The Early Mobility Bundle: a simple enhancement of therapy which may reduce incidence of hospital-acquired pneumonia and length of hospital stay

Abstract

Background: Early mobility facilitated by physiotherapy has been shown to reduce the incidence of hospital-acquired pneumonia (HAP) in patients with hip fractures but its effect on HAP incidence in medical patients has not yet been studied.

Aim: To determine whether early mobility aided by physiotherapy reduces the incidence of HAP and length of stay in patients on medical wards.

Methods: One respiratory and one elderly care medicine ward in one hospital association in Birmingham, UK, received the 'Early Mobility Bundle'. The bundle consisted of extra targeted physiotherapy and collaboration with ward staff to encourage and promote activity. The incidence of HAP, falls, pressure sores, length of stay (LOS) and activity level were then compared to two matched wards within the same hospital association.

Results: HAP incidence was significantly lower in the intervention group (P < 0.0001) and remained so after adjusting for confounders (P = 0.001). Activity levels were higher (P = 0.04) and patients' LOS was more likely to fall in the lowest quartile (OR: 1.44; P = 0.009) in the intervention group. There was no significant difference in other outcomes.

Conclusion: The Early Mobility Bundle demonstrates a promising method to reduce the incidence of HAP and to increase activity in medical inpatients.

Keywords: Activity; Hospital-acquired pneumonia; Length of stay; Physiotherapy; Prevention.