الفهرس 
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Abstract
CABG surgery is a reliable treatment option for patients with CAD.
Postoperative complications are the most common and directly contribute to increased
morbidity and mortality, reduce functional capacity of multiple body systems, increased
duration of hospital stay, use of resources and time to return to productive life. In
additior: to other health problems as pulmonary complications, pain, insulin resistance,
depression, anxiety, and delirium.
Because the consequence of changes induced by cardiac surgery and bed rest,
early exercising and progressive mobilization post CABG appears to have merit.
Implementation of even low levels of exercise in patients who had CABG surgery could
have beneficial effects on all of the previous factors and also help nurses view of the
early exercise as a core component of nursing care. Prevention and treatment of post
CABG complications and improve patient outcomes are considered the main nursing
goals for CABG patients.
Therefore, the aim of this study was to determine the effect of an early exercise
program on the clinical outcomes for post coronary artery bypass graft Patients.
Materials & Method
The present study was conducted at Sharq El Madina Hospital in the open heart
unit. A convenience sample of 60 adult post CABG patients as indicated by the (Epi-
info) power analysis after 2 hours post surgery were included in the study.
Three tools were used for data collection
Tool one: ”CABG patient’s profile data form”
This tool was developed by the researcher after reviewing the relevant literatures
to assess post CABG patients’ readiness, and safety criteria before applying exercise
program, it consists of two parts:
Part I: CABG patient’s demographic data which include: patient’s age, sex, marital
status, educational level, and smoking history.
Part 11: CABG patient’s clinical data including:
a) Clinical history.
b) Patients baseline physiological parameters
c) Safety criteria for CABG patients’ readiness includes: Myocardial stability,
Oxygenation adequacy.
Tool two ”Borg Rate of Perceived Exertion Scale (RPE)”
Tool three: ”Post CABG clinical outcomes assessment record”
This tool was developed by the researcher after reviewing the relevant literature to
assess the patients’ outcomes after implementation of early exercises program. It includes
the following two parts:
Part I: include data related to occurrence of pulmonary complications; occurrence of
pain, presence of infection, occurrence of delirium, depression and anxiety and length of
stay.
Part 11: include data related to the echocardiography results before and at the end of the
study using 2-dimentional echocardiography.
The main results and conclusion of the current study:
Practicing of the early exercises program for post CABG patients in the current
study minimized the occurrence of post operative complications; and improved the
clinical outcomes.
Current study findings illustrated that most studied CABG patients experienced
high insulin sensitivity, low incidence of pulmonary complications (atelectasis, hypoxia),
decreased incidence of delirium, pain and lower length of ICU stay.
Current study findings predicted a relationship between the clinical outcomes
among CABG patients and the following risk factors which included smoking history,
duration of mechanical ventilation, and history of diabetes.
Based on the current study findings, the following recommendations are suggested:
Implement an early exercise program as soon as possible while ongoing monitoring
for hemodynamic and oxygenation stability.
Ensure patients safety through accurate and ongoing assessment of hemodynamic and
oxygenation stability before, during, and after any exercise and mobility intervention.
Provide in-service training for critical care nurses on the steps of early exercises
program, patients’ screening for intolerance and safety to minimize possible
complications.
Develop strategies, policies, written protocols and guidelines for early exercise
program steps, techniques.
Ensure the availability of adequate staff and equipment required for initiating and
follow up the exercise program.
Replicate this study on large sample size and in different ICUs to evaluate the safety and feasibility of early exercise program for post CABG patients.
Determine the risk factors and the barriers for implementing the early exercise program and the progressive mobilization