Hospital Acquired Pneumonia
Conditions
Keywords
Pneumonia, promotion of activity
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.
Interventions
BEHAVIORALEarly mobility bundle
Sponsors
Heart of England NHS Trust
University of Birmingham
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
16 Years to No maximum
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 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
| Measure | Time frame | Description |
|---|---|---|
| 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 |
| 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 |
Other
| Measure | Time frame |
|---|---|
| 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 |
Countries
United Kingdom
Outcome results
None listed