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Staff perceptions of facilitators and barriers for ambulation of postoperative pediatric patients on a surgical unit:
Julianne Mathias1, Julie Peila Gee1, Brianna Peterson Waldron1
1Primary Children's Hospital, 100 Mario Capecchi Dr., Salt Lake City, UT 84113, USA.
Insights
Promoting early patient ambulation in pediatric surgery requires addressing staff readiness, patient engagement, and team coordination. Nurses play a key role in overcoming barriers and leveraging facilitators for better outcomes.
Area of Science:
- Pediatric Surgery
- Postoperative Care
- Patient Mobility
Background:
- Timely postoperative ambulation is crucial for reducing complications, accelerating recovery, and shortening hospital stays in pediatric surgical patients.
- Limited understanding of interdisciplinary staff perceptions regarding factors influencing pediatric patient ambulation hinders effective intervention design.
Purpose of the Study:
- To explore interdisciplinary staff perceptions of facilitators, barriers, and experiences related to promoting ambulation among pediatric patients recovering from surgery.
- To identify key factors influencing ambulation in a pediatric surgical unit setting.
Main Methods:
- Descriptive qualitative study utilizing semi-structured interviews with 16 interdisciplinary staff members (nurses, technicians, advanced practice providers, physical therapists).
- Manual thematic analysis of interview data, with member checking for enhanced credibility and validation of findings.
Main Results:
- Three main themes emerged: staff readiness/roles/safety, patient/family engagement, and interdisciplinary knowledge/coordination.
- Facilitators for ambulation include parental involvement, visual goals, and reminders; barriers include poor understanding, low motivation, pain, and fear.
- Interdisciplinary staff identified specific facilitators and barriers impacting pediatric patient ambulation.
Conclusions:
- Registered nurses are central to coordinating pediatric postoperative care and promoting ambulation, uniquely positioned to lead interventions.
- Leveraging facilitators and addressing barriers is key for improving ambulation consistency.
- Standardized protocols, consistent education, enhanced nurse training, and optimized orders can improve patient ambulation.
Background:
Routine, timely postoperative ambulation reduces complications, speeds up recovery, and shortens length of stay, yet little is known about how interdisciplinary staff perceive factors influencing ambulation for pediatric patients on surgical units. This gap limits the design of effective interventions in pediatric postoperative care.
Purpose:
To explore interdisciplinary staff perceptions of facilitators, barriers, and experiences related to promoting ambulation among pediatric patients recovering from surgery on a pediatric surgical unit.
Methods:
This descriptive qualitative study used semi-structured interviews with registered nurses, patient care technicians, advanced practice providers, and physical therapists (n = 16). Data were analyzed using manual thematic analysis, and member checking was conducted to enhance credibility and validate the findings.
Results:
Three overarching themes emerged: (a) staff readiness, roles, and safety; (b) patient and family engagement; and (c) interdisciplinary knowledge and coordination. Subthemes were identified as facilitators or barriers toward patient ambulation. For example, patient and family engagement demonstrated that parental involvement, visual goals, and reminders facilitate patient ambulation, while poor understanding of ambulation, low motivation, pain, and anticipatory fear limit engagement and hinder ambulation.
Conclusions:
Registered nurses, as frontline coordinators of pediatric postoperative care, collaborate closely with interdisciplinary team members, patients, and families to promote timely ambulation. Their central role uniquely positions them to lead interventions that leverage facilitators and barriers to improve ambulation consistency.
Practice Implications:
Nurses can improve patient ambulation by integrating standardized pediatric postoperative protocols into workflows, delivering consistent perioperative education, strengthening orientation and competency development for new nurses, and optimizing ambulation-related orders.
