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Ambulation Protocol for Adult Patients Receiving Extracorporeal Membrane Oxygenation: A Quality Improvement
Valentina Obreja1, Taline Marcarian2, Pamela S Miller3
1Valentina Obreja is a critical care nurse and evidence-based practice and quality improvement champion in the cardiothoracic intensive care unit at Ronald Reagan UCLA Medical Center in Los Angeles, California.
Critical Care Nurse
|January 31, 2025
Summary
Implementing an extracorporeal membrane oxygenation (ECMO) ambulation protocol increased the number of patients walking. While standing and ambulation times were not significantly different, the protocol showed clinical significance in patient mobility.
Area of Science:
- Critical Care Medicine
- Cardiopulmonary Support
- Rehabilitation
Background:
- Early mobility for extracorporeal membrane oxygenation (ECMO) patients reduces ventilation time, delirium, and ICU stay, improving physical function.
- Institutions develop ambulation protocols based on guidelines.
- A quality improvement initiative evaluated an ambulation protocol for adult ECMO patients.
Purpose of the Study:
- To evaluate the effectiveness of an ambulation protocol for adult intensive care unit patients receiving ECMO.
Main Methods:
- A quality improvement initiative compared adult ECMO patients who walked per protocol with a historical control group.
- Data analysis included descriptive statistics and independent t tests.
- Outcomes assessed included safety events, patient and session numbers, standing/ambulation time, and distance.
Main Results:
- 28% of patients (13/46) in the protocol group walked, compared to 10% (14/147) in 2019 and 15% (21/144) in 2020 in the control group.
- No significant differences were found in the mean number of ambulation sessions (protocol: 10, control: 9).
- Mean standing time, ambulation time, and distance were not significantly different between the protocol and control groups.
Conclusions:
- The ECMO ambulation protocol significantly increased the number of patients achieving ambulation.
- Despite no significant differences in time or distance, the protocol demonstrated clinical significance in promoting patient mobility.
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