There is little evidence that hospital policies that limit patient mobility succeed at reducing falls, according to data recently published in JAMA Internal Medicine. Researchers noted such policies may instead increase the risk of serious side effects.
“According to a 2009 estimate, hospital patients spend over 95% of their time in bed,” Sharon K. Inouye, MD, MPH, study coauthor and director of the Aging Brain Center at the Institute for Aging Research, Hebrew SeniorLife, said in a press release. “In-hospital immobility is one of several factors theorized to give rise to the ‘post-hospital syndrome,’ a transient state of heightened vulnerability following hospitalization that is associated with an increased risk of functional decline, medical adverse events and hospital readmission.”
Hospitals that attempt to reduce falls by limiting patient mobility could unintentionally spark an “unfortunate stream of consequences,” including many serious side effects, according to the release. Inouye said promoting mobility among patients could help prevent injurious falls in the long term.
According to the release, the researchers recommend that CMS develop quality measures to promote mobility rather than incentivizing strategies that keep patients in their beds. New measures to increase mobility could include supervised walks with mobility aids and trained staff or volunteers. The investigators cautioned against the use of bed and chair alarms, which have proven ineffective at reducing falls, may promote immobility and may contribute to stress and alarm fatigue in nurses.
“With the rapidly aging population, this issue will become all the more important — presenting the opportunity for health systems to align care with outcomes that matter to patients,” study coauthor Matthew E. Growdon, MD, MPH, of the Brigham and Women’s Hospital Department of Medicine, said in the release.
Growdon ME, et al. JAMA Intern Med. 2017;doi:10.1001/jamainternmed.2017.0840.
Disclosure: The researchers report no relevant financial disclosures.