Patients' experiences of postoperative intermediate care and standard surgical ward care after emergency abdominal surgery: a qualitative sub‐study of the Incare trial

Abstract

Intermediate care may increase patient perceptions of quality and safety of care.

Early intensive mobilization after acute high-risk abdominal surgery: a nonrandomized prospective feasibility trial

“…Other studies have also reported that patients felt restricted by surgical drains, tubes, oxygen lines and continuous monitoring of vital signs during hospital admission. 8 , 10 , 36 , 38 – 40 To reduce these restrictions, easy access to appropriate walking devices (e.g., the high walking frame with wheels) may facilitate independent mobilization owing to decreased pain when mobilized this way and less insecurity secondary to symptoms of fatigue or dizziness. Furthermore, the walking devices are suitable for transporting all the surgical equipment (e.g., epidural, catheter, intravenous infusion, surgical drains, parental nutrition).…”

“…Participants not remembering how much they had been out of bed, their lack of motivation toward physical activity and their diminished health-related quality of life after AHA surgery may have also influenced the feasibility of mobilization during hospital admission in the present study. 38 – 41 Evidence suggests that using activity monitors so that participants can monitor their level of physical activity from minute to minute can increase time out of bed and physical activity. 42 , 43 Such monitors, therefore, may be added to the mobilization program, especially for independent patients, being relevant for motivation and visual feedback on the amount of mobilization in daily practice during hospital admission, after discharge or in an RCT.…”

“…The nursing staff hold a key position in supporting mobilization, as they spend so much time with the patients, but several studies have reported that heavy workload, attitudes about mobilization and limited availability of health care staff can be a barrier for mobilization. 17 , 38 , 39 , 41 Overall, heavy workload or missing registration of walking distance in the evening shift may have affected the result of feasibility of the goals of time out of bed or walking distance. This highlights the importance of identifying all barriers when tailoring the implementation of early intensive mobilization to each context and patient abilities.…”

Enhanced Recovery After Surgery (ERAS®) Society Consensus Guidelines for Emergency Laparotomy Part 3: Organizational Aspects and General Considerations for Management of the Emergency Laparotomy Patient

“…Nursing ratios decrease as the patient recovers and moves through different levels of postoperative care. One study [ 88 ] illustrated patients’ perspectives around step-down from critical care, interviews confirmed that the transition could be difficult, and patients felt insecure due to greater nursing workload and a perception of busier areas with fewer staff. In the UK specialist nursing roles focused on EL have evolved.…”