Implementing a Mobility Program for Pretransplant Patients With Femoral Intra-Aortic Balloon Pump: A Nurse-Led Initiative Quality Improvement Approach.

Heart failure is a growing public health burden with high morbidity and mortality, often requiring mechanical circulatory support such as femoral intra-aortic balloon pump (f-IABP) for patients in cardiogenic shock awaiting heart transplantation. Traditionally, bedrest is a standard practice for f-IABP patients due to concerns over catheter displacement, leading to muscle deconditioning and functional decline. This quality improvement project implemented and evaluated a nurse-led, modified Ramsey protocol to assess the safety and feasibility of early mobility in f-IABP patients. The protocol included verticalization using a tilt bed, followed by structured ambulation for eligible patients. Sixty-two patients were enrolled, with 42 undergoing verticalization only and 20 advancing to ambulation. Data on ICU and hospital length of stay, adverse events, and discharge disposition were collected. Results showed minimal complications across groups, with improved post-transplant recovery and higher rates of home discharge in the ambulation group. This initiative demonstrates that nurse-led mobility programs can be safely executed in critically ill cardiac patients with f-IABP, offering promising implications for functional preservation and postoperative recovery. The study supports the integration of early mobility into standard care for this complex patient population.