Research Analysis This is a research analysis of an article titled “STEP-UP: Study of the Effectiveness of a Patient Ambulation Protocol” by authors C. R. Teodoro, K. Breault, C. Garvey, C. Klick, J. Obrien, T. Purdue, A. Stolaronek, H. W. Wilbur and L. Matney. This article is a study of the effects of implementing a patient ambulation protocol on a medical-surgical floor in a community hospital.
Problem
The problem identified by the researchers was the lack of an effective ambulation protocol in hospitals for patients with ambulation orders. Immobility results in a plethora of secondary issues such as deep vein thrombose, pressure ulcers, and loss of mobility; these can lead to increased length of stay and costs to both patients and the
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Following informed consent, the patients were studied over a three-day period. Group assignment was determined via computer randomization program on the first day of monitoring (Teodoro et al., 2016).
Instrument Amount of ambulation was determined by recording distance traveled in steps captured with a pedometer (ShrinQ, Model 304, Sportline, Hazleton, PA). this device was clipped to the gown by researcher and not removed until study conclusion. The number of steps recorded was transcribed as an average number of steps walked per hour for designated period of the day (Teodoro et al., 2016)
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This smells sample size could limit the studies applicability to the general population. There is also a significantly higher percentage of post-surgery patients than other admission types, this could skew the results to be more representative of post-op patients than of other kinds of patients. The research only occurred on one floor of a community hospital in one part of the united states (Teodoro et al., 2016). These same results might not be applicable to other hospitals or even other floors of the same
Once the mandate was given to area hospitals not to divert MH patients, each hospital had to figure out how to deal with MH patients in their own organization. This entailed a safe environment for the MH patient, safety for the staff, and the ability to “board” MH patients in the ED. “Boarding” patients in ED’s became necessary because of the lack of inpatient MH beds in the State of Washington.
Melling, C. A., Baqar, A., Eileen, M. S., & David, J. L. (2001, September 15). Effects of preoperative warming on the incidence of wound infection after clean surgery; a randomised control trial. The Lancet, 358, 876-880.
Hinkle, J., Cheever, K., & , (2012). Textbook of medical-surgical nursing. (13 ed., pp. 586-588). Philadelphia: Wolters Kluwer Health
Hospital readmission can impact the patient, nursing practice, the hospital, and the health care system. The patient’s quality of life can be altered physically, psychologically, and economically (Whittaker, 2014) and recurrent hospitalization is a good predictor of increased risk of mortality (Hummel, Katrapati, Gillespie, DeFranco, & Koellig, 2013). Moreover, a patient in an acute care setting has an increased risk of contracting hospital-acquired infections such urinary tract infections, sepsis, C. difficile, and methicillin resistant Staphylococcus aureus (medicare.gov|Hospital Compare, 2013). Nursing practice is impacted as patients spend the majority of their acute care stay with the bedside nursing staff. According to...
Subacute units offer a transition point between a hospital stay and their journey home or a nursing facility. Emerging to fill the gap between intensive hospital care and the care that can be given in the home or a nursing facility, and provide a more cost-effective form of care than hospital care (Pratt, 2017, p. 113). Subacute care’s focus on the quality of care given at the cheapest price possible allows subacute care to stay relevant in our ever-changing healthcare system. While also ensuring the patient’s care and overall quality of life are the best it can be. Say you have a stroke, after your stay in the hospital you may need physical therapy, this therapy is received in a subacute care facility (can be a part of hospital or nursing facility). When you enter the subacute care facility you enter with a projected check out date, with a set structured plan of action. I believe subacute care should be offered in hospitals and nursing facilities so that no matter what the finical situation of the patient they can receive quality regulated care at a cheaper price than acute
The hospital promised early ambulation following hernia surgery. The hospital facility was designed to encourage movement without unnecessarily causing discomfort. Postoperative regimen designed and communicated by the medical team to patients
Preventable hospital admission is a key patient safety and quality concern. A major cause of preventable readmission is poor coordination and communication of care during transitions. Transitions beteeen settings are vulnerable periods for patients. Transition contains admission and discharge between skilled nursing facilities, long-term care facilities, acute care hospitals, and assisted living facilities. Indigent coordination between a cure setting and primary care provider can results in poor longitudinal planning. About 50% of patients go see their primary care providers within a two week time period after discharge. Comprehensive programs can improve care while transitioning between setting, which can reduce a thirty day hospital readmission.
The healthcare world has simply grown too large, too quickly and, as a result, has forgotten the reason behind which it stands: the patient. Continuity of care is in dire need of repair and without effective communication and coordination of care, the problem will not be corrected.
Within this set, the investigators randomized how many trials the participants would complete: 7, 10, or 13. Then, they were giving the chance to do 3 or 6 more trials and were ask to record their results.
Although there are some similarities between an ambulatory care and an acute care facility there is a difference among the skills needed to provide the level of care. When thinking about clinical care there is additional training and education that is needed for clinical staff members who transition between caring for patient within the two different settings. Ambulatory care is more outpatient setting including clinics that operate during the day treating non-emergent patients. Acute care is inpatient care provided at bed side because they require continuous care. Their work mainly driven by hospital protocols and physician orders (Swan, 2007).
and was reassessed after 3 months. After 3 months subjects were randomly assigned to two
Davenport, Joan M., Stacy Estridge, and Dolores M. Zygmont. Medical-surgical nursing. 2nd ed. Upper Saddle River, N.J.: Pearson Prentice Hall, 2008, 66-88.
Brunner, L.S. & Suddarth, D. S Textbook of Medical- Surgical Nursing, 1988 6th ed. J. B. Lippincott Company, Philadelphia
1.I currently work in the surgical unit and one of the major recovery enhancements is early ambulation after any surgery, especially orthopedic and abdominal. Early ambulation will accelerate the return of bowel function (as evidenced by passage of stool and flatus) reduce the rate of overall complications and decrease the length of hospital stays. Evidence-based practices have shown that early post-operative ambulation contributes to decreased pulmonary complications. “When exploring postoperative activity in the general and orthopedic nursing literature, there is sparse evidence outlining nursing's critical thinking skills associated with decreasing the first postoperative activity from the historical 14-day mark to the most current model of day 1 or 2 for the joint replacement population. Also, there were no recently published reports describing a contemporary
When the patient has followed the instructions, things at the surgery center go much smoother. There are decreased incidents of high pressure, pain issues, and/or low/high blood sugar. Escorts and transportation home is readily available to the patient. Post surgery medications are handled. The whole experience is pleasant for the patient. Patient’s that have good encounters are happier patients. Content patients tell their friends, family, and co-workers, which in turn may influence that person at the end of the year to change health insurance plans.