Introduction Bed rest causes accelerated muscle loss in elderly patients: ten days bed rest ages muscle by ten years (Kortebein, Ferrando, Lombeida et al., 2007), most loss is lower limb and occurs in initial days of immobility. Hospitalised elderly patients spend 20 hours in bed, three sitting and just one standing/walking (Brown, 2009): deconditioning is likely. This results in risk of falls, pressure ulcers, functional incontinence and may be the difference between dependence and independence on discharge. Since 2017 an NHS initiative #endpjparalysis aims to reduce deconditioning using methods such as encouraging patients to dress, social dining, ward tea parties and activities.
Although our hospice inpatients have tailored physiotherapy, we believed the principles of this initiative could be appropriate for inpatients admitted for symptom control or respite.
Aim To increase staff awareness of risks of bed rest and increase the proportion of appropriate patients up, dressed and moving.
Method After baseline audit we held awareness sessions for staff, introduced daily social dining options, tea and cake club and weekend activity hour. Posters/information leaflets ensure patients/carers understand the importance of keeping moving, and that they bring appropriate clothes/footwear with them.
Results Baseline audit revealed 40% of patients well enough to get dressed were still in pyjamas at lunchtime. No patient went to the day room to eat. First quarter results to be presented at conference, along with patient and staff feedback.
Conclusion Despite good physio input, the wider hospice teams could do more to increase patient activity and reduce deconditioning. The ‘Sit up, get dressed, keep moving’ campaign can be/is appropriate for the hospice setting.
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