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Tytuł pozycji:

Testing the effectiveness of the Amputee Mobility Protocol: a pilot study.

Tytuł :
Testing the effectiveness of the Amputee Mobility Protocol: a pilot study.
Autorzy :
Marzen-Groller KD; Lehigh Valley Hospital and Health Network, Division of Education, Allentown, Pennsylvania 18103, USA.
Tremblay SM
Kaszuba J
Girodo V
Swavely D
Moyer B
Bartman K
Carraher W
Wilson E
Pokaż więcej
Źródło :
Journal of vascular nursing : official publication of the Society for Peripheral Vascular Nursing [J Vasc Nurs] 2008 Sep; Vol. 26 (3), pp. 74-81.
Typ publikacji :
Evaluation Study; Journal Article
Język :
English
Imprint Name(s) :
Publication: Norwood Ma : Society For Peripheral Vascular Nursing
Original Publication: Norwood, MA : The Society, c1990-
MeSH Terms :
Mobility Limitation*
Amputation/*rehabilitation
Critical Pathways/*organization & administration
Early Ambulation/*methods
Length of Stay/*statistics & numerical data
Patient Care Team/*organization & administration
Activities of Daily Living ; Adaptation, Psychological ; Amputation/nursing ; Early Ambulation/nursing ; Health Promotion ; Hospitals, Community ; Hospitals, Teaching ; Humans ; Models, Nursing ; Nursing Evaluation Research ; Outcome Assessment, Health Care ; Patient Education as Topic ; Pennsylvania ; Pilot Projects ; Postoperative Care/methods ; Postoperative Care/nursing ; Program Evaluation ; Retrospective Studies ; Self-Help Devices ; Total Quality Management/organization & administration
Entry Date(s) :
Date Created: 20080819 Date Completed: 20081202 Latest Revision: 20191210
Update Code :
20211220
DOI :
10.1016/j.jvn.2008.05.001
PMID :
18707996
Czasopismo naukowe
We studied prolonged length of stay (LOS) in the acute care setting on a medical-surgical vascular unit, related to loss of functional mobility status after lower extremity amputation, and implementation of the Amputee Mobility Protocol (AMP) as a standard of care for all patients pre- and post-lower extremity amputation who were admitted to the medical-surgical vascular unit. A comparative pre-post observational study evaluated the effect of AMP on level of functional mobility and LOS after lower extremity amputation in the patient population on the medical-surgical vascular unit. Data was collected retrospectively from patient chart reviews from November of 2004 to March of 2005 for the pre-AMP group and through concurrent patient chart reviews from November of 2005 to March of 2006 for the post-AMP group. Dependent variables included functional mobility and LOS, which were evaluated by a modified Functional Independence Measure (FIM) score and the hospital LOS. Forty-four eligible patients were enrolled in the AMP pilot study during a 5-month period. The sample population consisted of 30 patients pre-AMP and 14 patients post-AMP. LOS for transmetatarsal amputations decreased by 0.7 days, whereas functional mobility increased by a minimum of one level in the modified FIM score. Functional mobility increased for transtibial amputations by one level and transfemoral amputations by 2 levels using the modified FIM score. LOS increased for patients undergoing transtibial (7.1 days) and transfemoral (2.7 days) amputations. This quality improvement project heightened staff awareness regarding ambulation and its impact on functional mobility and early discharge. Vascular nurses were able to affect patients' functional mobility and LOS by implementing a standardized AMP. Data showed that using the standardized AMP increased patients' functional mobility but did not significantly decrease acute care setting LOS. The AMP continues to be used for this patient population because of its impact on functional mobility and independence. This pilot study relates to 3 of the top 20 vascular research priorities: 1) an interdisciplinary strategy to improve the patient's level of functional independence and thereby decrease LOS and cost; 2) the nursing intervention of early, predetermined ambulation schedules will increase the nursing knowledge of strategies that facilitate recovery after vascular surgery in this population; and 3) factors that affect patient outcomes after these three major vascular procedures will be addressed in pilot outcomes. Limitations of the AMP pilot study included the small sample size, staff turnover, and lack of a concurrent control group. The next phase of this project will create and implement a similar activity protocol for patients after abdominal aortic aneurysm repair and various types of lower extremity bypass procedures.

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