Physiotherapists may influence hospital patient physical activity levels indirectly through workforce training.

Abstract

Background: Lower levels of patient physical activity in hospital are associated with poorer functional outcomes. Physiotherapists may influence physical activity outside of therapy time through nursing workforce training.

Objective: To estimate physical activity levels in acute inpatients after the Risk Assessment for Moving Individuals SafEly (RAISE) manual handling training intervention for nurses. The secondary aims evaluated nurse experiences of training and the extent to which nurses learnt RAISE skills and incorporated them in clinical practice.

Methods: Using a pre-post design, nurses from an acute neurological and medical ward participated in a physiotherapy-led, 4-hour training session teaching dynamic risk assessment to safely move patients. Patient physical activity and clinical observation audits of patient transfers were assessed prior to, and 1-week following, training. Surveys evaluated nurse experiences of training.

Results: Among 26 patients, there was a non-significant, moderate positive effect size favoring increased daily steps by 43% (g=.35, MD 208, 95% CI -263 to 679, p = .370). There was no change in sit-to-stand transitions (g=-.02, MD -0.4, 95% CI -16 to 15, p =.963) or daily sedentary hours (g=.05, MD 0.05, 95% CI -0.8 to 0.9, p=.908). Training was well received by all nurse participants, and the physical risk assessment was implemented into practice 89% of the time post training (X²(1) = 5.00, p = .025).

Conclusion: A physiotherapy-led manual handling training program involving dynamic risk assessment may help hospital inpatients to increase physical activity outside of therapy time.