"Ambulation is an area that would benefit from research to define the clinical evidence, as well as the actual number of feet," said Rosenkranz. "That said, we feel ambulation is definitely important for preventing post-op complications (pulmonary, VTE, etc), even if there is no research or literature to define the distance and how often."
To make sure patients get up out of bed to walk, "tell them how far they need to walk and how many times a day they need to do it, but let them choose their schedule." Lacovara said. Timers and pedometers are useful for measuring progress, and visual cues in hospital hallways can help everyone better understand what 50 feet really looks like.
Mechanical compression with pharmacological prophylaxis makes all the difference
Intermittent Pneumatic Compression (IPC) devices (ideally in combination with pharmacological prophylaxis) may also reduce the chance of a VTE event, Lacovara said.
In patients who were contraindicated for pharmacological intervention, IPC devices were more efficient and resulted in better patient compliance during a hospital stay than graduated compression stockings. In terms of deep vein thrombosis (DVT), for example, the same research shows that IPC, on its own, reduces risk by 50 to 60 percent when compared to no intervention.
“For the majority of the patients, we only have them use the IPC devices and not the stockings," Lacovara said.
"There are patients who can't have chemical prophylaxis," Lacovara added, "and for them the [IPC] devices are even more important."