The Impact of Early Ambulation in the Pediatric Postoperative Appendectomy Patient

The purposes of this study were to quantify the mean time to ambulate in a population of pediatric postoperative appendectomy patients at a stand-alone children’s hospital and to identify the associations between mean time to ambulate with admitting floor, patient age, pain medication, occurrence of nausea and vomiting, and length of stay. For decades, it has been suggested that extended immobilization in the postoperative patient should be avoided. Scant literature is available addressing early ambulation for pediatric patients after appendectomy. In practice, we noted that patients are not routinely ambulated early. Data were gathered from a retrospective review of 300 pediatric appendectomy patient charts at a children’s hospital. The mean time to ambulate was 16.05 hours (95% CI [14.14, 17.96]). The mean time to ambulate for patients placed on the surgical specialty unit was 13.48 (95% CI [11.90, 15.07]), compared with 20.36 hours for patients admitted to overflow units (95% CI [16.97, 25.36], p < .0007). Patients who experienced nausea and/or vomiting had a longer mean time to ambulate than those patients who did not (21.17 and 13.49 hours, respectively; p < .0001). Patients who received intravenous narcotics, oral narcotics, and nonnarcotic analgesics had a mean time to ambulate of 17.30, 13.03, and 11.61 hours, respectively (p = .0661). The Spearman’s rank correlation coefficient between length of stay and time to ambulate was .47. The results of this research study suggest that early ambulation has a significant impact on length of stay. Despite ambulation being taught in basic nursing education as a crucial component of postoperative care, this nursing-driven intervention is not routinely practiced. Placing these patients on a surgical specialty unit may lead to improved patient outcomes and will provide a targeted audience for future educational interventions.