Ambulation following surgery has been found to be beneficial for patients; however, nurses
and doctors struggle with getting post-operative, hospitalized patients to walk on their own.
One promising strategy to address this might be an ambulation orderly, an employee whose
single responsibility is to assure that patients walk 3-4 times per day. However, the effect
of the ambulation orderly on post-operative physical activity has not yet been described. It
is important to quantify what the ambulation orderly does in order to assess if this is an
effective method for helping patients walk. As a result, the investigators will perform a
pilot randomized controlled trial to test the effects of an ambulation orderly in patients
hospitalized with recent cardiac surgery. Half of the patients will be assigned to walk with
the ambulation orderly 3-4 times/day and the control group will be given standard nursing
encouragement and assistance and encouragement to walk. The investigators will evaluate the
average total daily step counts (over the hospital course, usually 4-7 days) and the change
in walking distance between a baseline and a final 6 minute walk test. The investigators will
also evaluate exercise physiologic parameters (heart rate, oxygen saturation) during
ambulation, patient functional independence, and patient satisfaction.
The investigators will perform a prospective randomized controlled trial at Baystate Medical
Center, a 684-bed academic teaching hospital that serves as the referral center for a
population of approximately 800,000 people living in Western Massachusetts.
The responsibility of the ambulation orderly is to walk patients after having a cardiac
surgery, such as a coronary artery bypass surgery or a valve replacement or repair. Patients
will be randomized to receive visits from the ambulation orderly (ambulation group) or to
receive the standard care of Baystate Medical Center (control group). The standard of care
will be nurse-directed ambulation, as is currently done in all other nursing floors at
Baystate Medical Center. Nurses will be instructed to walk with the patients as they did
before the initiation of the ambulation orderly and as they do when the orderly is on
vacation, at conferences, training, or away for illness.
- Patients who have had a cardiac surgery procedure (coronary artery bypass grafting
surgery or valve surgery). Must be ambulatory prior to surgery
- Unable to consent, cognitively impaired, and patients unable to walk prior to surgery