None listed
Conditions
Brief summary
Medical patients often present to hospital with both medical and functional problems, including social dependency, reduced mobility and cognitive impairment. As such, discharge planning forms an important part of a patient's hospital stay. At present, an allied health team - consisting mainly of physiotherapist, occupational therapists, social workers, dieticians and speech pathologists - make recommendations for discharge destination based on clinical experience. If the patient is not for discharge home, the treating medical team makes a referral to the Consultant Liaison Rehabilitation and Aged Care team for a Geriatrician opinion. This process is potentially problematic when clinicians disagree on discharge destination. This can delay discharge and increase the patient's length of hospital stay. It can also detrimentally impact on the patient and family experience. We hypothesise that one factor effecting discharge destination may be physical activity levels, that is, patients who are less physically active prior to their admission and patients who are less physically active on the ward during an admission are more likely to need further subacute intervention on discharge from the acute setting. Thus, this study aims to investigate if pre-admission physical activity levels and / or in hospital physical activity levels are associated with discharge destination.
Interventions
Patients referred to Physiotherapy and admitted under a General Medical bed card and at the Royal Melbourne Hospital will be prospectively screened for inclusion into this study. The following data will be collected on 50 patients:
Patient Demographics
- Date of Birth
- Gender
- Weight
- Height
- Language spoken
- Principle diagnosis
- Co-morbidities
Pre-hospital physical activity level:
The Physical Activity Scale for the Elderly - a brief, valid and reliable questionnaire will be used to mea
Patients referred to Physiotherapy and admitted under a General Medical bed card and at the Royal Melbourne Hospital will be prospectively screened for inclusion into this study. The following data will be collected on 50 patients: Patient Demographics - Date of Birth - Gender - Weight - Height - Language spoken - Principle diagnosis - Co-morbidities Pre-hospital physical activity level: The Physical Activity Scale for the Elderly - a brief, valid and reliable questionnaire will be used to measure physical activity levels in the seven days prior to hospital admission. In hospital physical activity level Physical activity levels will be measured using accelerometers called Sensewear MF devices. Accelerometers will be worn from time of consenting (on day of initial physiotherapy contact) until day of discharge or 7 days from time first worn (whichever comes first). - Sedentary Activity– defined as an accelerometer output of 0-1.5 METs - Activity – where an accelerometer output of 1.51-3.0 METs is defined as “Low level activity”, 3.1-4.5 METs as “moderate” and >4.5 METs as “vigorous” - Step count - Metabolic equivalents (METs) - Energy expenditure - Sleep duration
Sponsors
Aruska D'Souza
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
- Patients referred to Physiotherapy and admitted under General Medical units on the General Medical wards at the Royal Melbourne Hospital (5 South East and 5 South West). - Patients under a General Medical bed card but requiring ICU will be eligible once they are discharged to the General Medical wards as this is where discharge planning would typically commence.
Exclusion criteria
- Patients who are for palliation - Patients already recruited who are readmitted - Patients less than 18 years of age - Patients transferred from other units (including the Acute Medical and Short Stay Units) and who have already had Physiotherapy intervention will not be included. - Patients under General Medical unit who are admitted under a different ward (“outliers”). This study requires the use of devices that may be unfamiliar to nursing staff which may reduce compliance. Staff working on the Medical Wards will receive basic training on these devices. - Similarly, patients who have had their initial Physiotherapy contact on the weekend or public holidays will not be included (including those patients transferred from ICU and seen on the ward on the weekend or public holiday). Patients admitted on the weekend or public holiday who have not had any physiotherapy intervention will remain appropriate to be included.
Outcome results
None listed