Cost savings associated with a nurse driven mobilization protocol for recovery after cranial tumor resection
By
David Zarrin
Shivani Baisiwala
Jonah Im
Keshav Goel
Myungjun Ko
Sonia Wang
Humza Zubair
Alexander Valenzuela
Tristan Bennett
Dupre Orr
Won Kim
September 2, 2025
Clinical Scorecard: Economic Benefits of a Nurse-Led Mobilization Strategy Following Cranial Tumor Surgery
At a Glance
Category Detail
Condition Post-operative recovery following cranial tumor resection Key Mechanisms Nurse-driven early mobilization, pain management, and patient education to enhance recovery Target Population Adult patients undergoing elective cranial tumor resection without neurological deficits Care Setting Post-operative care in hospital neurosurgical units
Key Highlights
NERVS protocol enables early post-operative mobilization led by nursing staff, bypassing PT/OT delays. Implementation of NERVS is associated with reduced hospital length of stay and resource utilization. NERVS protocol includes structured goals for mobilization, pain management, and patient education. Guideline-Based Recommendations
Diagnosis
Identify eligible patients: adults undergoing elective cranial tumor resection without pre- or post-operative neurological deficits. Management
Initiate nurse-driven mobilization within 4 hours post-surgery: sitting upright for 5 minutes, repeated every 2 hours. Progress mobilization to walking short distances with RN assistance starting POD0, increasing activity on POD1 and beyond. Implement baseline pain assessment and non-pharmacological pain management strategies. Provide patient education including medication cards, post-operative care instructions, and follow-up planning. Remove Foley catheter early per nursing guidelines. Monitoring & Follow-up
Assess achievement of mobilization and pain management goals regularly; re-attempt failed goals after 6–8 hours. Monitor for pathway failure; if goals are unmet after repeated attempts, initiate PT/OT evaluation for traditional discharge planning. Risks
Patients with neurological deficits or requiring prolonged intravenous analgesia are excluded from NERVS due to safety concerns. Failure to meet mobilization goals may delay discharge and require additional therapy resources. Patient & Prescribing Data
Adults undergoing elective cranial tumor resection without neurological deficits
Nurse-led mobilization protocols can reduce reliance on PT/OT services, decrease hospital length of stay, and optimize analgesic use post-operatively.
Clinical Best Practices
Use propensity matching to adjust for confounders when evaluating mobilization protocols in retrospective studies. Engage multidisciplinary teams including neurosurgeons, nurses, anesthesiologists, and rehabilitation specialists in protocol development. Incorporate structured, timed mobilization goals with clear escalation pathways for patients not meeting targets. Educate patients thoroughly on post-operative care and pain management to support recovery. Monitor pain scores and analgesic dosing to tailor individualized pain control strategies. References
