Paper Type

Doctoral Project


Brooks College of Health

Degree Name

Doctor of Nursing Practice (DNP)



NACO controlled Corporate Body

University of North Florida. School of Nursing

First Advisor

Dr. Barbara J. Kruger

Second Advisor

Dr. Michele Bednarzyk

Third Advisor

Dr. Jan Meires

Department Chair

Dr. Barbara J. Kruger

College Dean

Dr. Pamela S. Chally


The purpose of this quality improvement project was to increase physical activity among postoperative adult liver transplant patients, improve documentation of daily activity, and ultimately influence quality of life (QOL). Quality of life has been shown to improve dramatically after liver transplant, as patients enter transplant severely debilitated with limitations on their physical activity which carry over following transplant. The literature supports that liver transplant patients should engage in physical activity which may improve QOL. Thirteen liver transplant patients were recruited within the seven days of their post-operative hospitalization. Twelve patients consented, were educated about the benefits of walking, given instructions for how to gradually increase their walking activity, and how to track this activity in a daily log. The International Physical Activity Questionnaire (IPAQ) that calculates level of physical activity (metabolic equivalent or MET score) was conducted at baseline and six weeks. Patients were also asked to rate their perceived quality of life on a ten point scale. Eight patients completed the study with four patients medically unable to complete the walking program. Baseline MET and QOL scores were compared between Time 1 and Time 2 (six weeks). The IPAQ baseline score increased from 407.5 MET to 1,711.5 MET, however, results were not statistically significant. Quality of life improved from Time 1 average score of 5.5 (SD=2.51) to Time 2 average score of 8.25 (SD=1.67) and was statistically significant (P=0.27). Liver transplant patients gradually increased their walking activity over a six week period and documented that activity daily. QOL was also purported to increase which is consistent with findings in the literature. Implementing a post liver transplant walking program is feasible and beneficial for patients and should be a standard of care.