Early Mobility Bundle to Prevent Hospital Acquired Pneumonia (HAP) in Medical Inpatients
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Purpose
Hospital acquired pneumonia (HAP) is a common complication of extended hospital stay. In surgical specialities and critical care early physiotherapy is a recognised way of preventing such infections, and reducing length of hospital stay (LOS), however prevention of this problem is less well studied in medical inpatients.
The investigators propose a pilot study to assess the impact of introducing an early mobilisation strategy to general medical and respiratory wards at an acute Trust in the United Kingdom (UK). The investigators will recruit all new admissions to each of 2 respiratory and 2 elderly care wards - 1 of each ward type will be allocated to receive extra physiotherapy input targeting new admissions for early mobilisation. Patients' usual mobility, current mobility and actual activity levels will be studied by accelerometer and simple patient questionnaire in the first 48 hours of admission, and compared between groups. Incidence of HAP and total LOS will be recorded and compared between groups.
The investigators hypotheses are that the physiotherapy intervention will increase activity levels, reduce incidence of HAP and reduce LOS. The latter may result in cost savings to the National Health Service (NHS), which the investigators will model using local tariff data.
The investigators plan to use our data to power a larger randomised controlled study, or if the intervention is a marked success, such that a control group would be unethical, then a wider service development and evaluation programme.
| Condition | Intervention |
|---|---|
|
Hospital Acquired Pneumonia |
Behavioral: Early mobility bundle |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | Use of Early Mobilisation to Reduce Incidence of Hospital Acquired Pneumonia in Medical Inpatients |
- Incidence of hospital acquired pneumonia [ Time Frame: Duration of hospital stay (up to 12 days) ] [ Designated as safety issue: No ]The average length of stay is 8 days on the respiratory ward and 12 days on elderly care. This is the time period in which incidence of hospital acquired pneumonia will be measured, and expressed as incidence/week of stay. Patients whose length of stay is lower or higher than average will not be excluded.
- Length of hospital stay in days [ Time Frame: Duration of hospital stay (up to 12 days) ] [ Designated as safety issue: No ]The average length of stay is 8 days on the respiratory ward and 12 days on elderly care. This is the time period in which incidence of hospital acquired pneumonia will be measured. Patients whose length of stay is lower or higher than average will not be excluded
- Incidence of falls [ Time Frame: Duration of hospital stay (up to 12 days) ] [ Designated as safety issue: Yes ]The average length of stay is 8 days on the respiratory ward and 12 days on elderly care. This is the time period in which incidence of hospital acquired pneumonia will be measured. Patients whose length of stay is lower or higher than average will not be excluded
- Incidence of pressure area problems [ Time Frame: Duration of hospital stay (up to 12 days) ] [ Designated as safety issue: No ]The average length of stay is 8 days on the respiratory ward and 12 days on elderly care. This is the time period in which incidence of hospital acquired pneumonia will be measured. Patients whose length of stay is lower or higher than average will not be excluded
- Activity levels as reported by patient [ Time Frame: Days 1 and 2 of admission to ward ] [ Designated as safety issue: No ]
- Activity levels as measured by Actigraph [ Time Frame: Day 1 and 2 of admission to ward ] [ Designated as safety issue: No ]
| Enrollment: | 1178 |
| Study Start Date: | February 2013 |
| Study Completion Date: | September 2013 |
| Primary Completion Date: | September 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Early mobility bundle
Delivery of early targeted physiotherapy to patients on the interventional wards; to comprise assessment and communication of mobility to ward staff and patient, provision of mobility aids, guidance and encouragement to patient and staff to allow patient to dress and mobilise independently if clinically safe to do so
|
Behavioral: Early mobility bundle |
|
No Intervention: Usual care
Usual physiotherapy service only
|
Eligibility| Ages Eligible for Study: | 16 Years and older (Child, Adult, Senior) |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Any medical inpatient
Exclusion Criteria:
- Nil for main study
- Immobile patients and those unable to consent will be excluded from the sub-study using activity reporting and monitoring by Actigraph
Contacts and LocationsPlease refer to this study by its ClinicalTrials.gov identifier: NCT01769742
| United Kingdom | |
| Heart of England NHS Trust | |
| Birmingham, West Midlands, United Kingdom, B9 5SS | |
| Principal Investigator: | Alice Turner | University of Birmingham |
More Information
Publications:
| Responsible Party: | Alice Turner, Clinician Scientist and Honorary Consultant Physician, University of Birmingham |
| ClinicalTrials.gov Identifier: | NCT01769742 History of Changes |
| Other Study ID Numbers: | RG-12-237 |
| Study First Received: | November 27, 2012 |
| Last Updated: | December 1, 2014 |
| Health Authority: | United Kingdom: National Health Service |
Keywords provided by University of Birmingham:
|
Pneumonia promotion of activity |
Additional relevant MeSH terms:
|
Pneumonia Lung Diseases Respiratory Tract Diseases Respiratory Tract Infections |
ClinicalTrials.gov processed this record on September 28, 2016