The Early Mobility Bundle: a simple enhancement of therapy which may reduce incidence of hospital-acquired pneumonia and length of hospital stay

Stolbrink, Marie; McGowan, Laura; Saman, Harman; Nguyen, Thanh Nha; Knightly, Rachel; Sharpe, Julie; Reilly, Helen; Jones, S. R.; Turner, Alice

doi:10.1016/j.jhin.2014.05.006

Cited by 70 publications

(61 citation statements)

References 21 publications

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“…Although only two studies were found, early mobilization interventions appear to reduce HAP incidence [45]. Post-stroke patients in particular could benefit from early mobilization, especially in the 48 h after the ischemic event [43].…”

Section: Resultsmentioning

confidence: 99%

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Prevention of hospital-acquired pneumonia in non-ventilated adult patients: a narrative review

Pássaro

Harbarth

Landelle

2016

Antimicrob Resist Infect Control

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BackgroundPneumonia is one of the leading hospital-acquired infections worldwide and has an important impact. Although preventive measures for ventilator-associated pneumonia (VAP) are well known, less is known about appropriate measures for prevention of hospital-acquired pneumonia (HAP).AimThe purpose of this narrative review is to provide an overview of the current standards for preventing HAP in non-ventilated adult patients.MethodsA search of the literature up to May 2015 was conducted using Medline for guidelines published by national professional societies or professional medical associations. In addition, a comprehensive search for the following preventive measures was performed: hand hygiene, oral care, bed position, mobilization, diagnosis and treatment of dysphagia, aspiration prevention, viral infections and stress bleeding prophylaxis.FindingsRegarding international guidelines, several measures were recommended for VAP, whilst no specific recommendations for HAP prevention in non-ventilated patients are available. There is reasonable evidence available that oral care is associated with a reduction in HAP. Early mobilization interventions, swift diagnosis and treatment of dysphagia, and multimodal programmes for the prevention of nosocomial influenza cross-infection, have a positive impact on HAP reduction. The impact of bed position and stress bleeding prophylaxis remains uncertain. Systematic antibiotic prophylaxis for HAP prevention should be avoided.ConclusionScant literature and little guidance is available for the prevention of HAP among non-ventilated adult patients. In addition, the criteria used for the diagnosis of HAP and the populations targeted in the studies selected are heterogeneous. Oral care was the most studied measure and was commonly associated with a decrease in HAP rate, although a broad range of interventions are proposed. No robust evidence is available for other measures. Further high-quality studies are required to evaluate the impact of specific measures on HAP prevention in non-ventilated adult patients.

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Section: Resultsmentioning

confidence: 99%

“…A prospective cluster study including 1179 subjects from elderly and respiratory care compared the effect of an early mobility bundle programme in one hospital to usual care in a second one [45]. The primary outcome was incidence of HAP.…”

Section: Measures For Hap Preventionmentioning

confidence: 99%

Prevention of hospital-acquired pneumonia in non-ventilated adult patients: a narrative review

Pássaro

Harbarth

Landelle

2016

Antimicrob Resist Infect Control

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show abstract

“…Many early movement initiatives are considered safe and beneficial for patients in adult and pediatric populations . Children and their families admitted to hospital with critical illness, benefit from daily mobility activities and many long‐term functional consequences of hospitalization may be prevented with early and regular mobility, often with the guidance from a physiotherapist .…”

Section: Introductionmentioning

confidence: 99%

Mobilization patterns of children on a hematology/oncology inpatient ward

Johnston

Deliva

Evans

2017

Pediatric Blood & Cancer

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“…Introduction of a care bundle to enhance early mobility [17] was associated with a lower risk of HAP (OR 0.39; 95% CI 0.22 to 0.68, p=0.001), although falls rates were non-significantly higher in the early mobility group.…”

mentioning

confidence: 97%

Interventions to prevent non-critical care hospital acquired pneumonia – a systematic review

McAuley

Price

Phillips

et al. 2015

European Geriatric Medicine

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The Early Mobility Bundle: a simple enhancement of therapy which may reduce incidence of hospital-acquired pneumonia and length of hospital stay

Abstract: The Early Mobility Bundle demonstrates a promising method to reduce the incidence of HAP and to increase activity in medical inpatients.

Cited by 70 publications

References 21 publications

Prevention of hospital-acquired pneumonia in non-ventilated adult patients: a narrative review

Prevention of hospital-acquired pneumonia in non-ventilated adult patients: a narrative review

Mobilization patterns of children on a hematology/oncology inpatient ward

Interventions to prevent non-critical care hospital acquired pneumonia – a systematic review

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