EDUCATION PROGRAMME

“POST OPERATIVE EARLY MOBILIZATION”

Arranged by :

SENNI NOVIANI M

Class A RSHS

NPM : 1219016

PROGRAM STUDY OF NURSING

STIKES RAJAWALI BANDUNG

2020
 EDUCATION PROGRAMME

 
 
Subject : Post Operative early mobilization
 
Target : Patient and patient's family
 
The place : Pavilion Parahyangan on the 2nd floor – RSHS Bandung
 
Date and time : Monday,January,20,2020
 
Time : 10.00 – 10.30 AM (30 minutes)
 
Educator : Senni Noviani,AMK

 
 
A. Background
 
Postoperative patients need maximum care to speed up the recovery of bodily
functions. This is done immediately after surgery , recommended in the first 24-
48 hours with deep breathing exercises, effective cough and early
mobilization. Post-op care is a form of care given to patients who have undergone
surgery. The goal of treatment is to reduce complications, minimize pain, speed
healing, restore patient function as much as possible before surgery, maintain self-
concept and prepare to go home, this is done since the patient is still in the
conscious recovery room (Arif, 2010).
Post-operative laparotomy that does not get maximum treatment after surgery
can slow healing the patient itself. Report of the Indonesian Ministry of Health
(DEPKES RI), surgery increased from 162 in 2005 to 983 cases in 2006 and
1,281 cases in 2007.
 
 By looking at the condition of postoperative patients who need treatment it is
necessary to intervene with the intention to reduce stress through breathing
exercises and early mobilization to speed up the healing process and the patient's
return and can provide satisfaction with the care given.
 
 
B. Instructional purpose
 
 
1.General purpose
 
After participating in counseling activities, participants are expected to know
about postoperative early mobilization
 
2. Special Purpose:             
 
After participating in counseling, participants are expected to be able to:

1) Explain the purpose of postoperative early mobilization     

 
2) Explain the types of postoperative early mobilization     
 
3) Explain the range of motion in mobilization     
 
4) Explain the benefits of early mobilization     
 
5) Explain losses if not mobilizing     
 
6) Explain indications of postoperative early mobilization     
 
7) Explain the contraindications for postoperative early mobilization     
 
8) Explain the stages of postoperative early mobilization     
 
 
C. Sub subject
 
1. Definition of postoperative early mobilization
 
2. The purpose of postoperative early mobilization
 
3. Types of postoperative mobilization
 
4. Range of motion in mobilization
 
 5. Benefits of early mobilization
 
6. Losses if you do not mobilization
 
7. Stages of postoperative early mobilization
 
 
D. Implementation of Activities
 
1. Counseling Topics
 
Post perative early mobilization
 
2. Target
 
Pasen and the patient's family who were treated in the pavilion parahyangan
floor 2 – RSHS Bandung
 
3. Counseling Method
 
a. Lecture
 
b. Discussion and Question and Answer
 
c. Demonstration
 
4.Media and Equipment
 
a. Leaflet
 
5. Place
 
Counseling will be held in the meeting room of the Pavilion Pavilion 2nd floor
 
6. Time

a. Date and time : Monday,January,20,2020             

 
b. Hour : 10.00 – 10.30 AM               

E. Counseling Activities
 
Participant
Step Time Counseling Activities activities Method Media
           

5
Opening minutes • Open with • Listening   Lecture -
• Pay
    regards attention      
    • Introduce myself • Answering      
    • Explain mean question      
and the purpose of
    counseling        
    • Time contract        
    • Digging knowledge        
    participant before        
    counseling is done        
           
15
Presentation minutes • Explain about: • Listening   Lecture Leaflet
1. question
    Understanding Post • Giving   and  
Operative early answer
    mobilization response and methode  
    question      
2.Purpose
of post
operative
early
mobilizatio
    n    

3.Range of motion of
mobilization

4.Benefits of early
mobilization

5. Losses if not to do
early mobilization

6.Stage of post operative

    early mobilization    
  Giving change to
  ask / discuss      
    about theory     
counselin
    g        
           

 Digging
participant
knowledge after
counseling is
done
 Conclude result
extension
activities
• Answering
 Closes with
10 question
Closing minutes greeting Lecture Leaflet
,question
and
    answer  
    • Giving  
    feedback    
         
         
             
 
 
F. Evaluation
 
1. Structure evaluation
 
a. Students and audiences are in the planned position
 
b. Places and tools available according to plan
 
c. Pre Planning has been approved
 
d. 75% of the audience attends counselin

2. Process evaluation
 
a. Implementation of activities in accordance with the planned time
 
b. Student roles and assignments are according to plan
 
c. 75% of the audience plays an active role during the activity
 
3. Evaluate the results
 
In evaluating the results, it is expected that 75% of the audience
will understand the counseling material.

 
 Attachment 1
 
Counseling Materials
 
 
A. Definition of post operative early mobilization
 
Mobilization after surgery is the process of activities carried out after
surgery starting from light training on the bed to being able to get out of bed,
walk into the bathroom and walk out of the room (Brunner & Suddarth, 2002).
 
