The use of volunteers to help older medical patients mobilise in hospital: a systematic review

Abstract

Aims and objectives: To review current evidence for the use of volunteers to mobilise older acute medical in-patients.

Background: Immobility in hospital is associated with poor healthcare outcomes in older people, but maintaining mobility is frequently compromised due to time pressures experienced by clinical staff. Volunteers are established in many hospitals, usually involved in indirect patient care. Recent evidence suggests that trained mealtime volunteers had a positive impact on patients and hospital staff. It is unclear whether volunteers can help older inpatients to mobilise.

Design: Systematic review.

Methods: We searched Cochrane, Medline, Embase, CINAHL, AMED and Google databases using MeSH headings and keywords within six key themes: inpatients, older, mobility/exercise, delirium, falls and volunteers. Full texts of relevant articles were retrieved and reference lists reviewed.

Results: Of the 2428 articles that were identified, two scientific studies and three reports on quality improvement initiatives were included in the final review. One study included volunteer assisted mobilisation as part of a delirium prevention intervention (HELP). The second study has not reported yet (MOVE ON). The contribution of volunteers in both is unclear. Three quality improvement initiatives trained volunteers to help mobilise patients. They were not formally evaluated but report positive effects of the volunteers on patient and staff satisfaction.

Conclusions: This review has identified a lack of scientific evidence for the use of volunteers in mobilising older medical inpatients, but quality improvement initiatives suggest that volunteers can be employed in this role with reports of staff and patient satisfaction: this is an area for further development and evaluation.

Relevance to clinical practice: This review outlines the evidence for the involvement of volunteers in maintaining patients' mobility, identifies mobilisation protocols that have been used, the need to train volunteers and for formal evaluation of volunteers in this role. Prospero registration number: CRD42014010388.

Keywords: ambulation; hospital; inpatients; mobilisation; mobility; older; systematic review; volunteer; walking.