Ambulation: Essential for Senior Postop Recovery - Essay Sample

Introduction

Ambulation is a medical-associated term defining the capacity to move around with the use of any walking or standing assistance. Generally, it is a term applied in defining objectives of patients recovering following therapy or surgery (Hastings et al, 2018). In many circumstances early walking is one of the most important things seniors have to do following surgery for preventing postoperative complications. Walking can be defined as a low-intensity activity which is important for the majority of seniors recovering from surgery or any other hospitalizations. Normally it does not need any special equipment as well as is the least harmful on the back and joints (Saraf & Gupta, 2015). This paper discusses a variety of literature that demonstrates the effectiveness of postoperative ambulation and how it is applied in different settings.

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Ambulation describes the capacity of walking from one place to another independently without having assistive devices. Many studies conducted prove that early ambulation is the reason for improving postoperative recovery, reducing the incidence of postoperative complications and enhances early discharge (Saraf & Gupta, 2015). Early ambulation is a significant component of postoperative care following abdominal surgery. Its importance was first documented in the 1940s where early ambulation was witnessed to quicken recovery as well as reducing the incidence of postoperative pulmonary complications. Post-surgical ambulation offers a variety of benefits for all patients and particularly seniors (Hastings et al, 2018).

There are benefits of early ambulation following surgery. Walking is important since it promotes oxygen flow in the blood throughout the body concurrently ensuring maintenance of breathing functions. Ambulation, on the other hand, stimulates circulation which assists in stopping stroke-causing clots' development (Saraf & Gupta, 2015). Walking helps blood flow that helps in wound healing quickly. The genitourinary, gastrointestinal, unary tract and pulmonary functions are usually improved through walking. Ambulation assists seniors with posture, balance, and coordination. It is also important in joint flexibility, especially in hips, ankles, and hips (Saraf & Gupta, 2015).

Early ambulation is linked with improved outcomes for mechanically ventilated as well as stroke patients. Where the same correlation is present for patients admitted with acute heart failure is not yet investigated. Early ambulation assists in increasing appetites of seniors following surgery (Fleming et al, 2018). Walking enhances the feelings of independence of the patient, their self-esteem and their mood. Patients who are practicing ambulation are normally discharged sooner. In a research carried out in 2010 that senior patients hospitalized following acute illness were let go from the hospital two days earlier if they enhanced their walking by at least 600 steps (Fleming et al, 2018).

Some problems are associated with the absence of ambulation. Pressure ulcers are more prevalent where patients are not moved for a long time. Patients who do not practice walking following surgery are usually more susceptible to urinary infection and incontinence. Patients who can get up and reach the bathroom are less likely to report cases of incontinence (Saraf & Gupta, 2015). Moreover, where an individual's bones do not carry the weight they lose important minerals leading to osteoporosis. Patients who are immobile experience more instances of stress as compared to those who commence early ambulation. Non-walking patients have a high risk of developing deep venous thrombosis and venous stasis that may end up forming clots due to immobility. Walking post-surgery decreases gas pain and constipation (Saraf & Gupta, 2015).

Not walking after surgery can occasion lung problems as well as pneumonia for seniors. It declines their capacity to fight off some of these infections. Elderly patients admitted in hospitals have to keep moving (Adogwa et al, 2017). It may be regarded as a simple matter but walking for an hour or more can prevent very serious health problems after surgery. Not all hospitals and medical centers ensure that older patients are moving following surgeries or illnesses. Regardless of the overwhelming evidence as well as research that indicates staying in bed is harmful to the elderly and its occasional complications, there are still many hospitals that do not prioritize making their patients walk (Fleming et al, 2018).

Childbirth is perceived as a very important life occasion. In the course of the postnatal period, women encounter various complications. It is required in restoring women's health status which can also assist in improving post-operative recovery. It is noted that early ambulation assists post-CS women in recovering their health status as well as improving their muscle strength to carry out their daily chores effectively (Sepulveda-Pacsi, Soderman & Kertesz, 2016). Early ambulation in the course of the postoperative period is critical in realizing maximum and rapid muscle function as well as restoration of the health of the mother. Ambulation assists in decreasing the majority of the complications through ensuring good blood circulation, enhancing gastric motility, declining chances of thrombophlebitis, enhancing respiration, enhancing physical strength and prevention of orthostatic hypotension. A maximum ambulation program carried out during this time can lead to the prevention of complications that may come up later in life (Teodoro, 2016).