According to Carpenito (2000), early mobilization is the most important
aspect of physiological function because it is essential to maintain
independence. The concept of early oblization is actually to prevent
postoperative complications. From these two definitions it can be concluded
that early mobilization is an effort to maintain independence as early as
possible by guiding patients to maintain physiological functions.
 
Early mobilization is also defined as a movement, position or activity
carried out by the patient after a few hours post / postoperatively.
 
 
B. Purpose of Post Operative Early Mobilization
 
Some objectives of mobilization according to Susan J. Garrison
(2004), include:
 
a. Maintain bodily functions
 
b. Streamlining blood circulation
 
c. Helps breathing become better
 
d. Maintaining muscle tone
 
e. Smooth alvi and urine elimination
 
f. Speed up the process of closing the suture operation
 
g. Returns certain activities, so the patient can return to normal and or can
meet daily movement needs.
h. Provide opportunities for nurses and patients to interact or
communicate.
 C. Types of Mobilization
 
Menuruit Priharjo, 2000, mobilization was divided into two namely:
 
1. Passive mobilization
 
Mobilization in which the patient moves his body by helping others in
total or in total.
 
2. Active mobilization
 
Mobilization where the patient in moving the body is done independently
without help from others.
 
 
D. Benefits of Early Mobilization
 
According to Mochtar (2005 ), the benefits
of postoperative mobilization are:
 
a. Patients feel healthier and stronger with early ambulation . By moving,
the abdominal and pelvic muscles will return to normal so that the
abdominal muscles become strong again and can reduce pain so that the
patient feels healthy and helps gain strength, accelerate healing,
especially the closure of stitches. Bowel and bladder physiology is
better. By moving will stimulate the intestinal peristaltic back to
normal. This activity also helps speed up the organs of the body to work
as before.
 
b. Prevent thrombosis and thromboembolism, by mobilizing normal /
smooth blood circulation so that the risk of thrombosis and
thromboembolism can be avoided.
 E. Losses When Not to do early mobilization
 
Here are some of the disadvantages if you don't mobilize post surgery:
 
a. Wound healing takes a long time
 
b. Add pain
 
c. The body becomes achy and stiff
 
d. The skin becomes blisters and sores
 
e. Extend treatment at the hospital
 
 
F. Indications of post Operative early Mobilization
Mobilization exercises are usually given to patients with:
 
a. Lower extremity fractures that have been indicated for mobilization
exercises
 
b. Post lumbar compression treatment,
 
c. Post stroke patients with impaired physical mobility, as well
 
d. Postoperative patients who need mobilization exercises, such as
colostomy or laparostomy.
 
 
G. Contraindications for post operative early mobilization:
 
In certain cases bed rest is needed in the period not too long as in the case
of acute myocardial infarction, cardiac dysrhythmias, or septic shock, other
contraindications can be found in general weakness with less energy levels.

 
H. Guidelines for Implementing Mobilization
 
Activity tolerance assessment is very important especially in clients with
cardiovascular or cardiac disorders or in clients with prolonged immobiliation
due to paralysis. This is usually assessed at the time before mobilization,
 during mobilization and after mobilization. Signs that can be examined for
activity intolerance include (Gordon, 1976):
 
a. The pulse rate has increased, irregular rhythm
 
b. Blood pressure usually decreases systolic pressure / orthostatic
hypotension
 
c. Respiration occurs in frequency, shallow rapid breathing
 
d. Skin color and body temperature decrease
 
e. Body speed and position. Here will experience the speed of activity and
body position instability
 
f. Dizziness or extraordinary weakness
 
g. Unstable emotional status.
 
 
I. Stage of Early Mobilization
 
According to Kasdu (2003) early mobilization is carried out in stages, the
following will explain the early mobilization phase, including:
 
a. After surgery, in the first 6 hours the patient must rest first. Early
mobilization that can be done is to move the arms, hands, move the tips of
the toes and rotate the ankles, lift the heels, tense the calf muscles and bend
and shift the legs
 
b. After 6-10 hours, patients are required to be able to tilt left and right to
prevent thrombosis and thrombo embolism
  
c. After 24 hours the patient is recommended to be able to start learning to
sit

 
d. After the patient can sit down, it is recommended that patients learn to
walk. 
 Most of the patients still have concerns about the body moved in a certain
position postoperatively will affect the wound surgery that is still not
fully improved. Even though this problem is not entirely a concern, in fact
almost all types of operations require mobilization or body movement as early as
possible. As long as the pain can be restrained and body balance is no longer a
nuisance, by moving, the recovery period to reach the level of conditions such as
pre surgery can be shortened. And of course this will reduce time spent in
hospital, reduce funding and also can reduce psychological stress.
 

 
 
 
 

 
 References
 
 
 
 
 
Brunner & Suddarth. 2002. Surgical Medical Nursing Vol 1. Jakarta:
 
EGC
 
Beyer, Dudes (1997). The Clinical Practice of Medical Surgical Nursing
 
2nd: Brown Co Biston.
 
Potter & Perry. 2005. Nursing Fundamentals Textbook  Volume 2.
 
Jakarta: EGC.