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Early Mobility for Post-Cardiac Surgery Patients on Vasoactive Medication: A Nurse-Led Quality Improvement Project
Safanah AlSaeed1, Amani A AlJohi1, Ahmad Alohali2
1Physical Therapy Department, King Fahad Medical City, Riyadh, Saudi Arabia.
Nursing in Critical Care
|August 11, 2025
Summary
Early mobilisation (EM) in cardiovascular intensive care units improves patient outcomes and reduces length of stay. Nurse education enhanced knowledge and confidence, making EM safer and more feasible for patients on vasopressors.
Area of Science:
- Critical Care Medicine
- Cardiovascular Nursing
- Quality Improvement
Background:
- Early mobilisation (EM) is crucial for recovery in critically ill patients, improving outcomes like reduced length of stay (LOS) and functional decline.
- Implementing EM in cardiovascular intensive care units (CVICUs), especially for patients on vasopressors, faces challenges due to haemodynamic instability concerns.
- Nurses' knowledge and confidence are key to successful EM, but barriers exist in high-acuity settings.
Purpose of the Study:
- To enhance CVICU nurses' knowledge and perspectives on early mobilisation for patients receiving vasopressors.
- To assess the impact of an educational intervention on nurses' confidence and practice regarding EM.
- To evaluate the effect of EM on patient mobility and outcomes in the CVICU.
Main Methods:
- A quality improvement initiative in a tertiary hospital's adult CVICU in Riyadh, Saudi Arabia.
- Delivery of an educational program to CVICU nurses on EM and the Banner Mobility Assessment Tool.
- Implementation of EM protocols based on improved nurse understanding and confidence.
Main Results:
- The educational intervention significantly improved nurses' knowledge of ICU-acquired weakness in patients on vasopressors (p=0.005).
- Nurses showed increased confidence in initiating EM, starting without physician orders (p=0.002), and staying updated (p=0.001).
- ICU mobility scores significantly increased post-intervention (p<0.001), with higher scores at discharge in the EM group (8.9±0.9) compared to the pre-implementation group (7.8±0.6).
Conclusions:
- Nurse-driven early mobility is safe and feasible for post-cardiac surgery patients on vasoactive medications.
- EM facilitates improved patient mobility before discharge and contributes to a reduced length of stay.
- Nurse-led interventions are vital for enhancing patient outcomes through early mobilisation in critical care settings.
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