Training programmers, as well as health education for the nurses offering care to CS women, have to practice early ambulation within the ward 24 hours following CS. The role of the nurse researcher is preparing the mothers to be in a position of performing daily activity by themselves as soon as possible following CS as well as can independently hold the baby after the assistance of early ambulation practice. Overall early ambulation practice enhances early maternal recovery as well as a good sense of wellbeing following CS (van der Leeden et al, 2016). Early ambulation enhances the activity of daily living and enhances postoperative recovery following the cesarean section and generally improves the wellbeing of the newborn and the mother. Post CS women have to understand the significance of early ambulation as well as generating enthusiasm amongst women to engage in the practice on their own (Teodoro, 2016).

The correlation between the functional decline coupled with prolonged bed rest following surgery is well-documented. Immediate in-patient post-operative ambulation coupled with physical therapy (PT) service has been reported to work well in improving pain as well as disability, while concurrently declining the incidence of the perioperative complications (van der Leeden et al, 2016). Whether formal physical therapy before hospital discharge occasion enhanced ambulation, reduced duration of hospital admission, as well as lower peri-operative complications than nurse-assisted ambulation protocols, is not yet known. Complications owing to the absence of early ambulation are the major cause of morbidity and mortality in India and across the world (Adugbire & Aziato, 2018).

There is a significant variation in unstructured and structured preoperative teaching on early ambulation amongst the control group and study group. In the research modified early ambulation intervention demonstrated significant changes within the postoperative recovery, it positively improves and influences the postoperative recovery and also functional, physical and psychological wellbeing following surgery will benefit the patent a lot (Hoyer EH et al, nd). Modified early ambulation demonstrate postoperative recovery as well as a higher performance of activities of daily living as compared to control subjects in the course of the initial period of recovery following surgery. The modified early ambulation comprises three main steps: sitting in bed, standing as well as limited walking and finally extended walking. Great support, strong motivation, and assistance are needed for a patient following abdominal surgery (Teodoro, 2016).

Conclusion

Early ambulation involving an upright posture seems to be of great essence in the early postoperative period with evidence of improvement in pulmonary function. Upright ambulation plays an important role in the prevention of functional decline and can bear a positive impact on anxiety and depression. Modified early ambulation after abdominal surgery has been determined as the time spent to attain mobility goals like sitting out of bed, ambulating with assistance or independently ambulating. Various studies have demonstrated that immobility following surgery can lead to many complications for the patient. Caregivers are encouraged to take advantage of early ambulation to ensure that the patient gains from its benefits throughout the recovery process. Early ambulation can be also cost-saving since it leads to the prevention of complications that may become costly. Early ambulation helps the patient combat the incidence of complication that would have developed later on.

References

Adogwa, O. et al. (2017). Early Ambulation Decreases Length of Hospital Stay, Perioperative Complications and Improves Functional Outcomes in Elderly Patients Undergoing Surgery for Correction of Adult Degenerative Scoliosis. Spine. 42(18):1420-1425 doi: 10.1097/BRS.0000000000002189

Adugbire, B. & Aziato, L. (2018). Surgical patients' perspectives on nurses' education on post-operative care and follow up in Northern Ghana. BMC Nursing, 17(1), N.PAG. https://doi.org/10.1186/s12912-018-0299-6

Fleming, L. et al. (2018). Early Ambulation Among Hospitalized Heart Failure Patients Is Associated With Reduced Length of Stay and 30-Day Readmissions. Circulation: Heart Failure. 11:e004634 https://doi.org/10.1161/CIRCHEARTFAILURE.117.004634 https://www.ahajournals.org/doi/full/10.1161/CIRCHEARTFAILURE.117.004634

Hastings, S. et al. (2018). Early Mobility in the Hospital: Lessons Learned from the STRIDE Program. Geriatrics, 3(4), 61. doi: 10.3390/geriatrics3040061

Hoyer, H. et al. (2016). Promoting Mobility and Reducing LOS. J. Hosp. Med 2016; 5; 341-347. DOI:10.1002/jhm.2546

Saraf, A., & Gupta, A. (2015). Effect of Diabetes on Postoperative Ambulation Below Knee Amputation. Indian Journal of Physiotherapy & Occupational Therapy, 9(1), 1-4. https://doi.org/10.5958/0973-5674.2015.00001.5

Sepulveda-Pacsi, A. & Soderman, M., & Kertesz, L. (2016). Nurses' perceptions of their knowledge and barriers to ambulating hospitalized patients in acute settings. Applied Nursing Research, 32, 117-121. https://doi.org/10.1016/j.apnr.2016.06.001

Teodoro, C. R. (2016). STEP-UP: Study of the Effectiveness of a Patient Ambulation Protocol. MEDSURG Nursing, 25(2), 111-116.

Van der Leeden, M. et al. (2016). Early enforced mobilization following surgery for gastrointestinal cancer: feasibility and outcomes. Physiotherapy, 102(1), 103-110. https://doi.org/10.1016/j.physio.2015.03.3722