Implementation of an Activity Protocol in the Acute Care Setting: A Quality Improvement Project
Doctor of Nursing Practice
Sue Penque Ph.D., APRN, ANP-BC, NE-BC
Danielle Schmitt, MSN, FNP
Background: Physical activity following cardiothoracic surgery can help decrease post-operative complications, expedite functional recovery, improve overall well-being, shorten hospital length of stay (LOS), and reduce morbidity and mortality (Miwa et al., 2017). Of these patients, 58% developed complications after cardiac surgery; of these complications, 31% were pulmonary, 16% were of cardiac in nature, and 14% were neurological (Yayla, 2018).
Purpose: This quality improvement project aims to implement an evidence-based protocol for evaluating the correlation between physical activity in uncomplicated post-operative coronary artery bypass and length of stay.
Methods: The Plan-Do-Study-Act (PDSA) tool from the Institute for Healthcare Improvement (IHI) guided the implementation phase. With guidance from an evidence-based protocol, staff were educated on the importance of activity post-operatively, provided with the evidence-based protocol, and guided through how to document in the electronic medical record (EMR). A weekly retrospective chart review was performed for 10 weeks to determine the activity status with biweekly reinforcements to ensure staff participation.
Results: The staff demonstrated compliance with activity documentation. The target rate for adhering to a maximum hospital stay of 5-7 days post-operatively was 60% for all patients that the criteria are applicable for use of the tool over the 10-week span. During the project, 65% (n=13) of patients out of 20 (n=7) met the length of stay criteria.
Conclusions: Activity status post-operatively provides a method that is safe, feasible and an effective intervention to prevent or lessen complications. Furthermore, it is cost-effective and simple to implement, requiring only minimal oversight by nurses and all members of the healthcare team. The project provided insight into the importance of activity post-operatively not only for the patients, but for the organization’s return on investment.
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Ryan, C. M. (2023). Implementation of an activity protocol in the acute care setting: A quality improvement project [Unpublished DNP project]. Sacred Heart University.
Available for download on Friday, May 10, 2024
A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.