Get up, get dressed, get moving

First national 60-day challenge in acute hospitals in Ireland

ABOVE: Staff of Kavanagh Ward in St James’ Hospital in their pyjamas to highlight the vulnerability of patients when they are in their pyjamas. Photo: Brid Ryan, Senior Clinical Photographer, St James’s Hospital.

The Get up Get dressed Get moving (GuGdGm) challenge is an initiative that will be taking place in a number of hospitals throughout Ireland between October 4th and December 3rd 2021. Each of the participating hospitals has nominated a ward/wards that will be involved in encouraging older people to get up, dressed and to get moving during their hospital stay. Each hospital has also identified a control ward, where no GuGdGm intervention will be introduced to facilitate comparison of data.

Why are we doing it?

During a hospital stay older adults can spend 97% of their day lying or sitting down. These reduced activity levels can have a serious impact on the quality of life of the older person. Each day spent immobile is associated with loss of muscle strength, which in a vulnerable person can be the difference between being able to climb the stairs or being able to get up off the toilet independently. It can actually make the

Insert logo here

Get up Get dressed Get moving

FOR MORE INFORMATION ON THE CHALLENGE, search Get up Get dressed Get moving, on hse.ie and #GUGDGM2021 on Twitter.

difference in their ability to be discharged back home or in having to go to long term care facilities.

What are the benefits?

During the 60-day challenge all members of the multi-disciplinary team will be supporting the older person to increase their levels of functional activity. And the benefits of simply becoming more active include less risk of: • Getting an infection. • Losing mobility and agility. • Losing fitness and strength. • Developing pressure sores. • Having a fall.

One of the significant risk factors for falls is inappropriate footwear, which can include slippers. Therefore if the older person is encouraged to bring in appropriate clothing and footwear they will be at less risk of falls while mobilising. Also we know when people are dressed healthcare professionals are more likely to notice their ability, rather than see them in the ‘sick role’ and so plan for their discharge.

Staff of the Slieve Bloom ward in Midland Regional Hospital Portlaoise.

SLIGO WARD DELIGHTED TO PARTICIPATE IN CAMPAIGN

The Get up Get Dressed Get Moving challenge is being implemented in Sligo University Hospital at ward level on Medical 5 by the entire MDT with support from local and national senior management. Medical 5 specialises in the care of patients with neurological conditions where the focus on mobility is so important to ensure that patients do not become deconditioned during their hospital stay. Every effort is made to maximise patients physical functioning when they have a neurological diagnosis and this initiative fits in very well to this ethos. This challenge requires the input of all staff to work with each patient who wishes to and is able to participate – health care assistants, catering staff, household staff, doctors and nurses, physiotherapists, occupational therapists, dieticians, speech and language therapists, podiatrists, clinical students, family members, carers and visitors. Data is collected on a daily basis on the number of patients who are up and dressed by 12 midday but data is also collected to measure the impact of the challenge on metrics such as number of falls, pressure ulcers, lengths of stay, readmission rates, and discharge destinations. We are hopeful that this challenge will result in a permanent change of mindset and daily routine on Medical 5 which will ultimately result in improved outcomes for our patients. Medical 5 is delighted to participate in this new campaign, staff have seen an area of care that can easily improve the inpatient experience of our patients and have embraced it. The tagline was cleverly thought up by Staff Nurse Davinia Paul. As ward managers, both Smitha Nair CNM1 and Dean Flanagan CNM2 hope that small changes in the daily routine of all staff on the ward nurtures a new outlook on bedside attire. Both CNMs took part in handover in their pyjamas and showed staff and themselves just how vulnerable you can become. #GUGDGM2021

What is involved?

Get up Get dressed Get moving teams are collecting data on the participating wards over the 60 days on the numbers of patients up, dressed and moving at midday each day. At the end of the challenge the Health Pricing Office will compare lengths of stay, discharge destinations, 30-day readmission rates and falls on the intervention wards and compare this with the same data on the control ward in an effort to ascertain the cost of functional decline.

The National Ambulance Service and Dublin Fire Brigade are also supporting the challenge by encouraging older adults, where appropriate, to pack their day clothes and footwear, for their hospital stay.

This is a collaborative of the Office of the Nursing & Midwifery Services Director and the Health & Social Care Professions Office. Staff working collaboratively is integral to embedding the culture change of the Get up Get dressed Get moving campaign.

Mairéad O’Sullivan, Clinical Placement Co-Ordinator, Midland Regional Hospital, Portlaoise, said, “When doing a little education on the ward and giving out information leaflets, one lady asked me if I could give her one of the posters to put up at home to remind her of why it is of benefit to her to get dressed and moving even when at home as she lives alone and often just stays in her PJs for the day. It made me think again about how this initiative really does start in the community and filters into the hospital and back out home again.”

ABOVE: The team from Medical 5 ward in Sligo University Hospital in the pyjamas in support of the Get up Get dressed Get moving challenge.