• Amy Jo Lisanti, Stephanie Helman, Andrea Sorbello, Jamie Fitzgerald, Annemarie D'Amato, Xuemei Zhang, and J William Gaynor.
• Amy Jo Lisanti is a nurse scientist - clinical nurse specialist, Cardiac Nursing and the Center for Nursing Research and Evidence-Based Practice, Children's Hospital of Philadelphia and Adjunct Assistant Professor of Nursing, University of Pennsylvania, School of Nursing. She was a Ruth L. Kirschstein National Research Service Award Postdoctoral fellow, University of Pennsylvania School of Nursing, while this work was performed.
• Crit Care Nurse. 2020 Aug 1; 40 (4): 16-24.

BackgroundNursing care of pediatric patients after cardiac surgery consists of close hemodynamic monitoring, often through transthoracic intracardiac catheters, requiring patients to remain on bed rest and limiting holding and mobility.ObjectivesThe primary aim of this quality improvement project was to determine the feasibility of safely mobilizing pediatric patients with transthoracic intracardiac catheters out of bed. Once feasibility was established, the secondary aim was to increase the number of days such patients were out of bed.Methods And InterventionsNew standards and procedures were implemented in July 2015 for pediatric patients with transthoracic intracardiac catheters. After initiation of the new policies, complications were tracked prospectively. Nursing documentation of activity and positioning for all patients with transthoracic intracardiac catheters was extracted from electronic health records for 2 fiscal years before and 3 fiscal years after the new policies were implemented. The Cochran-Armitage test for trend was used to determine whether patterns of out-of-bed documentation changed over time.ResultsA total of 1358 patients (approximately 250 to 300 patients each fiscal year) had activity and positioning documented while transthoracic intracardiac catheters were in place. The Cochran-Armitage test for trend revealed that out-of-bed documentation significantly increased after the new policies and procedures were initiated (P < .001). No major complications were noted resulting from patient mobility with transthoracic intracardiac catheters.ConclusionPediatric patients with transthoracic intracardiac catheters can be safely held and mobilized out of bed.©2020 American Association of Critical-Care Nurses.

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