Research suggests that there is little proof that hospital policies keeping patients in bed and limiting their mobility actually prevent falls. Rather, it may increase the risk of serious side effects.
The study, by Sharon K. Inouye, MD, MPH, director of the Aging Brain Center at the Institute for Aging Research, Hebrew SeniorLife, appeared recently in JAMA Internal Medicine.
“According to a 2009 estimate, hospital patients spend over 95% of their time in bed. In-hospital immobility is one of several factors theorized to give rise to the ‘posthospital syndrome,’ a transient state of heightened vulnerability following hospitalization that is associated with an increased risk of functional decline, medical adverse events, and hospital readmission,” she writes, according to a media release from Hebrew SeniorLife Institute for Aging Research.
Per the release, she cites several studies that demonstrate that such policies increase the risks of many serious side effects, and that promoting mobility in hospitals may actually help to prevent injurious falls in the long run.
In her study, she recommends that the Centers for Medicaid and Medicare Services develop quality measures that promote mobility rather than incentives that keep patients in their beds. Such measures could include supervised walks with mobility aids, accompanied by trained staff or volunteers.
She also cautions against the use of bed and chair alarms, which she notes have been proven ineffective at reducing falls, often promote immobility, and contribute to stress and alarm fatigue in nurses.
“With the rapidly aging population, this issue will become all the more important—presenting the opportunity for health systems to align care with outcomes that matter to patients,” states study co-author Matthew Growdon, MD, MPH, from Brigham and Women’s Hospital, in the release.
[Source(s): Hebrew SeniorLife Institute for Aging Research, Science Daily]
I agree whole heartedly with this article & these comments. I also feel many times this is true at subacute rehab. We are keeping pts too confined which in turn deconditions them.