The Effect of the Safe Early Mobilization Protocol Developed for Patients Underwent Coronary Artery Bypass Graft Surgery on Patient Outcomes
The Effect of the Safe Early Mobilization Protocol Developed for Patients Underwent Coronary Artery Bypass Graft Surgery on Patient Outcomes
Aim: This study aimed to evaluate the effect of a Safe Early Mobilization Protocol (SEMP) developed for patients undergoing coronary artery bypass graft (CABG) surgery on patient outcomes.
Design: A single-center, parallel-group, randomized controlled trial. Methods: The study was conducted with 60 patients in 2023. The intervention group received a Safe Early Mobilization Protocol including bedside elevation, deep breathing and coughing exercises, sitting upright in bed, sitting on the edge of the bed, standing, ambulation, and sitting in a bedside chair from the day of surgery until the fourth postoperative day. The control group received routine mobilization care. Respiratory parameters, orthostatic hypotension (OH), orthostatic intolerance (OI), mobilization distance, anxiety level, and hospital stay were evaluated.
Inclusion Criteria:
Hemodynamic stability, defined as:
Resting heart rate <110/min
Mean arterial pressure between 60-110 mmHg
Oxygen saturation (SpO₂) >88%
Receiving dopamine infusion ≤5 mcg/kg/min at the time of enrollment
No auditory, speech, or visual impairments
No neurological contraindications (e.g., cerebrovascular accident [CVA], ataxia, multiple sclerosis [MS])
No orthopedic contraindications that prevent mobilization (e.g., fractures or sequelae)
Provided informed consent to participate in the study
Age ≥18 years
Able to speak Turkish
Literate patients
Exclusion Criteria:
Requirement for intra-aortic balloon pump (IABP) support
Postoperative cerebrovascular events
High-dose inotropic drug infusion in the early postoperative period:
Dopamine ≥10 mcg/kg/min
Norepinephrine ≥0.5 mcg/kg/min
Concurrent dopamine and norepinephrine infusion
Severe arrhythmias preventing mobilization, including:
Sinus tachycardia ≥120/min
Rapid atrial fibrillation
Ventricular tachycardia
Ventricular fibrillation
Advanced chronic obstructive pulmonary disease (COPD) or bronchiectasis
Diagnosed anxiety disorders