Abstract Introduction Deconditioning remains a significant challenge for hospital inpatients, particularly the older patients. National campaigns such as ‘End PJ Paralysis’ and ‘Sit Up, Get Drssed, Keep Moving’ endorsed by the British Geriatrics Society, highlight the importance of maintaining mobility during hospital stays. We designed a QIP to raise awareness of deconditioning among nursing staff and resident doctors and to identify barriers preventing mobilisation. Method We conducted a QIP on a geriatric ward at Lincoln County Hospital, collecting quantitative data on the frequency of patients sitting out of bed, sitting up for meals, wearing appropriate footwear, and wearing their own clothes. Qualitative feedback was obtained through short interviews with nurses and healthcare assistants (HCAs) to explore reasons patients remained in bed. Patients receiving end-of-life care, those medically unwell (NEWS5), or those with baseline immobility (i.e bed bound) were excluded. Following an initial cycle, teaching sessions were delivered to staff and resident doctors over two weeks before repeating data collection. Results In the first cycle, 69% of patients sat out of bed daily, 50% sat up for meals, 42% wore appropriate footwear, and 26% wore their own clothes. After staff education, the second cycle showed no significant improvement: 64% sat out of bed, 48% sat up for meals, 40% wore appropriate footwear, and 36%wore their own clothes. Barriers identified included patient factors (fatigue, lack of motivation and awareness), equipment shortages (e.g. recliner chairs), staffing pressures, and difficulty accessing personal clothing. Notably, some patients who could mobilise independently remained in bed. This showed that the risk of prolonged bedrest is even greater for those needs support. Conclusion Despite increased staff awareness, this QIP showed a neutral impact on outcomes, highlighting that education alone is insufficient. Multifactorial barriers, including patient factors, limited equipment, and staffing constraints, been identified and have to be addressed collectively to improve outcome.
Tan et al. (Sun,) studied this question.