We propose the use of activity trackers (such as 'Fitbits') in an inpatient center to encourage patient mobility and more precisely measure the amount and types of activities patients are performing. De-identified data from these activity trackers would be presented electronically both to providers/staff and to patients in order to motivate patients and to allow staff to see patients that were due for a mobilization session.
This project could use off-the-shelf technology with some minor modifications to enable it to be used in a health care setting and to enable data to be collected and displayed in a centralized location.
Our desired outcomes would be increased mobility of inpatients, stable level of functionality at discharge, decreased length of stay, decreased falls, and increased rate of discharge to home.
As the population of hospitalized patients ages we will increasingly encounter patients with functional limitations of at least 1 ADL upon admission (1). During hospitalization these patients are vulnerable to the consequences of hospitalization and decreased mobility such as pressure ulcers, delirium, decrease in muscle mass, and ultimately an additional decline in their functional status (1).
In a study of patients aged 70 and older and with low or intermediate levels of mobility 29% had a decline in at least one ADL at discharge and 22% were discharged to a new institutional living situation (2).
The STRIDE program at the Durham VA (3) has demonstrated that an activity program can lead to a decreased rate of discharge to skilled nursing facilities. A challenge that this program faced was monitoring and encouraging activity. There is some evidence that activity trackers can lead to a change in behavior and an increase in frequency and amount of activity.
Our innovation would be to bring this technology to the inpatient setting and display mobilization data in real time and in a centralized location. Receiving this grant would allow us to purchase equipment and enable staff to implement this project. This would then hopefully lead to improved functionality and health of our patients.
1. Kleinpell RM, Fletcher K, Jennings BM. Reducing Functional Decline in Hospitalized Elderly. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 11. Available from: http://www.ncbi.nlm.nih.gov/books/NBK2629/
2. Brown, C. J., Friedkin, R. J. and Inouye, S. K. (2004), Prevalence and Outcomes of Low Mobility in Hospitalized Older Patients. Journal of the American Geriatrics Society, 52: 1263–1270. doi: 10.1111/j.1532-5415.2004.52354.x
3. Hastings, S. Nicole, Sloane, Richard, Morey, Miriam C.,Pavon, Juliessa M.,Hoenig, Helen, Assisted Early Mobility for Hospitalized Older Veterans: Preliminary Data from the STRIDE Program, J Am Geriatr Soc 62:2180–2184, 2014
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