Study validates the value of mobility for older patients

Geriatric Nursing Journal article confirms daily walking was associated with less functional decline

It’s well known that immobility results in many complications including pressure injuries, pneumonia, venous thromboembolism, and urinary tract infections just to name a few. Some studies show up to 35% of older hospitalized patients experience a functional decline after admission.¹ Mobilizing patients is essential to prevent complications and positively impact patient outcomes. It’s imperative for nurses and other healthcare professionals to focus on progressing mobility for all hospitalized patients.

The aim of the study² recently published in the Geriatric Nursing Journal was to describe characteristics of mobility and functional change using interviews with a structured questionnaire and a naturalistic non-participant observational design of care provided. Participants were 70 years or older and admitted with acute general medical conditions with a minimal stay of 48 hours. The sample of 41 patients was enrolled from a 32-bed general medical ward of a 300-bed hospital in Melbourne, Australia. The frequency and duration of mobility-related activity was assessed using observations conducted over 246 hours (41 six-hour sessions) of continuous observations for patient activity and processes of care from Day 2 of hospitalization. One-quarter of the patients experienced significant functional decline between baseline and discharge.

Activity for patients included walking exercises, but the majority mobilized with incidental activity (toileting, showering and meals). Those who performed walking exercises for at least 10 minutes in the 6-hour observation period were less likely to have functional decline. Results from this study are similar to previous studies and systematic reviews identifying and validating 20 minutes of activity in hospitalized patients may be the ‘sweet spot’.^3,4

Nurses need to be aware of minimum mobility needs for hospitalized patients, especially elderly patients (>70 years of age) who are at greater risk for functional decline in a short period of time. By focusing on improving mobility, functional decline can be prevented.

Although limited by a small sample size, this study was consistent with other studies and adds additional support for at least 20 minutes of mobility per day for hospitalized elderly patients.^3,4 The major strength of the study was the method of direct observation rather than reported or documented mobility. Direct observation in the clinical setting provides valuable insights into actual practice. The use of a validated measurement tool for measuring functional decline at various time points during hospitalization also adds to the strength of this study. To read the full article, click here.

It's essential to promote mobility to prevent functional decline during hospitalization because patients who lose functional status will be more apt to require long-term care and more resources at discharge. Nurses should identify best practices for mobilizing patients.⁵ It’s also important for nurses to identify barriers and facilitate mobility in hospitalized elderly patients.⁶ If you’re interested in implementing a program to promote repositioning and early mobility at your facility, you can find more information about our products and services here.

Future research with a larger sample size is needed to validate and expound on the findings in this study as well as to determine optimal mobility frequency and dose for prevention of other hospital-acquired complications, not just in older adults, but in all hospitalized patients.