Implementation of a Frailty Care Bundle (FCB) targeting mobilisation, nutrition and cognitive engagement to reduce hospital associated decline in older orthopaedic trauma patients: pretest-posttest intervention study

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dc.contributor.authorNaughton, Corinaen
dc.contributor.authorde Foubert, Margueriteen
dc.contributor.authorCummins, Helenen
dc.contributor.authorMcCullagh, Ruthen
dc.contributor.authorWills, Teresaen
dc.contributor.authorSkelton, Dawn A.en
dc.contributor.authorDahly, Darrenen
dc.contributor.authorO’Mahony, Denisen
dc.contributor.authorAhern, Emeren
dc.contributor.authorTedesco, Salvatoreen
dc.contributor.authorSullivan, Bridie O.en
dc.contributor.funderHealth Research Boarden
dc.contributor.funderHealth Service Executiveen
dc.date.accessioned2024-03-13T10:11:39Z
dc.date.available2024-03-13T10:11:39Z
dc.date.issued2024-03en
dc.description.abstractObjective: To implement and evaluate a Frailty Care Bundle (FCB) targeting mobilisation, nutrition, and cognition in older trauma patients to reduce hospital associated decline. Methods: We used a two group, pretest-posttest design. The FCB intervention was delivered on two orthopaedic wards and two rehabilitation wards, guided by behaviour change theory (COM-B) to implement changes in ward routines (patient mobility goals, nurse assisted mobilisation, mealtimes, communication). Primary outcomes were patient participants' return to pre-trauma functional capability (modified Barthel Index - mBI) at 6-8 weeks post-hospital discharge and average hospital daily step-count. Statistical analysis compared pre versus post FCB group differences using ordinal regression and log-linear models. Results: We recruited 120 patients (pre n=60 and post n=60), and 74 (pre n=43, post n=36) were retained at follow-up. Median age was 78 years and 83% were female. There was a non-significant trend for higher mBI scores (improved function) in the post compared to pre FCB group (OR 2.29, 95% CI 0.98-5.36), associated with an average 11% increase in step-count. Conclusion: It was feasible, during the Covid-19 pandemic, for multidisciplinary teams to implement elements of the FCB. Clinical facilitation supported teams to prioritise fundamental care above competing demands, but sustainability requires ongoing attention. ISRCTN registry: ISRCTN15145850 (https://doi.org/10.1186/ISRCTN15145850)en
dc.description.sponsorshipHealth Research Board of Ireland ((Ref APA-2019-009): HSE South West Hospital Group as part of the HRB Applied Partnership funding award)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationNaughton, C., De Foubert, M., Cummins, H., McCullagh, R., Wills, T., Skelton, D.A., Dahly, D., O’Mahony, D., Ahern, E., Tedesco, S. and Sullivan, B.O., (2024) 'Implementation of a Frailty Care Bundle (FCB) Targeting Mobilisation, Nutrition and Cognitive Engagement to Reduce Hospital Associated Decline in Older Orthopaedic Trauma Patients: Pretest-Posttest Intervention Study', Journal of Frailty, Sarcopenia and Falls, 9(1), pp.32–50. https://doi.org/10.22540/JFSF-09-032en
dc.identifier.doihttps://doi.org/10.22540/JFSF-09-032en
dc.identifier.endpage50en
dc.identifier.issn2459-4148en
dc.identifier.issued1en
dc.identifier.journaltitleJournal of Frailty, Sarcopenia and Fallsen
dc.identifier.startpage32en
dc.identifier.urihttps://hdl.handle.net/10468/15663
dc.identifier.volume9en
dc.language.isoenen
dc.publisherHylonome Publicationsen
dc.relation.ispartofJournal of Frailty, Sarcopenia and Fallsen
dc.rights© 2024. Published under Creative Common License CC BY-NC-SA 4.0 (Attribution-Non Commercial-ShareAlike)en
dc.rights.urihttps://creativecommons.org/licenses/by-nc-sa/4.0/en
dc.subjectHospital associated declineen
dc.subjectMobilityen
dc.subjectNutritionen
dc.subjectOrthopaedicen
dc.titleImplementation of a Frailty Care Bundle (FCB) targeting mobilisation, nutrition and cognitive engagement to reduce hospital associated decline in older orthopaedic trauma patients: pretest-posttest intervention studyen
dc.typeArticle (peer-reviewed)en
dc.typejournal-articleen
oaire.citation.issue1en
oaire.citation.volume9en
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