Deconditioning in the Acute Setting
​​Hospitalised patients spend time away from their normal home environment and daily routine leading to a reduction in meaningful and purposeful activity which contributes to acute deconditioning.
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Acute medical and surgical patients in hospital spend >90% of their time sedentary, often completing less than 1000 steps a day*.
Hospital inactivity and immobility increases*:​
​• Length of stay
• Hospital readmission
• Discharge with additional therapy or care
• Pressure injuries
• Delirium
• Pneumonia
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• Urinary tract infections
• Falls
• Incontinence
• Venous thromboembolism
• Skeletal muscle atrophy
• Functional decline
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Scroll down for more detail the negative impacts of deconditioning on patients, staff and the system
​The effects of acute deconditioning are often more severe in vulnerable older people (age >65 years old), especially in those already living with frailty and/or cognitive impairments. Other risk factors of acute deconditioning include*:
​​​• Female gender
• Dwelling place (nursing home)
• Worse functional status on admission
• Visual impairment
• Acute renal failure
• Polypharmacy
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• Delirium
• Hypoxia
• Poor nutritional status
• Length of hospitalisation
• Use of bladder catheter
• Lack of mobilisation
The impact of deconditioning sets in just 24 hours into a hospital admission with a loss of 2-5% muscle power and 5% reduction in circulatory volume after 1 day of bed rest*. So, we know we need to intervene early in the patients journey to prevent acute deconditioning​.​
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​​​​​​A focus on patient flow in hospitals leads to the prioritisation of procedures and processes that will expedite discharges over patient mobility, communication, skin care, hydration and nutrition which results in the above complications and subsequent physical, psychological and functional decline*.
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When considering the three groups of risk factors for HAD (severity of illness/stressor, hospital environment and processes of care, preexisting vulnerability/frailty)* hospital staff and service users have most influence over, and much work to reduce, the risks associated with hospital environment and processes of care.
It's the small changes to hospital environment and processes of care that The EDDM Programme aims to address through engaging and empowering staff on the front-line to consider improvement ideas using continuous quality improvement methodology. Find out more on the Continuous Quality Improvement page here!
Negative impacts of Acute Deconditioning
Patients
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Staff
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System
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