Quality Improvement Project- Sitting out of Older Patients on chair in the ward at General Hospital, Chester

Introduction

Sitting out of bed plays a crucial role in preventing deconditioning, muscle wasting, pressure injuries and thrombosis among older inpatients. It also fosters social interaction and cognitive engagement, reducing hospital stay duration and combating 'PJ Paralysis'. 

Objective

To improve the number of older patients sitting out of bed during lunchtime in the COTE ward, thereby supporting their functional recovery and overall well-being.

Methods

Direct observations were conducted over two consecutive days at baseline and again three weeks after intervention were implemented. Patients were assessed for eligibility and whether they were sitting out during lunchtime (12- 2pm).

Interventions

Introduction of comfortable seating (eg: recliner chairs, cushions)

Visual prompts: Posters placed at the ward entrance and bedside to encourage families to provide suitable day clothing for patients.

Results

Pre-intervention: 

20/06/2025- 12 out of 22 eligible patients sat out 

23/06/2025- 11 out of 19 eligible patients sat out 

Post-intervention:

16/07/2025- 22 out of 27 eligible patients sat out 

17/07/2025- 19 out of 26 eligible patients sat out 

There was a marked improvement in sitting out rates post-intervention approaching the target of 100% eligible patient participation.

Conclusion

This project demonstrated that simple, cost-effective environmental and visual changes can significantly enhance patient mobilisation during meals. Future recommendations may include increasing the frequency of sitting out sessions by involving family involvement and refreshing posters regularly by making it visually appealing and highlighting the importance of sitting out on the chair.