We aimed to test the replicability and reproducibility of the OOBP project in a different clinical environment. This study will use a larger sample size and considering more clinical outcomes such as delirium, discharge destination and length of stay in addition to the primary outcomes.We aimed to test the replicability and reproducibility of the OOBP project in a different clinical environment. This study will use a larger sample size and considering more clinical outcomes such as delirium, discharge destination and length of stay in addition to the primary outcomes.
We used a prospective cohort design. Data from 452 patients was collected for a 4-month period pre-intervention and post-intervention.
Data was collected using the National Hip Fracture Database (NHFD) and the HipSprint audit data sets [Royal College of Physicians (RCP)].
Training was completed by therapists at the hospital and data was collected by a member of the research team based at the hospital.
Primary outcome measures:
- Percentage of patients mobilised out of bed by the day after surgery
- Percentage of patients mobilised out of bed by HCAs by the day after surgery
Secondary outcome measures:
- Post-operative delirium
- 30-day mortality
- Length of stay
- Discharge destination
There were no significant differences between the cohorts demographic and intervention data.
Primary outcomes.
There was a significant difference in the percentage of patients mobilised out of bed by healthcare assistants with an increase from 2% pre-intervention to 42.4% post intervention.
There was no significant different in the overall percentage of patients mobilised out of bed pre-intervention, 88%, versus, post-intervention, 89%.
Secondary outcomes.
There were no significant differences in length of stay, post-operative delirium or mortality at 30 days post operatively.
A therapy led training programme can lead to improvements in HCAs mobilising patients as an alternative to physiotherapists.
There was no significant difference in secondary outcomes suggestion no negative impact of HCAs mobilising hip fracture patients for the first time after surgery.
We intend to investigate the implementation science behind our findings using qualitative semi-structured interviews to understand the facilitators and barriers to this intervention.
These findings indicate that a therapy led training programme could lead to increased multidisciplinary engagement in early mobilisation.
This could allow better utilisation of physiotherapy skillset to provide rehabilitation and focus on more complex patients.
Early mobilisation
Training
