Clinical trial NCT01769742: Early Mobility Bundle to Prevent Hospital Acquired Pneumonia (HAP) in Medical Inpatients
Official title: Use of Early Mobilisation to Reduce Incidence of Hospital Acquired Pneumonia in Medical Inpatients
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Hospital Acquired Pneumonia
Keywords: Pneumonia
promotion of activity
Lead sponsor: University of Birmingham
Sponsor class: OTHER
Collaborators: name: Heart of England NHS Trust
First posted: 2013-01-17
Enrollment: 1178
Sex: ALL
Minimum age (years): 16
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

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.


Eligibility criteria: 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

Primary outcomes:
measure: Incidence of hospital acquired pneumonia
timeFrame: Duration of hospital stay (up to 12 days)
Secondary outcomes:
measure: Length of hospital stay in days
timeFrame: Duration of hospital stay (up to 12 days)
measure: Incidence of falls
timeFrame: Duration of hospital stay (up to 12 days)
measure: Incidence of pressure area problems
timeFrame: Duration of hospital stay (up to 12 days)
Other outcomes:
measure: Activity levels as reported by patient
timeFrame: Days 1 and 2 of admission to ward
measure: Activity levels as measured by Actigraph
timeFrame: Day 1 and 2 of admission to ward
Locations:
city: Birmingham
country: United Kingdom
facility: Heart of England NHS Trust
state: West Midlands
Study officials:
affiliation: University of Birmingham
name: Alice Turner
role: PRINCIPAL_INVESTIGATOR
References:
citation: 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.