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Implementation of a Frailty Care Bundle (FCB) Targeting Mobilisation, Nutrition and Cognitive Engagement to Reduce Hospital Associated Decline in Older Orthopaedic Trauma Patients: Pretest-Posttest Intervention Study.
- Source :
-
Journal of frailty, sarcopenia and falls [J Frailty Sarcopenia Falls] 2024 Mar 01; Vol. 9 (1), pp. 32-50. Date of Electronic Publication: 2024 Mar 01 (Print Publication: 2024). - Publication Year :
- 2024
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Abstract
- Objective: To implement and evaluate a Frailty Care Bundle (FCB) targeting mobilisation, nutrition, and cognition in older trauma patients to reduce hospital associated decline.<br />Methods: We used a two group, pretest-posttest design. The FCB intervention was delivered on two orthopaedic wards and two rehabilitation wards, guided by behaviour change theory (COM-B) to implement changes in ward routines (patient mobility goals, nurse assisted mobilisation, mealtimes, communication). Primary outcomes were patient participants' return to pre-trauma functional capability (modified Barthel Index - mBI) at 6-8 weeks post-hospital discharge and average hospital daily step-count. Statistical analysis compared pre versus post FCB group differences using ordinal regression and log-linear models.<br />Results: We recruited 120 patients (pre n=60 and post n=60), and 74 (pre n=43, post n=36) were retained at follow-up. Median age was 78 years and 83% were female. There was a non-significant trend for higher mBI scores (improved function) in the post compared to pre FCB group (OR 2.29, 95% CI 0.98-5.36), associated with an average 11% increase in step-count.<br />Conclusion: It was feasible, during the Covid-19 pandemic, for multidisciplinary teams to implement elements of the FCB. Clinical facilitation supported teams to prioritise fundamental care above competing demands, but sustainability requires ongoing attention. ISRCTN registry: ISRCTN15145850 (https://doi.org/10.1186/ISRCTN15145850).<br /> (Copyright: © 2024 Hylonome Publications.)
Details
- Language :
- English
- ISSN :
- 2459-4148
- Volume :
- 9
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of frailty, sarcopenia and falls
- Publication Type :
- Academic Journal
- Accession number :
- 38444547
- Full Text :
- https://doi.org/10.22540/JFSF-09-032