomes after TAVR.</p>\",\"PeriodicalId\":16931,\"journal\":{\"name\":\"Journal of nursing care quality\",\"volume\":\" \",\"pages\":\"187-192\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of nursing care quality\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/NCQ.0000000000000835\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/20 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of nursing care quality","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/NCQ.0000000000000835","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/20 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"NURSING","Score":null,"Total":0}
Implementing a Nurse-Driven Early Ambulation Protocol to Enhance Post-Transcatheter Aortic Valve Replacement Outcomes: A Quality Improvement Initiative.
Background: Immobility in patients undergoing transcatheter aortic valve replacement (TAVR) is linked to adverse outcomes and prolonged length of stay (LOS). Advancements in TAVR procedures allow for early ambulation post-procedure.
Local problem: In a large teaching hospital, ambulation occurred at an average of 16.9 hours post-TAVR procedures, higher than the goal of 6 hours.
Methods: A pre/post-implementation design was used. Data on ambulation times, LOS, and discharge disposition were collected and analyzed.
Results: Time to the first ambulation significantly decreased from a mean of 16.9 (SD = 13.1) to 8.9 hours (SD = 5.3), P < .001. Patients meeting the goal of ambulation 4-6 hours post-procedure had a significantly lower LOS, P < .005. Fewer patients needed a higher level of care at discharge, P = .064.
Conclusions: Early ambulation reduced LOS and had a positive impact on patient discharge disposition. A nurse-driven ambulation protocol can improve outcomes after TAVR.
期刊介绍：
Journal of Nursing Care Quality (JNCQ) is a peer-reviewed journal that provides practicing nurses as well as nurses who have leadership roles in nursing care quality programs with useful information regarding the application of quality principles and concepts in the practice setting. The journal offers a forum for the scholarly discussion of “real world” implementation of quality activities.
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