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Effects of a nursing care program on functional outcomes in older acute medical in-patients

protocol for a randomized controlled trial

Rodrigues, Cecília, Nurse, PhD Student in Nursing Sciencea,b,c,*; Mendonça, Denisa, Professor of Biostatisticsa,d; Martins, Maria Manuela, Professor of Nursinge,f

doi: 10.1016/j.pbj.0000000000000024
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Background: Hospitalization often leads to long periods of bed rest and inactivity which is associated with an increase in length of hospital stay, loss of capacity for basic self-care and discharge into a nursing home.

Objective: This trial aims to verify if a nursing care program centered on basic self-care and predefined physical activity, improves functional outcomes in older hospitalized patients.

Methods: This is a 2-group randomized controlled trial with repeated measures: 182 older acute medical patients will be blindly randomly allocated to the control group (n = 91) or intervention group (n = 91). The intervention will consist of nursing care intervention centered on basic self-care that includes a twice daily walking training, plus privileging pre-established trips to the toilet by walking and all daytime meals seated, off the bed. The main outcome was changes in the number of independent activities of daily living from 2 weeks before admission (baseline) to discharge. Trial registration: ClinicalTrials.gov (Identifier NCT03106064).

Results: This intervention has the potential to change the outcomes of the older patient in the acute setting.

Conclusion: The loss of independence in self-care is determinant in future health care needs. If our hypothesis is correct and demonstrate that this nursing care program centered on basic self-care for older acute medical patients improves functional outcomes, a change in the paradigmatic organization of hospital care may be justifiable.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

aDoutoramento em Ciências de Enfermagem, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto

bMedicina C, Departamento de Medicina, Centro Hospitalar do Porto

cGabinete de Governação Clínica, Departamento da Qualidade, Centro Hospitalar do Porto

dEPIUnit, Instituto de Saúde Pública, Universidade do Porto

eEscola Superior de Enfermagem do Porto

fGrupo de Investigação NursID: Inovação e Desenvolvimento em Enfermagem – Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS), Universidade do Porto, Porto, Portugal.

Corresponding author. Departamento Qualidade, Centro Hospitalar do Porto Largo Prof. Abel Salazar 4099-001 Porto, Portugal. E-mail address: ceciliarodrigue@gmail.com (Cecília Rodrigues).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Trial registration: ClinicalTrials.gov (Identifier NCT03106064).

Funding statement: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Received May 9, 2018

Accepted July 11, 2018

Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc.