The purpose of this study was to identify and evaluate factors affecting early mobilisation on the day following hip fracture surgery. The purpose of this study was to identify and evaluate factors affecting early mobilisation on the day following hip fracture surgery.
The design was a mixed methods, scoping review.
Data sources were MEDLINE, AMED, CINAHL, APA PsycINFO, APA PsycArticles, ISRCTN, Clinical Trials registry and grey literature accessed in November 2022 with publication dates between 2001 and November 2022.
Eligibility criteria English language publications that:
1. Include patient populations who sustain a fragility hip fracture managed surgically
2. Include patient populations who are mobilised out of bed on the day following their hip fracture surgery
3. Report factors which influence the ability to undergo early mobility post-surgery
One reviewer screened all titles and abstracts for inclusion. Two reviewers performed data extraction and quality assessments using the relevant Critical Appraisal Skills Programme tools and the Mixed Methods Appraisal Tool.
3337 papers were identified, of which 23 studies were eligible for review, representing 210 811 patients. The heterogeneity in the types of study included, the definition of early mobilisation and the outcome measures used precluded meta-analysis. 13 factors were identified as having an effect on whether people were mobilised on day 1 post-hip fracture surgery, grouped into 5 principal themes: (1) healthcare setting or worker-related factors, (2) patient psychological factors, (3) acute patient health factors, (4) non-acute patient health factors and (5) surgical factors.
There was a paucity of robust research investigating day 1 mobilisation post-hip fracture surgery.
We identified five themes that impact on early mobilisation, highlighting a lack of inclusivity for patients with dementia and a lack of unified definition for early mobilisation
Each of the five themes identified is potentially modifiable through service improvement change and innovation strategies. There is an opportunity to explore how service provision change could be implemented to improve outcomes for all patients following hip fracture surgery demonstrating the clinical and cost benefits of these changes against the cost of delivering the change.
Three of the five themes identified, acute health factors, patient behaviour and healthcare worker behaviour, could be readily implemented into practice, such as education and training programmes to the wider multidisciplinary team, to help reduce the variation in achieving this important metric.
early mobilisation
barriers
