Essay Sample on Early Ambulation

Introduction

After undergoing surgery, patients require to be provided with medical care to prevent the occurrence of complications such as deep vein thrombosis (DVTs). Adult patients with total hip replacement are a perfect example of victims who can suffer from such complications. Early ambulation refers to the light activities such as walking or standing that a patient is engaged in after an operation. The period between an operation and these activities should be as short as possible to prevent health concerns such as DVTs (Liu, Tao, Chen, Fan & Li, 2015). Deep vein thrombosis occurs as a result of a blood clot in veins. Light activities are effective in preventing this occurrence since they enable such veins to be active and capable of resisting the occurrence of a blood clot. Unlike the opinion of most patients, bed rest is not a safe option since it increases the chances of health concerns such as pulmonary embolism and early ambulation (Wang et al., 2017). Early ambulation is, therefore, a more beneficial practice and relevant to healthcare practitioners compared to bed rest when it comes to the treatment of DVTs due to its association with light activities such as walking and sitting.

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Methodology

The literature review conducted in this case was based on identifying studies that focused on the benefits of early ambulation in the treatment of health concerns such as DVTs compared to bed rest. Secondary research was used in the paper since previous studies based on this topic were used. Research papers were obtained from CINAHL database which made them reliable since they contained comprehensive data concerning the topic of early ambulation. Some of the keywords used included early ambulation, bed rest, DVTs and pulmonary embolism. These keywords made it possible to locate the required articles easily. CINAHL database also provided the platform where comparisons could be made between previous studies that were focused on the relevance of early ambulation among patients who have undergone surgery.

Literature Review

Different studies have been conducted in the past to prove that early ambulation is effective especially to patients with total hip replacement. This in comparison with bed rest which was associated with some health complications in some of the studies (Aissaoui, Martins, Mouly, Weber & Meune, 2009). A study conducted by Aissaoui et al in 2009 was aimed at proving that even though bed rest is recommended as the best way to manage complications such as DVTs and pulmonary embolism, the method is not evidence-based and as a result, it should not be employed by patients (Aissaoui et al., 2009). An example of such patients includes the ones with total hip replacement. In this study, prospective registries were used to analyze the outcome of patients with both DVTs and PE. The progression o patients who employed bed rest was made in comparison with that of the patients who opted to use early ambulation. Relative risks were calculated to understand the efficiency of both methods (Aissaoui et al., 2009). Results showed that early ambulation the best recommendation that can be suggested to patients who have undergone surgery since it contributes to the reduction of DVT progression, unlike bed rest.

A study conducted by Allen, Glasziou and Del Mar (1999) was aimed at studying the need for evaluation of bed rest. Research from this study showed that bed rest is the most preferred method for patients who are unable to mobilize. The treatment method is employed to manage patients who have undergone surgery. However, research from the study suggested that this management method requires careful analysis and evaluation especially when it is applied to different patients such as the ones with total hip replacement. Though early ambulation is preferred in many cases, bed rest can also decrease post-op DVTs especially in the case where medical professionals are keen in the evaluation of the entire process (Allen, Glasziou, & Del, 1999). In this study, reports were retrieved from different sources such as MEDLINE and the Cochrane Library. Most of these reports contained the results of controlled trials of bed rest compared to early mobilization. Out of the 39 trials reviewed, results showed that bed rest had no effect on the reduction of DVTs in 24 cases (Allen, Glasziou, & Del, 1999). These were the cases where physicians failed to evaluate management practice. It was concluded that bed rest becomes a dangerous treatment method for patients such as the ones with total hip replacement once the method fails to be evaluated effectively.

A study conducted by Siu et al. (2006) was aimed at identifying the effects of early ambulation after hip fracture. Various considerations were made in this study such as the influence of mortality on these effects. The relationship between early ambulation and functional outcomes was analyzed carefully in this research. Patients with hip fracture were used as the sample population to identify the effects of early ambulation after surgery. In the research, 532 patients were involved (Siu et al., 2006). The patients were 50 years and older (Siu et al., 2006). The focus on older patients made it possible to analyze the effectiveness of early ambulation as a management method among patients whose bodies required careful evaluation after surgery. A total of 4 hospitals were applied in the study (Siu et al., 2006). Results from the study showed that longer duration of immobility played a key role in the effects of early ambulation. Patients whose locomotion was supervised ended up progressing well. Medical results showed that this supervision contributed to the reduction of DVTs among the patients (Siu et al., 2006). it was concluded that the best way to improve the medical conditions of patients with hip fracture was to get them out of bed to avoid further medical complications.

