Niek Koenders1, Sandra Potkamp-Kloppers2, Yvonne Geurts1, Reinier Akkermans3,4, Maria W G Nijhuis-van der Sanden3, Thomas J Hoogeboom3. 1. Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Rehabilitation, Nijmegen, the Netherlands. 2. Residential Care Center IJsselheem, Zwolle, the Netherlands. 3. Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Allied Healthcare Sciences of IQ Healthcare, Nijmegen, the Netherlands. 4. Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, the Netherlands.
Abstract
OBJECTIVE: The purpose of this study was to explore differences in sedentary behavior, length of hospital stay, and discharge destination of patients before and after the Ban Bedcentricity implementation at ward level. METHODS: The Ban Bedcentricity innovation and implementation procedure were implemented at the cardiothoracic surgery, cardiology, and orthopedics-traumatology wards. Sedentary behavior data were collected 2 weeks before and after the implementation using behavioral observations and analyzed with Pearson chi-square. Length of hospital stay and discharge destination data were collected from all admitted patients and analyzed with multiple and logistic regression analyses. RESULTS: Behavioral observations showed that in 52% of the observations, patients were lying in bed before implementation and 40% after implementation at the cardiothoracic surgery, 64% and 46% at the cardiology, and 53% and 57% at the orthopedics-traumatology wards, respectively. The mean length of hospital stay after implementation (compared with implementation before) was 5.1 days at the cardiothoracic surgery (n = 1923; mean = +0.13 days, 95% CI = -0.32 to 0.60), 2.6 days at the cardiology (n = 2646; mean = -0.22 days, 95% CI = -0.29 to -0.14), and 2.4 days at the orthopedics-traumatology wards (n = 1598; mean = +0.28 days, 95% CI = 0.06 to 0.50). After the implementation, more patients were discharged home from the cardiothoracic surgery (odds ratio [OR = 1.23], 95% CI = 1.07 to 1.37) and cardiology wards (OR = 1.37, 95% CI = 1.22 to 1.49), and no statistically significant difference was found at the orthopedics-traumatology ward (OR = 1.09, 95% CI = 0.88 to 1.27). CONCLUSION: The results indicate beneficial outcomes after the implementation with less sedentary behavior and proportionately more patients being discharged home compared with before the implementation. However, little information is available about the adoption and fidelity of Ban Bedcentricity; therefore, outcomes should be interpreted with caution. IMPACT: This multifaceted innovation to reduce sedentary behavior of patients during the hospital stay seems to be promising, with outcomes indicating less sedentary behavior in patients and more patients being discharged home after the implementation. LAY SUMMARY: We introduced Ban Bedcentricity, an intervention to reduce the amount of time patients lie in the hospital bed during their hospitalization. This study shows that after the introduction of Ban Bedcentricity, patients lie in bed less and are more often discharged home.
OBJECTIVE: The purpose of this study was to explore differences in sedentary behavior, length of hospital stay, and discharge destination of patients before and after the Ban Bedcentricity implementation at ward level. METHODS: The Ban Bedcentricity innovation and implementation procedure were implemented at the cardiothoracic surgery, cardiology, and orthopedics-traumatology wards. Sedentary behavior data were collected 2 weeks before and after the implementation using behavioral observations and analyzed with Pearson chi-square. Length of hospital stay and discharge destination data were collected from all admitted patients and analyzed with multiple and logistic regression analyses. RESULTS: Behavioral observations showed that in 52% of the observations, patients were lying in bed before implementation and 40% after implementation at the cardiothoracic surgery, 64% and 46% at the cardiology, and 53% and 57% at the orthopedics-traumatology wards, respectively. The mean length of hospital stay after implementation (compared with implementation before) was 5.1 days at the cardiothoracic surgery (n = 1923; mean = +0.13 days, 95% CI = -0.32 to 0.60), 2.6 days at the cardiology (n = 2646; mean = -0.22 days, 95% CI = -0.29 to -0.14), and 2.4 days at the orthopedics-traumatology wards (n = 1598; mean = +0.28 days, 95% CI = 0.06 to 0.50). After the implementation, more patients were discharged home from the cardiothoracic surgery (odds ratio [OR = 1.23], 95% CI = 1.07 to 1.37) and cardiology wards (OR = 1.37, 95% CI = 1.22 to 1.49), and no statistically significant difference was found at the orthopedics-traumatology ward (OR = 1.09, 95% CI = 0.88 to 1.27). CONCLUSION: The results indicate beneficial outcomes after the implementation with less sedentary behavior and proportionately more patients being discharged home compared with before the implementation. However, little information is available about the adoption and fidelity of Ban Bedcentricity; therefore, outcomes should be interpreted with caution. IMPACT: This multifaceted innovation to reduce sedentary behavior of patients during the hospital stay seems to be promising, with outcomes indicating less sedentary behavior in patients and more patients being discharged home after the implementation. LAY SUMMARY: We introduced Ban Bedcentricity, an intervention to reduce the amount of time patients lie in the hospital bed during their hospitalization. This study shows that after the introduction of Ban Bedcentricity, patients lie in bed less and are more often discharged home.
Authors: Sven Jacobus Gertruda Geelen; Hanneke Corine van Dijk-Huisman; Marike van der Schaaf; Antoine François Lenssen; Robert Adriaan de Bie; Cindy Veenhof; Raoul Engelbert Journal: Syst Rev Date: 2021-11-04
Authors: E Klooster; N Koenders; J Vermeulen-Holsen; L Vos; P J van der Wees; T J Hoogeboom Journal: BMC Health Serv Res Date: 2022-07-12 Impact factor: 2.908