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Older patients should 'walk around the ward'


Encouraging older hospital patients to walk around the ward can boost recovery times and lead to earlier discharge, nurse researchers have found.

Israeli researchers from the nursing department at Haifa University looked at 485 patients over the age of 70, who were admitted to hospital with acute non-disabling conditions for an average of six days.

They found patients who walked around at least once per day stayed in hospital on average 1.5 days fewer than those who remained in their bed or seated next to it, regardless of the patients’ overall health status.

Writing in the Archives of Internal Medicine, the researchers said older patients might mistakenly believe that they should remain in bed when in fact immobility could quickly result in loss of muscle reserve capacity, resulting in complications.

Linda Nazarko, senior lecturer at South Bank University and nurse consultant for older people at Ealing Hospital NHS Trust, backed the findings. She said: “Staff sometimes think ‘it’s quicker’ to wheel rather than a walk a person. But nursing is about doing what’s right for the patients not what’s quickest.” 

However, she also said a “great deal” could be done to make hospitals “more supportive of frail people who have mobility difficulties”, for example by putting seats in corridors and having more physiotherapists available at evenings and weekends “to help older people and support nurses in their efforts”.

Christine Fear, a nurse lecturer at the University of the West of England, added: “Exercise of any sort improves mobility and reduces falls as it gives the confidence back to older people that they lost after falling.”

But she said: “The supervision needed to achieve this would have implications for staffing levels on wards and risk assessments would probably need to be undertaken.”  



Readers' comments (15)

  • This, to me, seems obvious and common sense. Though it can tbh get disheartening to read more and more theory of how nursing should be done and then to be given less and less time to do it in. I actually believe nurses do know the theory, we KNOW! surely the challenge is how to deliver this theory in an entirely resourse/budget based environment. With all the will in the world, we all do some things in some ways because they are quicker - let's be real. and reference to more chairs, more physios, more support for nurses = more £s on a shrinking budget. it would need someone to cost base this kind of study - if the resources were put in, patient stay would be shorter = a saving. sad but, I believe true, all about the time, all about the £.

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  • I remember when the patients used to take the tea trolley around to the other patients on the ward... it was a valuable part of their rehabilitation/convalescence prior to discharge. Well, Health and Safety and Risk Assesments have put paid to that!! I visit patients on the wards as part of my specialist nurse role and find patients, who should be up and mobile, confined to bed because the nurses are frightened of them falling. If a patient falls, you have 'accident reports' to complete and then probably have to bear the wrath of the patients relatives..threatening to sue the hospital. Then there is the other issue that the there is no physiotherapy/OT input over the weekends. All combine to take away independence and a speedier recovery. I have seen patients completely lose their mobility in hospital and some never regain it.

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  • I agree with the previous comments.
    I also remember those 'day rooms' where patients could walk to to relax and watch TV or read. They have too often been removed in order to accommodate a store room or extra bed spaces.
    Of course, the minute a patient is able to walk, they are being discharged!

    It's all very well for Ms Nazarko to comment on a nurse's need to save time - how long is it since she worked a shift on a ward? Maybe that would explain why nurses chose such options? I am by no means saying that it is right but it is, in reality, what happens.
    Physiotherapy numbers, like nursing staff numbers, have been reduced and trimmed to an absolute minimum already and there are further cuts to be made. Physios have to prioritise their work so much at weekends and Bank Holidays. There is also so much writing which has to be done that many of them spend the majority of their time sat down at the desk doing tedious paperwork, instead of treating patients. I know they hate this.

    It is a sad fact of life that hospitals do not provide anywhere near a 24hr/day, seven days/week service.

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  • Oh my word, I cant believe they have researched this. When I did my training way back in the 80's we were taught to 'encourage mobility', and the 'problems of immobility'. What has been going on all these years if we now have to be told that maybe its a good idea to encourage elderly patients to mobilise?! Surely this is standard practice? Anyone who wheels a pt somewhere because its quicker is a lazy nurse, and this practice should be discouraged. Pt welfare should always come first, no matter how busy you get.

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  • Highly interesting, deeply profound and most revealing. I wonder what aspects of nursing are going to be uncovered or reinvented next? I wish I could get a such a cushy job carrying out this type of research.

    If we were only just discovering all that is published by researchers nowadays none of our patients would have ever survived!

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  • tinkerbell

    is this some kind of a wind up? Is it april fools day delayed? Knock me down with a feather, heather. I can stand it no longer. I give up. Arghh........................................

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  • Well, hello 'reader called Tinkerbell'
    first - good bit of editing in the previous article - if you are looking for another job......?

    I know you are a nurse too, just like me with donkeys years of experience, which includes caring for the elderly but I do now wonder what we have been doing all these years with all these revelations which keep cropping in the press recently but I hadn't realised that we were expected to let elderly patients out of bed too!

    It really is no wonder that nobody else besides us really understands what nursing really is.

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  • I am looking for funding to start a research project on ......... thinks

    how about 'nurses should 'walk around the ward', instead of having to sit doing paper work and staring at computer screens most of the day, to raise the standards of care and reduce the risks associated with prolonged periods of sitting and RSIs from overuse of writing instruments and computers!

    staffing levels could be affected, leading to a further reduction in nurses as more managers may be needed on the wards for supervision to ensure nurses just keep on walking. Detailed risk assessments would be required on managerial salaries.

    We are about to submit our proposal.........!

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  • tinkerbell

    Anonymous | 16-Aug-2011 2:47 pm

    and some research needed on 'should you teach your granny to suck eggs?' and ' An introduction on how to tie your shoelaces' and 'Variations on how to walk through a door'. Must stop because it''s endless and totally inane and truly bizarre and i need to protect what little sanity i have left and it must surely be someone having a laugh!

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  • Tinkerbell

    as you say, bizarre!

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