To promote rehabilitation throughout the day by involving patients' relatives & members of the multidisciplinary team (MDT) in prompting participation in bedside exercises, as physiotherapy sessions are daily at best & many of our patients have a poor memory.
Following physiotherapy assessment, patients were provided with suitable NHS exercise sheets for them to practice. With their permission we asked their relatives & the ward MDT staff to help by reminding & prompting them.
- NHS standardised bed / chair / standing exercise / mobility sheets (depending on their functional level)
- Walking aids
- Monitoring sheet
- Feedback questionnaire (1-5 Likert scale)
Overall this approach was a success for the 11 patients in the pilot. Feedback showed all were 'happy' or 'very happy' to participate.
Feedback using a Likert scale (1= very unhappy to 5 = very happy) showed that all were either happy or very happy to participate.
Examples of feedback:
- It is good to stretch my legs.
- This should help me get home.
- Happy for them to help.
- I get stiff sitting down, it is nice to go for a walk.
- Very keen to be involved.
- I didn't know how good he was on his feet.
- You've overdone it a bit - he wouldn't walk as much as this at home.
- I can see this is good for her.
- It is nice to have something to do when I visit.
From staff (6 nurses, 4 doctors):
- Gets patients moving more, highlights that patients in hospital tend not to move much unless prompted.
- Develops relationships with patients, and helps their rehab. But time consuming and I was worried in case they fell.
- Patients become more motivated.
- Good to develop rapport with patients and families. It is often more beneficial than examining a patient who is medically well.
Patients & relatives were more engaged with rehab which could facilitate early and safe discharge, & continuing with an active lifestyle could prevent readmission.
Engaging the ward MDT staff in patients' short term rehabilitation helped with rapport, though was time consuming.
Overall the feedback indicated that using relatives and ward staff to prompt exercises is acceptable. We plan to make this a more routine part of care.
This work was presented at Physiotherapy UK 2019 and BGS Scotland & NRS Ageing Specialty Group Spring Meeting 2019.