Open Heart Surgery

The Importance of Early Activity after Open Heart Surgery Open heart surgery is one of the most important procedures in today’s time. Some of the more common performed corrective procedures include myocardial revascularization, valve repair or replacement, repair of congenital or acquired structural abnormalities, placement of a mechanical assist device, and heart transplantation. The postoperative period is the most critical time when it comes to these patients; it is during this time that the most severe and often fatal complications can occur (Ahmed, Ibrahim, El Soussi, & El Said, 2006, p. 34). This is where early physical activity comes in. Early activity is a solution to many of the severe problems that occur during the post-op period.
Their mission was to examine the exact effects on early activity on patient outcome. They selected a sample of forty adult patients of both sexes who were undergoing open heart surgery. Twenty of the patients underwent an activity program during post-op; the activities included positioning supine, left and right in bed; early ambulation activities such as dangling, standing near the bed, chair sitting and walking; and chest physiotherapies such as coughing, breathing exercises, percussion, vibration and incentive spirometry. Their results were compared to a control group of twenty other patients who recovered in the ICU under normal standards with no early physical activities. The results proved that the patients that underwent a physical activity regimen during post-op had a better outcome. They had better recover with respiratory function, especially with crackles, dyspnea, and lung function. Also, they had lower rates of dysrhythmia and atelectasis. Most importantly, the patients who participated in early physical activity had a significantly shorter length of stay in the ICU (Ahmed, Ibrahim, El Soussi, & El Said,
I was able to find a committee meeting from 2011 that outlines critical care service and what is expected from the staff regarding these post-op open heart patients. The report from the meeting states, “Bed rest is no longer the default activity for patients in the ICUs…” (Bailey, 2011, p. 1). Prior or around the time of this meeting, an ambulation program was implemented in the ICU, CCU, and the PCU at Northeast Georgia. It includes a multi-disciplinary program that was developed by nursing, PT, and RT. In the CCU and the PCU, this initiative includes all open heart patients. The goals include ambulation of patients four times a day, using the family as “coaches”, daily reviews by the attending physician, and it includes a “walking sheet” which is a place to record every time the patient walks. This is very important for the critical patients in these ICUs, but the meeting also discussed the fact that early activity and ambulation has also been implemented in other hospital floors as well, such as Med/Surg (Bailey, Pollock, 2011, p. 1-2). I also obtained a physician order form that documents everything a nurse must do status post-op with open heart patients; the third item is activity, which states, “out of bed- dangle feet to side of bed within 4 hours of extubation then up to chair TID as tolerated,” and, “ambulate after Swan removed POD #1”