Nurse-Led Early Mobilization After Colorectal Surgery

Condition(s) studied

Investigational drug(s) / intervention(s)

Nurse-Led Early Mobilization: 1. Preoperative Period Patients will receive verbal education regarding the purpose, benefits, and process of early mobilization. To support this education, a Postoperative Mobilization Information Brochure prepared by the researchers will be provided to the patient and their caregiver. 2. Postoperative Day 0 Within the first 6-8 hours after surgery, vital signs will be monitored, and mobilization will be initiated in clinically stable patients under nurse supervision. 2.1. In-Bed Activities (Postoperative Hour 5) The following lower-extremity exercises will be performed: Ankle dorsiflexion and plantar flexion Toe movements Leg extension without knee flexion Circular foot movements Each exercise will be performed 5-10 repetitions. The patient will then be positioned in an upright sitting position in bed. 2.2. First Standing and Ambulation (Postoperative Hours 6-8) Vital signs will be assessed. The patient will be assisted to sit at the bedside for 1-2 minutes under nurse

Standard Mobilization Care: Participants in the control group will receive standard postoperative mobilization care routinely provided in the institution. Mobilization activities will be performed according to existing clinical practices, and no structured or protocol-based nurse-led early mobilization program will be implemented. Participants in the control group will continue to receive usual nursing care without any disadvantage or additional risk in terms of patient care.

Study summary

This study was designed to evaluate the effectiveness of a nurse-led early mobilization protocol on postoperative recovery outcomes in patients undergoing elective colorectal surgery. The outcomes assessed include walking distance, mobility levels, gastrointestinal function (time to first flatus and first defecation), nausea, vomiting, comfort, fatigue, time to initiation of oral intake, patient satisfaction, incidence of postoperative complications, and length of hospital stay.

Research Question:

In patients undergoing colorectal surgery (P), does a nurse-led early mobilization protocol (I), compared with standard mobilization practices (C), improve postoperative recovery outcomes (O), including walking distance, mobility levels, gastrointestinal function (time to first flatus and first defecation), nausea, vomiting, comfort, fatigue, time to initiation of oral intake, patient satisfaction, postoperative complication rates, and length of hospital stay?

Eligibility

Primary outcome measure(s)

• Mobility level assessed — between postoperative day 0 and postoperative day 3
  Patient-reported / Observer-rated Mobility Scale The Patient Mobility Scale is used to assess pain and perceived exertion experienced during the postoperative period while performing four activities: turning from one side to the other in bed, sitting at the bedside, standing up at the bedside, and walking in the patient's room. Permission to use the scale was obtained from the responsible authors. The Observer Mobility Scale evaluates the degree of patient dependence/independence during mobilization activities. Blood pressure, heart rate, and respiratory rate are measured by the observer two minutes before and after mobilization. Furthermore, the Patient- and Observer-rated Mobility Scales will be administered on postoperative days 1, 2, and 3, and the results will be documented in the monitoring form.
• Total walking distance (measured by pedometer) — between postoperative day 0 and postoperative day 3
  Mobilization will be monitored using the Mobilization Monitoring Form and step counts obtained from the pedometer will be recorded at the end of each day.
• Time to first flatus (hours postoperatively) — From the end of surgery until the patient-reported first postoperative passage of flatus (within the first 72 hours postoperatively)
  The time interval (in hours) from the end of surgery to the first passage of flatus reported by the patient.
• Time to first defecation (hours postoperatively) — From the end of surgery until the patient-reported first postoperative passage of defecation (within the first 72 hours postoperatively)
  The time interval (in hours) from the end of surgery to the patient's first defecation will be determined and recorded based on patient self-report.

Trial sites (1)

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