Thoracic Walker: A First at Fox Chase
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Jackie Culver, RN, a nurse on 3 South, takes her patient for a walk using the thoracic walker.
Use of Thoracic Walker Speeds Patient Recovery
Following thoracic surgery, patients often manage multiple tubes and catheters, including oxygen, a chest tube to suction, a bladder catheter or epidural catheter for pain control. As a result, nurses and patients are generally apprehensive about walking as they are concerned the tubes or catheters may become disconnected. The thoracic walker was created to remedy these valid concerns.
Encouraging Patients to Walk Earlier Following Thoracic Surgery
The walkers, used in the Intensive Care Unit (ICU) and on 3 South, are designed to enable safe, early, stable, patient mobilization in a simple, practical and non-labor intensive manner, which is crucial to improving patient outcomes. Compared to a regular walker, these are unique in several ways:
- Individualized care for each patient — arm rests are adjustable to the patient's chest height, allowing the patient to feel secure and stable on their feet.
- The walker is a mobile self-sufficient device with built-in portable oxygen and suction for chest tubes.
- All external monitors, pumps, tubes, catheter bags and other devices are mounted on its sides.
Outside of Fox Chase Cancer Center only three other institutions in the country are using the thoracic walker: Brigham and Women's Hospital in Boston, where it was invented; Case Western Reserve in Cleveland, Ohio; and Mount Sinai Medical Center in New York, New York.
Walker Designed Solely for Thoracic Patients
The walker enables one nurse to walk a patient, without additional assistance, on the day following major thoracic surgery.
A nurse on 3 South who has been caring for thoracic patients for more than five years added, "The thoracic walker has become an integral part of patient care at Fox Chase. We know that walking speeds recovery. It is an important part of rehabilitation, so we work closely with the physical therapists who evaluate each patient before they start walking."
Eileen Fagan-Fittery, a case manager, works exclusively with thoracic surgical patients. "Several months after the walker was in use, I noticed a change in patient discharges that I had not seen during my twelve years here at Fox Chase."
Eileen assumed there was a change in the operating room. After reviewing several cases, she chalked up the positive change to the thoracic walker. She says, "I noticed patients were staying fewer nights, going home without the need for a visiting nurse, reported fewer respiratory complications and needed less oxygen."
Improved Patient Satisfaction
The results speak for themselves.
- Patients return home with less, if any, oxygen
- Reduces hospital stay
- Decreases the amount of post operative respiratory complications, such as hospital acquired pneumonia, deep vein thrombosis (DVT) and pulmonary embolism
Eileen adds, "The walker has had a positive impact on patient satisfaction. Typically, patients are not feeling well before surgery. It is important that they notice an improvement after surgery, early ambulation after surgery seams to really boost their confidence, which has happened."
Tracking Patient Progress
Once the walker was put into use, the post-operative nursing team on 3 South realized they needed a more effective way to track patient progress. Patients are encouraged to increase how far they walk each day. With the staff shift change, the team wanted to easily identify how far each patient had walked that day.
"Strides of Success"
The nursing team came up with a plan called "Strides of Success." Picture frames were placed on the walls in the hallway exactly 11 feet apart. This encourages patients to walk 11 feet further each time they walk.
Outside of each patient's room, the nurses attached a row of small plastic hooks, each representing the number of times the patient walked that day. A band was set on each hook after each walk. "Each time my patients walk, I place a band on the next hook," says Jackie Culver, RN. "Our goal is for patients to increase their distance by at least 11 feet each walk."
This device gives patients, nurses, doctors and family members a concrete measurement of how far the patient has walked each day. Because it is so easy to use, patients and their family members can move the band to the appropriate hook after taking a walk.
"It is extremely gratifying to see how the thoracic walker inspired the nurses to come up with a way to track patient progress. Fox Chase nurses are devoted to improving patient care, which results in healthier, happier patients," noted a staff surgeon.