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

Not Applicable

Completed

• Conditions: Hospital Acquired Pneumonia
• Interventions: Behavioral: Early mobility bundle

• Registration Number: NCT01769742
• Lead Sponsor: University of Birmingham

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.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2012-11-27
• Study First Submitted QC: 2013-01-16
• Study First Posted: 2013-01-17
• Study Start: 2013-02
• Primary Completion: 2013-09
• Study Completion: 2013-09
• Status Verified: 2014-12
• Last Update Submitted: 2014-12-01
• Last Update Posted: 2014-12-03

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 1178

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

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Early mobility bundle	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

Primary Outcome Measures

Name	Time	Method
Incidence of hospital acquired pneumonia	Duration of hospital stay (up to 12 days)	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.

Secondary Outcome Measures

Name	Time	Method
Incidence of pressure area problems	Duration of hospital stay (up to 12 days)	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
Length of hospital stay in days	Duration of hospital stay (up to 12 days)	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	Duration of hospital stay (up to 12 days)	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

Trial Locations

Locations (1)

Heart of England NHS Trust; 🇬🇧 Birmingham, West Midlands, United Kingdom