Outcomes of Mobilisation of Vulnerable Elders in Ontario (MOVE ON): a multisite interrupted time series evaluation of an implementation intervention to increase patient mobilisation.
Outcomes of Mobilisation of Vulnerable Elders in Ontario (MOVE ON): a multisite interrupted time series evaluation of an implementation intervention to increase patient mobilisation.
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DOI：
10.1093/ageing/afx128
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发表时间：
2018-01-01
期刊：
影响因子：
6.7
通讯作者：
MOVE ON Collaboration
中科院分区：
文献类型：
--
作者：
Liu B;Moore JE;Almaawiy U;Chan WH;Khan S;Ewusie J;Hamid JS;Straus SE;MOVE ON Collaboration
住院的老年患者有因行动不便而发生医院获得性疾病的风险。本研究的目的是实施和评估以工作人员为目标的循证干预措施，以促进普通医疗住院单位收治的老年患者的早期动员。在加拿大安大略省的14家学术医院，针对工作人员的早期动员实施干预措施是多方面的，并根据当地情况量身定制。主要结果是患者的活动情况。次要结局包括住院时间（LOS）、出院地点、跌倒和功能状态。目标患者年龄≥65岁，入院时间为2012年1月至2013年12月。采用中断时间序列设计，在干预前、干预期间和干预后三个时间段对干预进行评估。总体分析共纳入12490例患者，平均年龄80.0岁[标准差8.36]。干预后活动增加，与干预前相比，干预后每天下床的患者显著增加（截距差= 10.56%,95% CI: [4.94, 16.18]; P < 0.001）。与干预前相比，干预期间医院LOS中位数显著缩短（截距差= - 3.45天，95% CI: [- 6.67, - 0.23], P = 0.0356）。与干预前相比，干预后住院天数显著减少（截距差= - 6.1,95% CI: [- 11, - 1.2]; P = 0.015），继续降低。这是一项评估老年普通住院患者早期动员实施策略的大规模研究。这一简单的干预措施对让更多病人下床这一重要功能目标的积极影响，在改善对住院老年病人的护理方面取得了显著的成功。
older patients admitted to hospitals are at risk for hospital-acquired morbidity related to immobility. The aim of this study was to implement and evaluate an evidence-based intervention targeting staff to promote early mobilisation in older patients admitted to general medical inpatient units. the early mobilisation implementation intervention for staff was multi-component and tailored to local context at 14 academic hospitals in Ontario, Canada. The primary outcome was patient mobilisation. Secondary outcomes included length of stay (LOS), discharge destination, falls and functional status. The targeted patients were aged ≥ 65 years and admitted between January 2012 and December 2013. The intervention was evaluated over three time periods—pre-intervention, during and post-intervention using an interrupted time series design. in total, 12,490 patients (mean age 80.0 years [standard deviation 8.36]) were included in the overall analysis. An increase in mobilisation was observed post-intervention, where significantly more patients were out of bed daily (intercept difference = 10.56%, 95% CI: [4.94, 16.18]; P < 0.001) post-intervention compared to pre-intervention. Hospital median LOS was significantly shorter during the intervention period (intercept difference = −3.45 days, 95% CI: [−6.67,−0.23], P = 0.0356) compared to pre-intervention. It continued to decrease post-intervention with significantly fewer days in hospital (intercept difference= −6.1, 95% CI: [−11,−1.2]; P = 0.015) in the post-intervention period compared to pre-intervention. this is a large-scale study evaluating an implementation strategy for early mobilisation in older, general medical inpatients. The positive outcome of this simple intervention on an important functional goal of getting more patients out of bed is a striking success for improving care for hospitalised older patients.
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DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
168.9
作者：
Bernhardt, Julie;Langhorne, Peter;Donnan, Geoffrey
通讯作者：
Donnan, Geoffrey
影响因子：
2.7
作者：
Callen, BL;Mahoney, JE;Enloe, M
通讯作者：
Enloe, M
影响因子：
--
作者：
Ogrinc, G.;Mooney, S. E.;Watts, B.
通讯作者：
Watts, B.
影响因子：
4.9
作者：
Reisinger, Heather Schacht;Yin, Jun;Perencevich, Eli
通讯作者：
Perencevich, Eli