Effectiveness of a Supervised Patient Ambulation Program in Reducing Fall Risk Following Total Joint Arthroplasty.

Area of Science:

• Orthopaedic surgery outcomes
• Patient safety in healthcare
• Hospital quality improvement initiatives

Background:

• Total hip and knee arthroplasty are common procedures worldwide.
• Early mobilization is crucial for post-arthroplasty recovery but falls remain a significant risk.
• Patient safety during mobilization is paramount to prevent complications and reduce healthcare costs.

Purpose of the Study:

• To evaluate the impact of a supervised ambulation program on patient safety and outcomes after total hip and knee arthroplasty.
• To assess the effectiveness of the "No One Walks Alone" (NOWA) program in reducing fall rates and complications.
• To determine the influence of the NOWA program on hospital length of stay.

Main Methods:

• Retrospective review of total hip/knee arthroplasty patients from 2011-2017.
• Comparison of pre-implementation (2011-2013) and post-implementation (2015-2017) groups.
• Inclusion of patients enrolled in the "No One Walks Alone" supervised ambulation program in the post-implementation group.

Main Results:

• Inpatient fall rates decreased significantly from 2.5 to 1.0 per 1000 inpatient days post-program implementation (P < 0.002).
• Fall-related complications were notably reduced in the group participating in the supervised ambulation program.
• Average hospital length of stay decreased by 0.75 days in the post-implementation group (P < 0.001).

Conclusions:

• A supervised ambulation program effectively reduces fall rates and associated complications in post-arthroplasty patients.
• Implementing proactive interventions like supervised ambulation programs is vital for enhancing patient safety.
• The NOWA program demonstrated significant improvements in patient outcomes, including reduced length of stay.