Early Mobility Bundle to Prevent Hospital Acquired Pneumonia (HAP) in Medical Inpatients

NCT01769742 | Completed

• 1 other identifier: RG-12-237
• Study Type: interventional
• Target: 1,178
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Hospital Acquired Pneumonia

Keywords

Pneumonia; promotion of activity

Outcome Measures

Primary Outcomes (1)

• Incidence of hospital acquired pneumonia

  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.

  Duration of hospital stay (up to 12 days)

Secondary Outcomes (3)

• Length of hospital stay in days

  Duration of hospital stay (up to 12 days)

• Incidence of falls

  Duration of hospital stay (up to 12 days)

• Incidence of pressure area problems

  Duration of hospital stay (up to 12 days)

Other Outcomes (2)

• Activity levels as reported by patient

  Days 1 and 2 of admission to ward

• Activity levels as measured by Actigraph

  Day 1 and 2 of admission to ward

Study Arms (2)

Early mobility bundle

EXPERIMENTAL

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

Usual care

NO INTERVENTION

Usual physiotherapy service only

Interventions

Early mobility bundle BEHAVIORAL

Early mobility bundle

Eligibility Criteria

• Age: 16 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Any medical inpatient

You may not qualify if:

• 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

Sponsors & Collaborators

• University of Birmingham: lead
• Heart of England NHS Trust: collaborator

Study Sites (1)

Heart of England NHS Trust

Birmingham, West Midlands, B9 5SS, United Kingdom

Location

Related Publications (1)

• Stolbrink M, McGowan L, Saman H, Nguyen T, Knightly R, Sharpe J, Reilly H, Jones S, Turner AM. The Early Mobility Bundle: a simple enhancement of therapy which may reduce incidence of hospital-acquired pneumonia and length of hospital stay. J Hosp Infect. 2014 Sep;88(1):34-9. doi: 10.1016/j.jhin.2014.05.006. Epub 2014 Jun 20.

  PMID: 25063011 RESULT

MeSH Terms

Conditions

Healthcare-Associated Pneumonia; Pneumonia

Condition Hierarchy (Ancestors)

Cross Infection; Infections; Respiratory Tract Infections; Lung Diseases; Respiratory Tract Diseases; Iatrogenic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Alice Turner

  University of Birmingham

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Clinician Scientist and Honorary Consultant Physician

Study Record Dates

• First Submitted: November 27, 2012
• First Posted: January 17, 2013
• Study Start: February 1, 2013
• Primary Completion: September 1, 2013
• Study Completion: September 1, 2013
• Last Updated: December 3, 2014

Record last verified: 2014-12

Locations

GB (1)