Early Ambulation after Surgery

Early ambulation and mobilization post-surgery are cornerstone practices in modern postoperative care, promoting faster recovery and reducing the risk of complications such as deep vein thrombosis, pneumonia, and muscle weakness. By encouraging and guiding patients to move soon after surgery within safe limits, nurses help shorten hospital stays, enhance patient outcomes, and expedite the return to daily activities.

Last updated: October 9, 2024

What is early ambulation after surgery, and why is it so important?

Early ambulation after surgery refers to the practice of getting patients up and moving around as soon as possible following a surgical procedure.

Benefits include:

Helps prevent clot formation
Stimulates circulation and blood flow
Improves GI, GU, respiratory functions
Improves client’s outlook and feeling of independence
Can relieve pain and increase muscle tone
Decreases length of hospital stay

Assistive devices and safety measures

Prior to ambulation, ensure all safety devices are in use and that the client has the proper mobilization devices.
Be aware of any limitations or activity restrictions set by the provider.
Assistive devices: gait belt, non-slip socks, walker or cane

Client education & nursing tips around ambulation after surgery

Marking distances in the unit can quantify distances for documentation and help with goal setting.
Assess whether you need additional assistance.
Coordinate with physical and occupational therapy.
Make sure IV poles are unplugged and catheters are secured.
Include family members in early ambulation.
Provide encouragement and reassurance. Client may not be able to walk on first attempt. Can encourage standing.

Steps and actions in progressive ambulation after surgery for mobilization

#1 Bed exercises

Assess client’s muscle strength, sensation, and coordination.
Assist client to perform foot pumps, leg lifts, and turning.

#2 Dangling at bedside

Assist client to dangle feet at the bedside.
Help them to the edge of the bed.
Guide their feet over the side of the bed.
Support balance.

#3 Standing

Assist client to standing position.
Ask the client to rise on the count of 3.
Assess client’s balance and any signs of distress or weakness.
Ask client to walk in place.

#4 Walking

Assist client to ambulate.
Start with a short distance.
Maintain grip on gait belt.
Have wheelchair or seat available if needed.

How to document postoperative ambulation

Documentation should include:

Distance client ambulated
Level of assistance required
Any assistive devices used
Client’s balance and gait
Response to ambulation
Any falls or incidents
Client teaching completed

Example exercises after specific surgeries

Knee exercises after surgery

Quad sets (tightening the thigh muscle with the leg straight and holding)
Ankle pumps

Breathing exercises after surgery

Carpal tunnel exercises after surgery

Wrist flexion and extension
Tendon gliding exercises

Shoulder/rotator cuff exercises after surgery

Passive range of motion (caregiver or therapist moves arm in various directions without patient using muscles actively)
Pendulum exercises (letting arm hang and swing in small circles)
Scapular squeezes (pulling shoulder blades together to strengthen upper back muscles)

Splinting: Breathing & Coughing after Surgery

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