Early Mobility Bundle to Prevent Hospital Acquired Pneumonia (HAP) in Medical Inpatients

Hospital Acquired Pneumonia Clinical Trial

Official title:

Use of Early Mobilisation to Reduce Incidence of Hospital Acquired Pneumonia in Medical Inpatients

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01769742
• Other study ID #: RG-12-237
• Status: Completed
• Phase: N/A
• First received: November 27, 2012
• Last updated: December 1, 2014
• Start date: February 2013
• Est. completion date: September 2013

Study information

• Verified date: December 2014
• Source: University of Birmingham
• Contact: n/a
• Is FDA regulated: No
• Health authority: United Kingdom: National Health Service
• Study type: Interventional

Clinical Trial 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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1178
• Est. completion date: September 2013
• Est. primary completion date: September 2013
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 16 Years and older

Eligibility

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

Study Design

Allocation: Non-Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention

Related Conditions & MeSH terms

• Hospital Acquired Pneumonia
• Pneumonia

Intervention

Behavioral:
• Early mobility bundle

Locations

Country	Name	City	State
United Kingdom	Heart of England NHS Trust	Birmingham	West Midlands

Sponsors (2)

Lead Sponsor	Collaborator
University of Birmingham	Heart of England NHS Trust

Country where clinical trial is conducted

United Kingdom, 

References & Publications (1)

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. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Activity levels as reported by patient		Days 1 and 2 of admission to ward	No
Other	Activity levels as measured by Actigraph		Day 1 and 2 of admission to ward	No
Primary	Incidence of hospital acquired pneumonia	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.	Duration of hospital stay (up to 12 days)	No
Secondary	Length of hospital stay in 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	Duration of hospital stay (up to 12 days)	No
Secondary	Incidence of falls	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	Duration of hospital stay (up to 12 days)	Yes
Secondary	Incidence of pressure area problems	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	Duration of hospital stay (up to 12 days)	No