Movement is medicine, especially in the hospital
No matter what condition you enter the hospital with, if you don’t stay as active as you can during your stay, it can lead to what’s known as “post-hospital syndrome,” a condition that can quickly land you back in the hospital, said Cape Cod Hospital physical therapist John Corsino, PT.
“The idea of bed rest is outdated,” he said. “We need to keep moving all the time.”
The importance of movement and its part in recovery has long been known to physical and occupational therapists, but convincing patients of the value and enlisting busy nurses and CNAs to help patients achieve their highest level of mobility can be challenging, said Cape Cod Hospital occupational therapist Mary Ellen Nelson.
“Patients don’t realize that lying in bed most of the time they are hospitalized creates greater risk for complications,” she said. “And, with greater challenges to nursing and CNAs, which involve a large amount of daily documentation on top of their multiple daily demands, adding one more item to document about may be challenging.”
Then the Cape Cod Hospital rehabilitation team learned about a Johns Hopkins Hospital program that addresses this very issue. Called “Highest Level of Mobility [pdf],” the program focuses on having nurses and CNAs help their patients achieve the highest level of mobility every day during their stay.
Inspired by the Johns Hopkins program, the hospital rehab team brought the idea of starting a similar project at Cape Cod Hospital to Lisa Burke, RN, nurse manager, and Heidi Wright, RN, clinical leader on Mugar 3, where neurological and medical patients recover. Julie Drake, Director of Rehabilitation Services for CCH, Burke, Wright and the team of nurses, nursing assistants and float pool staff embraced it.
In December, they launched the “Moving Forward” program, which focuses on helping patients stay active while in the hospital, even if it’s simply to walk a few more steps each day.
The Mugar 3 team is having a friendly competition to see whose patients get better Moving Forward scores. The scores are based on a scale developed by Johns Hopkins and range from one to eight, with one being lying in bed and eight being walking more than 250 feet a day. In between, activity scores range from moving your arms and legs while in bed to sitting at the edge of the bed, to transferring to a chair, to increasing the number of steps taken each day.
To make it more fun, the Moving Forward competition has a football and Patriots theme, and a large board with a tally of scores (no patient names appear) sits right by the nurses’ station.
Getting patients moving is also good for hospitals, since patients who are in better health when they leave the hospital, are less likely to return with post-hospital complications.
“Staying active in the hospital has a positive impact on pneumonia, deep vein thrombosis, skin breakdown, digestion and muscle wasting,” Corsino said. “We view (the incidence of post-hospital) pneumonia, in particular, as something we can really change.”