{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T17:25:42Z","timestamp":1774977942547,"version":"3.50.1"},"reference-count":23,"publisher":"AACN Publishing","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Coronary artery bypass graft surgery is one of the most common cardiac procedures performed worldwide. The longer these patients remain in bed, the greater their risk of postoperative complications and prolonged length of stay.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Local Problem<\/jats:title>\n                  <jats:p>At the authors\u2019 institution, the average length of stay after coronary artery bypass graft surgery was 7.27 days, longer than the national average of 6.9 days. This quality improvement project was undertaken to increase these patients\u2019 postoperative mobility and thereby reduce their length of stay.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data on mobility and length of stay of patients with isolated coronary artery bypass graft surgery during an 8-week period were collected retrospectively to establish preintervention values. These values were compared with postintervention values for an equivalent period. An evidence-based nurse-driven early mobility protocol was used to mobilize appropriate patients from bed to chair on postoperative day 0. This level of mobility was documented as a score of 4 on the Johns Hopkins Highest Level of Mobility Scale.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From before to after protocol implementation, the postoperative length of stay decreased by 1.04 days. None of the 103 patients in the preintervention group scored a 4 on the Johns Hopkins Highest Level of Mobility Scale, compared with 36 of 134 patients in the intervention group. The difference in postoperative length of stay was clinically but not statistically significant (2-sided P = 1.95).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Early mobility may help improve patient outcomes by reducing hospital length of stay and minimizing complications associated with prolonged immobility.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4037\/ccn2024509","type":"journal-article","created":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:02:33Z","timestamp":1733011353000},"page":"15-23","source":"Crossref","is-referenced-by-count":3,"title":["Early Mobility After Cardiac Surgery: A Quality Improvement Project"],"prefix":"10.4037","volume":"44","author":[{"given":"Ansley","family":"Cook","sequence":"first","affiliation":[{"name":"Ansley Cook is an acute care nurse practitioner, University of South Alabama Hospital, Mobile, Alabama."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faith","family":"Grill","sequence":"additional","affiliation":[{"name":"Faith Grill is a cardiovascular surgery acute care nurse practitioner, UAB Hospital, Birmingham, Alabama."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cole","family":"Taylor","sequence":"additional","affiliation":[{"name":"Cole Taylor is an acute care nurse practitioner, CHI Memorial, Chattanooga, Tennessee."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Toles","sequence":"additional","affiliation":[{"name":"Lauren Toles is a registered nurse, University of Alabama at Birmingham School of Nursing, Birmingham, Alabama."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Baker","sequence":"additional","affiliation":[{"name":"Natalie Baker is an associate professor, University of Alabama at Birmingham."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2471","reference":[{"key":"2024120100022495200_b1-0440015","unstructured":"iData Research\n          . New study shows approximately 340,000 CABG procedures per year in the United States. Published July 9, 2018. https:\/\/idataresearch.com\/new-study-shows-approximately-340000-cabg-procedures-per-year-in-the-united-states"},{"issue":"11","key":"2024120100022495200_b2-0440015","doi-asserted-by":"publisher","first-page":"1306","DOI":"10.1016\/j.amjmed.2017.04.044","article-title":"Effects of an ambulation orderly program among cardiac surgery patients","volume":"130","author":"Miwa","year":"2017","journal-title":"Am J Med"},{"issue":"6","key":"2024120100022495200_b3-0440015","doi-asserted-by":"publisher","first-page":"e12784","DOI":"10.1111\/ijn.12784","article-title":"Effects of early mobilization protocol performed after cardiac surgery on patient care outcomes","volume":"25","author":"Yayla","year":"2019","journal-title":"Int J Nurs Pract"},{"issue":"4","key":"2024120100022495200_b4-0440015","doi-asserted-by":"publisher","first-page":"1286","DOI":"10.1016\/j.athoracsur.2014.05.073","article-title":"Prediction of costs and length of stay in coronary artery bypass grafting","volume":"98","author":"Osnabrugge","year":"2014","journal-title":"Ann Thorac Surg"},{"issue":"3","key":"2024120100022495200_b5-0440015","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.jvn.2017.02.001","article-title":"Early mobilization reduces the atelectasis and pleural effusion in patients undergoing coronary artery bypass graft surgery: a randomized clinical trial","volume":"35","author":"Moradian","year":"2017","journal-title":"J Vasc Nurs"},{"issue":"3","key":"2024120100022495200_b6-0440015","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1016\/j.jtcvs.2017.08.144","article-title":"Cost of individual complications following coronary artery bypass grafting","volume":"155","author":"Mehaffey","year":"2018","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"1","key":"2024120100022495200_b7-0440015","doi-asserted-by":"publisher","first-page":"e280","DOI":"10.5114\/amsad.2019.91432","article-title":"Pulmonary complications following cardiac surgery","volume":"4","author":"Mali","year":"2019","journal-title":"Arch Med Sci Atheroscler Dis"},{"issue":"1","key":"2024120100022495200_b8-0440015","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1186\/s12877-020-01823-1","article-title":"Precision implementation of early ambulation in elderly patients