Dr Marie March1, Dr Seema Radhakrishnan1,2,3, Ms Annabel Darmali1, Ms Christina Eagleton1, Ms Minh Pham1, Ms Sarah Faulds1, Ms Robyn El-Khair1, Ms Katie Gilbert1, Ms Carmen Lazar1, Prof Friedbert Kohler1,2, Prof Rebecca Ivers2,3
1South Western Sydney LHD, Liverpool, Australia, 2UNSW, Sydney, Australia, 3Ageing Futures Institute, UNSW, Sydney, Australia
Biography:
Annabel is an early career physiotherapist at Fairfield Hospital. She completed a Bachelor of Applied Science (Physiotherapy) with First Class Honours in 2023 and is particularly experienced with vulnerable aged and paediatric populations. Annabel led qualitative data analysis for the BOOST 2.0 project at Fairfield Hospital and was also involved in providing the BOOST 2.0 intervention, giving her a unique perspective.
Abstract:
Introduction:
Frail older adults are at very high risk of hospital acquired deconditioning. High frequency exercise and mobility training has been demonstrated to improve functional outcomes and hospital length of stay when conducted by physiotherapists. However, the potential for other health professionals to implement high frequency exercise is unknown.
Aim:
The aim of this study was to explore the patient, carer and staff experiences of implementing high frequency exercise in subacute care using nursing students and allied health assistants.
Methods:
Embedded qualitative study within an implementation evaluation. Semi-structured interviews based on the Consolidated Framework for Intervention Research were conducted with patients and carers close to discharge home, and with purposively sampled staff after 6 months of implementation. A pragmatic approach to thematic analysis was used.
Results:
Patients and carers thought BOOST was beneficial. Families valued having exercise information at the bedside to support the implementation.
All staff considered BOOST to be beneficial, however the structure of nursing student placements, and the perceived role of nursing in the multidisciplinary team were considered barriers to sustained implementation. Ward nurses expressed that they did not have ownership of the intervention which created issues for electronic documentation.
Weekend allied health assistance exercise was consistently implemented and well received, but the lack of flexibility to change exercise prescription was noted.
Conclusion:
Use of nursing students to implement inpatient exercise in subacute care requires more intensive, nursing-specific strategies compared to implementation using allied health assistants.