Bed rest in hospital can be bad for you. Here’s what nurses say would help get patients movingAugust 16, 2021
If you or a loved one is unlucky enough to be in hospital, you might think the best thing to do is rest in bed as much as possible. But while rest is important, lying or sitting in bed too much can actually make many conditions worse.
Researchers have developed mobility recommendations for some hospital settings but in practice, most patients still aren’t active enough.
To find out more, we asked 138 nurses from five Australian states about the challenges they face trying to to get patients moving more, and what changes would help. We also did some in-depth interviews with a sample of nurses involved in the study.
Our results, published in the Journal of Clinical Nursing, showed there is much we can do. Managers and team leaders have an important role in empowering nurses because our study found nurses do not always feel able to reduce sedentary behaviour in their patients.
The dangers of sedentary behaviour in hospital
Lying or sitting too much while in hospital can lead to deconditioning (such as loss of strength, joint function and mobility), pressure injuries, blood clots, infections, prolonged hospital stays and unplanned hospital re-admissions.
In rehabilitation settings, where a person is recovering from conditions such as stroke, amputation or arthritis, older adults spend as little as 5% of the day upright.
In acute settings — where a patient in hospital may require surgery or treatments to repair a fracture, remove a tumour or relieve nerve pain — it can be much worse. Older adults spend a median of just 3% of their day standing or walking.
These are staggering figures but the good news is even small increases in activity and movement can help prevent the rapid loss of muscle mass and strength that comes from lying down or sitting too long in hospital.
Our study found nurses have a key role in supporting patients’ mobility and in reducing their sedentary behaviour.
What are the barriers?
Perhaps unsurprisingly, nurses in this study told us workload and lack of time to encourage reduced sedentary behaviour were significant barriers.
However, they also told us there was a perception among family and sometimes patients themselves that they needed to rest and that older people had earned the right to sit back and relax.
This was especially the case when people were unwell or had complex needs. As one nurse said:
So how much exercise should you get while in hospital? There’s no “one size fits all” answer. For some patients, it might just mean getting out of bed and walking to the bathroom, getting dressed or moving around a room. For others, it might mean walking around hospital hallways or doing more specialised movement programs such as My Therapy.
What would help?
Nurses told us that help from family in getting patients up and moving would be a huge bonus.
Some patients, however, have only family members or visitors who are, themselves, older and unable to assist the patient with walking. Or, a patient may have no visitors at all.
Working closely with other members of the care team yields results, with one saying:
One nurse spoke of the value of interventions aimed at getting patients more active, such as the UK’s End PJ Paralysis program.
Creative and sustainable solutions
Our study shows that reducing sedentary behaviour in hospitals is often complex and there are important roles for nurse leaders and organisations in working together on creative and sustainable solutions.
As influential British doctor, Richard Asher, put it in his oft-quoted poem about the danger of sedentary behaviour in hospitals:
This article was originally posted on Bed rest in hospital can be bad for you. Here’s what nurses say would help get patients moving