If you or a loved one is unlucky enough to find yourself in hospital, you could think it is best to rest in bed for so long as possible. But while rest is essential, lying or sitting in bed for too long can actually make many health conditions worse.
Scientists have developed mobility recommendations in some hospitals, but in practice most patients are still not lively enough.
To discover more, we asked 138 nurses from five Australian states concerning the challenges they face when trying to provide patients more freedom of movement, and what changes could help. We also conducted several in-depth interviews with the group of nurses participating within the study.
Our resultspublished within the Journal of Clinical Nursing showed that we will do rather a lot. Managers and team leaders play a very important role in empowering nurses, as our study found that nurses don’t all the time feel capable of reduce their patients’ sedentary lifestyle.
The dangers of a sedentary lifestyle within the hospital
Lying or sitting too long while in hospital It may result in deterioration (similar to lack of strength, joint function and mobility), pressure injuries, blood clots, infections, prolonged hospital stays and unplanned hospital readmissions.
In rehabilitation facilities where an individual is recovering after a stroke, amputation or arthritis, older people spend roughly just 5% of the day
perpendicularly.
In acute situations – where a patient in hospital may have surgery or treatment to repair a fracture, remove a tumor or relieve nerve pain – the situation could be much worse. On average, older adults spend only approx 3% of their day standing or walking.
These are astounding numbers, but the excellent news is that even a small increase in activity and exercise may also help prevent this disease rapid lack of muscle mass and strength from lying or sitting too long in hospital.
Our study showed that nurses play a key role in supporting patients’ mobility and reducing their sedentary lifestyle.
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What are the barriers?
Perhaps unsurprisingly, nurses on this study told us that workload and lack of time to encourage less sedentary behavior were significant barriers.
However, in addition they told us that there’s a belief amongst families, and sometimes patients themselves, that they need rest and that older people have earned the best to rest and leisure.
This was especially the case when people were sick or had complex needs. As one in every of the nurses said:
For example: “Dad is 80 years old, does he have to do this?” This is a standard mentality within the family of an elderly person.
So how much exercise do you have to get in hospital? There is not any one answer that matches all. For some patients, this will mean simply getting away from bed and going to the lavatory, getting dressed, or moving across the room. For others, it might mean walking the hospital corridors or doing more specialized exercise programs similar to My therapy.
What would help?
Nurses told us that having family help getting patients up and moving could be an enormous bonus.
Families can even help by providing really comfortable shoes and clothing. We know that patients are less prone to take part in a trial in the event that they do not feel comfortable.
Another said:
We involved relations during meals [by walking to] within the front room and improved her nutrient intake by introducing them [special] food and contributing to social features. One brought Italian food and so they loved it.
However, some patients are accompanied only by relations or visitors who’re themselves elderly and unable to help the patient in walking. Or the patient may don’t have any visitors in any respect.
Working closely with other members of the care team brings results, and one in every of them says:
It’s good to go to team meetings […] they tell the patient, that is what we’re aiming for, do you agree that you’ll sit all the way down to dinner daily? […] it is a team effort.
Another told us:
I wish to read the physical therapists’ notes daily after which just have an idea of what their actual functional goals and actual functional level are. Encouraging people to realize these small goals like “oh, we went to the toilet”, “oh, we brushed our teeth at the sink”.
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One nurse mentioned the worth of interventions to extend patient activity, as is the case within the UK No more PJ paralysis program.
[…] although not thoroughly promoted, [it] she was an amazing help. Quite a lot of resources have been put into this. Thanks to our care model the social aspect was an amazing success, they began friendship groups, organized many activities, we hosted a Melbourne Cup match within the front room and so they watched tennis together. It was so positive. We used to essentially encourage them to go only once, now they need to go on a regular basis. But some nurses have yet to learn that it is not about getting people downstairs.
In other words, it’s about walking, not cycling.
The nurse leader said:
It’s amazing how long it took them [patients] spend alone. There is a possible connection here. Isolation and tedium are one thing. If we cope with boredom, address sedentary lifestyles, there’s a connection and we are going to solve social isolation. Enabling nurses to be coached in lifting patients, which definitely has an academic aspect.
Creative and sustainable solutions
Our research shows that reducing sedentary behavior in hospitals is usually complex, and nurse leaders and organizations play a very important role in collaborating on creative and sustainable solutions.
As the influential British physician Richard Asher put it in his much-cited article row about danger sedentary lifestyle in hospitals:
Teach us to live in order that we may fear;
unnecessary time in bed.
Raise the people and perhaps we are going to save;
patients from an early grave.