Implementing a Nurse-Driven Early Ambulation Protocol to Enhance Post-Transcatheter Aortic Valve Replacement Outcomes

BACKGROUND: Immobility in patients undergoing transcatheter aortic valve replacement (TAVR) is linked to adverse outcomes and prolonged length of stay (LOS). Advancements in TAVR procedures allow for early ambulation post-procedure. LOCAL PROBLEM: In a large teaching hospital, ambulation occurred at an average of 16.9 hours post-TAVR procedures, higher than the goal of 6 hours. METHODS: A pre/post-implementation design was used. Data on ambulation times, LOS, and discharge disposition were collected and analyzed. RESULTS: Time to the first ambulation significantly decreased from a mean of 16.9 (SD = 13.1) to 8.9 hours (SD = 5.3), P < .001. Patients meeting the goal of ambulation 4-6 hours post-procedure had a significantly lower LOS, P < .005. Fewer patients needed a higher level of care at discharge, P = .064. CONCLUSIONS: Early ambulation reduced LOS and had a positive impact on patient discharge disposition. A nurse-driven ambulation protocol can improve outcomes after TAVR.