Fit To Sit

Introduction

Immobility during hospitalisation is a major contributor to muscle loss, deconditioning, functional decline, and prolonged length of stay in older adults. Evidence shows that increased mobility in hospitalised older people is associated with improved health outcomes, reduced functional limitation, and improved quality of life. Hospital-based mobility interventions, such as supervised walking and structured sit-to-stand protocols, help counteract the adverse effects of inactivity and support independence at discharge.

Method

This quality improvement project was conducted on the Acute Frailty Unit at West Middlesex University Hospital, London. The aim was to increase the proportion of patients sitting out of bed by 10:00 am. Data were collected daily on all inpatients, every weekday, for two consecutive weeks per intervention, with no exclusion criteria. Three interventions were sequentially introduced: (1) informational posters for patients and nursing staff, (2) bed-end information signs, and (3) electronic "Fit to Sit" prescriptions (entered as free-text on the Cerner system). Each intervention was allowed one week before new data collection commenced.

Results

Baseline results showed 23.8% (14/59) of inpatients were sitting out of bed by 10:00 am. After poster intervention, this increased to 37.9% (22/58); following bed-end signs, to 45.5% (25/55); and after electronic prescriptions, to 46.8% (29/62). Cumulatively, the percentage of patients mobilised out of bed at 10:00 amincreased by 22.9 percentage points from baseline. The greatest improvement was observed after the first and second interventions

Conclusion

The introduction of visual prompts and structured nurse-led interventions significantly improved patient mobilisation in the acute frailty setting. Multidisciplinary engagement and increased staff awareness were key to sustaining change. Further improvements may be achieved through optimised staffing levels and additional frailty-focused staff training.