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.