Pediatric Sickle Cell Patients ‘Walk It Out’ to Reduce Length of Hospital Stay: A Children’s Hospital of the King’s Daughters Quality Improvement Project

Abstract

The hematology/oncology unit (8B) at the Children’s Hospital of the King’s Daughters (CHKD) focuses on the care of children diagnosed with blood disorders and oncologic diagnoses. Problem Statement: Adolescents and young adults (AYAs) with sickle cell disease (SCD) face unique challenges. Longer hospitalizations increase their morbidity and mortality risks (Matthie & Jenerette, 2015). Purpose: The purpose of this quality improvement project was to improve nursing practice at CHKD, to decrease length of hospital stay for AYAs with SCD by increasing their daily ambulation through the use of pedometers. Methods: A nursing implemented ambulation protocol (Walk It Out) was created based on previous studies and evidence-based practice. A quasi-experimental pre-post design was used to compare the average length of hospital stay of AYAs with SCD before and after Walk It Out implementation. Prior to Walk It Out implementation 102 AYAs with SCD (44 males and 58 females) were admitted to 8B from August 1, 2017 – January 31, 2018. Nursing staff implemented Walk It Out from August 1, 2018 – January 31, 2019 at which time 62 AYAs with SCD were admitted to 8B (20 males and 42 females). Results and Significance: There was a 30% decrease in the overall average length of stay for male and female AYA patients with SCD after Walk It Out implementation. These results were significant because previous research indicated that a shorter length of hospital stay decreases patients’ morbidity and mortality risks. Therefore, this small practice change is beneficial to patients’ overall quality of life.