You gotta move: current practice of, and health professionals perspectives about, promoting early mobilisation in admitted patients
Jenne Farrant1, Jo Nolan1, Karen Sherwell1, Anna Phillips2, Kylie Johnston2, Christie Siatis2, Saravana Kumar2 1Southern Adelaide Local Health Network, Adelaide, South Australia, Australia2Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
Abstract
There is strong and consistent evidence to indicate that for older people, the longer they stay in hospital, the poorer their function. From a patient perspective, poorer function can result in functional decline, increased need for support and changes in accommodation post discharge. From a system perspective, increased length of stay puts burden on an already overstretched system as well as restricts access to those who would benefit from access to hospital care. Despite this, an evidence-practice gap exists in clinical practice where older people who are at risk of functional decline do not receive early and timely intervention. Therefore, the aim of this collaborative research between clinicians and researchers was to map the current practice of, and doctors, nurses, and physiotherapists perspectives about, early mobilisation in intensive care and the general medical unit in a tertiary hospital in South Australia. Retrospective audit (quantitative research) > 100 randomly selected medical records of consecutively admitted patients to the target wards was undertaken. Six discipline and clinical area specific focus groups (qualitative research) were conducted with 32 participants (9/32 (28%) male; doctors n=14, nurses n=6, physiotherapists n=12). Audit findings indicated limited early mobilisation of patients, despite indications to do so. The data quality was variable due to missing or incomplete data. Semi-structured interviews highlighted complex and intertwined patient, local context and organisational factors influenced if, and when, early mobilisation occurred. Early mobilisation of patients continues to be hampered by systemic issues. Addressing this evidence-practice gap will require collaboration between stakeholders and sectors.
Biography
Jo is the Allied Health Research Coordinator at Southern Adelaide Health Network (SALHN) and Senior Program at the Allied and Scientific Health office (ASHO), Department of Health and Wellbeing, South Australia. Jo has strong interest, and extensive experience, in working with older people. She also is passionate about linking research with clinical practice and as such has undertaken numerous service and practice improvement initiatives. In her role at SALHN and ASHO, Jo spearheads initiatives to grow the research capacity of allied health professionals and facilitate the implementation of allied health best practice.