Research conducted by Cohn et al. (2016) was focused on identifying the factors that influence the outcome of early ambulation, especially after hip fracture surgery. Research from the study showed that hip fracture is an occurrence which is common among the elderly especially in the United States of America. Early functional outcome is a process which has been proved to be effective in the overall improvement of the medical condition of patients after hip surgery. Some of the factors that influence the outcome of early ambulation to include the time of surgery and support staff. Both factors determine whether the management method is effective in the reduction of occurrences such as DVTs. In this research, 99 patients who had undergone hip surgery were involved. These patients were treated by the same surgeon between the period 2009-2013 (Cohn et al., 2016). The time of surgery was also considered in the research where factors such as delays were considered. The level of training of the support staff was also considered since it determined their ability to identify the benefits of employing early ambulation compared to bed rest. Results showed that 62 patients who were supervised effectively after surgery managed to recover well (Cohn et al. 2016). These were also the same patients who were treated without any delays by a support staff that had competent skills. The staff identified essential early ambulation techniques such as walking and sitting as the best way to reduce health complications after surgery. It was recommended that factors such as surgical delays play a key role in the overall recovery of patients who have undergone hip surgery.

The study conducted by Chua et al. (2017) was focused on identifying the benefits of early mobilization in the treatment of patients who have undergone hip surgery. In this research, patients who had undergone either hip or knee surgery were involved (Chua et al., 2017). These patients were from 19 different Australian hospitals. The effects of different mobile-related variables were considered after the surgery was complete (Chua et al., 2017). The results of early ambulation in post-operative days were recorded and their effects in the reduction of occurrences such as DVTs were analyzed in detail. Results showed that Patients who had undergone hip surgery improved in terms of health due to the application of early mobilization in their treatment (Chua et al., 2017). This management practice made it possible for physicians to prevent acute complications that could not be solved by other processes such as bed rest. The research was therefore effective in proving that early ambulation is an effective management practice among adult patients with total hip replacement compared to bed rest.

Comparison of the Articles

The studies discussed in the literature review section vary in terms of purpose, design, sample, and results. However, similarities can also be seen especially from the fact that all studies were based on proving that early ambulation is a more effective management method compared to bed rest. The latter is identified as an ineffective management method due to its inability to decrease DVTs in patients who have undergone hip surgery. Most of the studies suggest that after total hip replacement, patients should be focused on employing early mobilization techniques to prevent further complications. Identification of the effectiveness of early ambulation is, therefore, the major similarity that can be drawn from these documents.

As stated earlier, differences can be identified in terms of the purpose of the study. The study conducted by Assaoui et al. (2009) was aimed at comparing bed rest versus early ambulation in the management of different conditions such as DVTs. This is unlike the research conducted by Allen et al. (1999) which was aimed at identifying the harm that can be caused by bed rest in the treatment of conditions such as DVTs. The study conducted by Siu et al. (2006) also differed in the sense that it was focused on the effects of early ambulation on both function and mortality. The purpose of Cohn et al. (2016) research was to analyze the factors that influenced early ambulation after hip surgery. Chua et al. (2017) on the other hand based their research on early mobilization after total hip replacement.

The sample of the research conducted by Aissaoui et al. (2009) was composed of results from controlled trains and Medine. The data was therefore available from these sources, a factor which made the research simple to conduct. This was unlike the sample used in the research conducted by Allen et al. (1999) which was obtained from the Cochrane library. In the study conducted by Siu et al. (2006), data were obtained from 532 patients who were involved in the research. Respondents were also involved in the research conducted by Cohn et al. (2016). In the research conducted by Chua et al. (2017) the sample was composed of patients from 19 different hospitals. This discussion shows the differences in the samples used in each article. Below is a table showing the comparison between the studies used in this case.

Research Sample Results Implications Limitations

Aissaoui et al., (2009) The sample was obtained from different sources such as Medline, and Embase. Early ambulation did not result in a higher incidence of complications such as DVTs compared to bed rest. It was concluded that early ambulation is a more effective management method compared to bed rest in the reduction of complications such as DVTs and PE. Data used may have been biased since it was obtained from recorded sources.

Allen et al., (1999) The sample was obtained from MEDLINE and the Cochrane Library 25 trials out of the total 39 involved showed that bed rest worsened the medical condition of patients after surgery. Bed rest can become an effective management method of the patient after surgery through proper evaluation. Data use...