Risk factors for manifestations of frailty in hospitalized older adults: A qualitative study.
Faye Wray, Susanne Coleman, David Clarke and 3 others
PMID 34850424WHAT IT FOUND
Hospitalized older adults and ward staff described fear of falls, low staffing, poor communication and lost routines as factors that may restrict independence and worsen frailty signs such as delirium, falls and immobility.
Key findings
01Ward staff described fear of organizational repercussions for falls, and patients said they felt they needed permission to move independently or use the toilet.
02Patients and staff reported that poor continuity and communication meant ward staff did not know what patients could do, so assistance needs such as feeding help were missed.
03Staffing pressures and outdated risk labels led to missed mobility opportunities, including using commodes instead of supporting patients to walk and leaving falls alarms on after delirium had resolved.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
26 patients consented, but nine dropped out before interview, so the analysed patient sample was 17 patients and one carer. All patient participants were of white ethnicity, and there were more female than male participants, so the findings may not reflect other groups. The purposive sampling strategy was not fully achieved because of limited recruitment time. The study was done in two hospitals in one area of England, so ward experiences may not apply elsewhere. The study was done before the COVID-19 pandemic, and the analysis did not formally compare the two sites or explore how reason for admission affected experience. The themes are experiences and possible risk factors, not proof that any ward change reduces delirium, falls, incontinence, immobility or loss of function.
Declared interests
No conflict of interest was declared. The work was supported by a National Institute for Health Research Project Development Grant.
The easy way to misread this
Do not read this as evidence that changing ward routines, staffing or equipment reduces frailty outcomes. The study reports experiences and themes from a small sample, not a tested intervention.