Staff perceptions of facilitators and barriers for ambulation of postoperative pediatric patients on a surgical unit: A qualitative study.

BACKGROUND: Routine, timely postoperative ambulation reduces complications, speeds up recovery, and shortens length of stay, yet little is known about how interdisciplinary staff perceive factors influencing ambulation for pediatric patients on surgical units. This gap limits the design of effective interventions in pediatric postoperative care. PURPOSE: To explore interdisciplinary staff perceptions of facilitators, barriers, and experiences related to promoting ambulation among pediatric patients recovering from surgery on a pediatric surgical unit. METHODS: This descriptive qualitative study used semi-structured interviews with registered nurses, patient care technicians, advanced practice providers, and physical therapists (n = 16). Data were analyzed using manual thematic analysis, and member checking was conducted to enhance credibility and validate the findings. RESULTS: Three overarching themes emerged: (a) staff readiness, roles, and safety; (b) patient and family engagement; and (c) interdisciplinary knowledge and coordination. Subthemes were identified as facilitators or barriers toward patient ambulation. For example, patient and family engagement demonstrated that parental involvement, visual goals, and reminders facilitate patient ambulation, while poor understanding of ambulation, low motivation, pain, and anticipatory fear limit engagement and hinder ambulation. CONCLUSIONS: Registered nurses, as frontline coordinators of pediatric postoperative care, collaborate closely with interdisciplinary team members, patients, and families to promote timely ambulation. Their central role uniquely positions them to lead interventions that leverage facilitators and barriers to improve ambulation consistency. PRACTICE IMPLICATIONS: Nurses can improve patient ambulation by integrating standardized pediatric postoperative protocols into workflows, delivering consistent perioperative education, strengthening orientation and competency development for new nurses, and optimizing ambulation-related orders.