Effects of a nursing care program on functional outcomes in older acute medical in-patients: protocol for a randomized controlled trial

Abstract

Background: Hospitalization often leads to long periods of bed rest and inactivity which is associated with an increase in length of hospital stay, loss of capacity for basic self-care and discharge into a nursing home. Objective: This trial aims to verify if a nursing care program centered on basic self-care and predefined physical activity, improves functional outcomes in older hospitalized patients. Methods: This is a 2-group randomized controlled trial with repeated measures: 182 older acute medical patients will be blindly randomly allocated to the control group (n = 91) or intervention group (n = 91). The intervention will consist of nursing care intervention centered on basic self-care that includes a twice daily walking training, plus privileging pre-established trips to the toilet by walking and all daytime meals seated, off the bed. The main outcome was changes in the number of independent activities of daily living from 2 weeks before admission (baseline) to discharge. Trial registration: ClinicalTrials.gov (Identifier NCT03106064). Results: This intervention has the potential to change the outcomes of the older patient in the acute setting. Conclusion: The loss of independence in self-care is determinant in future health care needs. If our hypothesis is correct and demonstrate that this nursing care program centered on basic self-care for older acute medical patients improves functional outcomes, a change in the paradigmatic organization of hospital care may be justifiable.

Effects of a nursing care program focused on basic self-care in older acute medical in-patients: a randomized controlled trial

“… 24 25 For each BADL, patients were considered independent if the activity was performed without personal assistance (amendment in comparison with the initial protocol where it was envisaged that the functional status will be assessed through the Katz Index plus the Nursing Patient Classification Systems data). 23 …”

“…Daily walk would consist of walking as far as possible with or without assistance (amendment in comparison with the initial protocol where it was envisaged that walk training will consist of walking as far as possible with or without assistance for 20 minutes). 23 …”