undergoing off-pump coronary artery bypass graft surgery: a randomized-controlled clinical trial","volume":"20","author":"Cui","year":"2020","journal-title":"BMC Geriatr"},{"issue":"1","key":"2024120100022495200_b9-0440015","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.physio.2016.08.003","article-title":"Effects of early mobilisation in patients after cardiac surgery: a systematic review","volume":"103","author":"Dos Santos","year":"2017","journal-title":"Physiotherapy"},{"key":"2024120100022495200_b10-0440015","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1186\/s12913-016-1591-3","article-title":"Systematic review of factors influencing length of stay in ICU after adult cardiac surgery","volume":"16","author":"Almashrafti","year":"2016","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"2024120100022495200_b11-0440015","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1016\/j.jcot.2019.05.007","article-title":"Decreasing hospital length of stay and enhancing recovery in total knee arthroplasty","volume":"11","author":"Agarwala","year":"2020","journal-title":"J Clin Orthop Trauma"},{"issue":"3","key":"2024120100022495200_b12-0440015","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1378\/chest.13-2046","article-title":"Impact of early mobilization on glycemic control and ICU-acquired weakness in critically ill patients who are mechanically ventilated","volume":"146","author":"Patel","year":"2014","journal-title":"Chest"},{"issue":"2","key":"2024120100022495200_b13-0440015","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1093\/neuros\/nyz501","article-title":"Ambulation on postoperative day #0 is associated with decreased morbidity and adverse events after elective lumbar spine surgery: analysis from the Michigan Spine Surgery Improvement Collaborative (MSSIC)","volume":"87","author":"Zakaria","year":"2020","journal-title":"Neurosurgery"},{"issue":"9\u201310","key":"2024120100022495200_b14-0440015","doi-asserted-by":"publisher","first-page":"1298","DOI":"10.1111\/jocn.15986","article-title":"The effect of mobilization protocol on mobilization start time and patient care outcomes in patients undergoing abdominal surgery","volume":"31","author":"Koyuncu","year":"2022","journal-title":"J Clin Nurs"},{"issue":"5","key":"2024120100022495200_b15-0440015","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1080\/20009666.2020.1801373","article-title":"A novel early mobility bundle improves length of stay and rates of readmission among hospitalized general medicine patients","volume":"10","author":"Bergbower","year":"2020","journal-title":"J Community Hosp Intern Med Perspect"},{"key":"2024120100022495200_b16-0440015","unstructured":"Johns Hopkins Medicine\n          . Activity and Mobility Promotion (JH-AMP). Accessed June 5, 2023. https:\/\/www.hopkinsmedicine.org\/physical_medicine_rehabilitation\/education_training\/amp\/toolkit.html"},{"issue":"3","key":"2024120100022495200_b17-0440015","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1016\/j.bjpt.2020.07.010","article-title":"Inter-rater reliability of the Johns Hopkins Highest Level of Mobility Scale (JH-HLM) in the intensive care unit","volume":"25","author":"Hiser","year":"2021","journal-title":"Braz J Phys Ther"},{"key":"2024120100022495200_b18-0440015","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.ahj.2020.02.002","article-title":"Association of postoperative complications and outcomes following coronary artery bypass grafting","volume":"222","author":"Jawitz","year":"2020","journal-title":"Am Heart J"},{"issue":"6","key":"2024120100022495200_b19-0440015","doi-asserted-by":"publisher","first-page":"1258","DOI":"10.1111\/jocs.14577","article-title":"Seasonality of postoperative pneumonia after coronary artery bypass grafting: a national inpatient sample study","volume":"35","author":"Martin","year":"2020","journal-title":"J Card Surg"},{"issue":"6","key":"2024120100022495200_b20-0440015","doi-asserted-by":"publisher","first-page":"2045","DOI":"10.1111\/jocs.15471","article-title":"Impact of postoperative complications after cardiac surgery on long-term survival","volume":"36","author":"Pahwa","year":"2021","journal-title":"J Card Surg"},{"issue":"6","key":"2024120100022495200_b21-0440015","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1007\/s00408-020-00405-7","article-title":"Pulmonary complications of cardiac surgery","volume":"198","author":"Tanner","year":"2020","journal-title":"Lung"},{"issue":"12","key":"2024120100022495200_b22-0440015","doi-asserted-by":"publisher","first-page":"e0279269","DOI":"10.1371\/journal.pone.0279269","article-title":"Hemodynamic impact of early mobilization in critical patients receiving vasoactive drugs: a prospective cohort study","volume":"17","author":"Borges","year":"2022","journal-title":"PLoS One"},{"issue":"2","key":"2024120100022495200_b23-0440015","doi-asserted-by":"publisher","first-page":"e122","DOI":"10.5001\/omj.2020.40","article-title":"Implications of language barriers for healthcare: a systematic review","volume":"35","author":"Shamsi","year":"2020","journal-title":"Oman Med J"}],"container-title":["Critical Care Nurse"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aacnjournals.org\/ccnonline\/article-pdf\/44\/6\/15\/159668\/15.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/aacnjournals.org\/ccnonline\/article-pdf\/44\/6\/15\/159668\/15.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:02:35Z","timestamp":1733011355000},"score":1,"resource":{"primary":{"URL":"https:\/\/aacnjournals.org\/ccnonline\/article\/44\/6\/15\/32585\/Early-Mobility-After-Cardiac-Surgery-A-Quality"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,1]]},"references-count":23,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,12,1]]}},"URL":"https:\/\/doi.org\/10.4037\/ccn2024509","relation":{},"ISSN":["0279-5442","1940-8250"],"issn-type":[{"value":"0279-5442","type":"print"},{"value":"1940-8250","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,1]]}}}