Date of Award

Summer 2026

Abstract

Background: Early ambulation following cardiac surgery is an evidence-based practice that promotes postoperative recovery, reduces complications, and supports earlier discharge (Cook et al., 2024; Engelman et al., 2019; Kanejima et al., 2020). Despite its recognized benefits, consistent implementation remains challenging in busy inpatient settings due to workflow demands, competing priorities, and patient-related barriers.

Local Problem: Inconsistent early ambulation practices were identified on the Cardiac Surgical Step-Down Unit, creating an opportunity to improve adherence to evidence-based postoperative mobility practices.

Methods: This quality improvement project used the Plan-Do-Study-Act (PDSA) model to evaluate the impact of a brief nurse-focused educational intervention on early ambulation practices. Outcome measures included the percentage of eligible patients who ambulated by postoperative day one and nurse perceptions of early ambulation expectations and consistency.

Intervention: The intervention consisted of a one-minute educational discussion, a one-page educational handout, and a workflow cue reminding nurses to incorporate early ambulation into routine patient care.

Results: Fourteen eligible postoperative cardiac surgery patients were observed, and eleven nurses completed pre- and post-intervention surveys. Following implementation, the percentage of eligible patients who ambulated by postoperative day one increased from 57.1% to 71.4%. Nurse-reported understanding of early ambulation expectations and perceptions of consistent mobility practices also improved modestly. Although the project's specific aim of achieving an 80% ambulation rate was not met, positive changes were observed across both patient and nursing outcome measures.

Conclusions: The findings suggest that a brief, low-cost educational intervention may improve nurse awareness and support more consistent early ambulation practices following cardiac surgery. Additional reinforcement, longer implementation periods, and broader multidisciplinary involvement may be necessary to achieve larger and more sustained improvements.

Keywords: early ambulation, cardiac surgery, quality improvement, nursing, postoperative mobility, PDSA

Document Type

Master's Thesis

First Advisor

Elizabeth Evans

College or School

CHHS

Department or Program

Nursing

Degree Name

Master of Science

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