Abstract
BackgroundHandgrip strength is a non-invasive marker of muscle strength, and low grip strength in hospital inpatients is associated with poor healthcare outcomes including longer length of stay, increased functional limitations, and mortality. Measuring grip strength is simple and inexpensive. However, grip strength measurement is not routinely used in clinical practice. The aim of this study is to evaluate the feasibility of implementing grip strength measurement into routine clinical practice.Methods/designThis feasibility study is a mixed methods design combining qualitative, quantitative, and economic elements and is based on the acute medical wards for older people in one hospital. The study consists of three phases: phase 1 will define current baseline practice for the identification of inpatients at high risk of poor healthcare outcomes, their nutrition, and mobility care through interviews and focus groups with staff as well as a review of patients’ clinical records. Phase 2 will focus on the feasibility of developing and implementing a training programme using Normalisation Process Theory to enable nursing and medical staff to measure and interpret grip strength values. Following the training, grip strength will be measured routinely for older patients as part of admission procedures with the use of a care plan for those with low grip strength. Finally, phase 3 will evaluate the acceptability of grip strength measurement, its adoption, coverage, and basic costs using interviews and focus groups with staff and patients, and re-examination of clinical records.DiscussionThe results of this study will inform the translation of grip strength measurement from a research tool into clinical practice to improve the identification of older inpatients at risk of poor healthcare outcomes.Trial registrationClinicaltrials.gov NCTO2447445 Electronic supplementary materialThe online version of this article (doi:10.1186/s40814-016-0067-x) contains supplementary material, which is available to authorized users.
Highlights
Introduction toJamar dynamometer + practically measuring grip strength according to the standard protocol.Present the paperwork that need to be completed in relation to grip strength measurement and use of care plan.Cognitive participationCompetence in grip strength measurement using the standardised protocol
The results of this study will inform the translation of grip strength measurement from a research tool into clinical practice to improve the identification of older inpatients at risk of poor healthcare outcomes
Many studies have demonstrated that older hospital patients with low grip strength have an increased risk of functional decline, long length of stay, admission to care homes, and death
Summary
Introduction toJamar dynamometer + practically measuring grip strength according to the standard protocol.Present the paperwork that need to be completed in relation to grip strength measurement and use of care plan.Cognitive participationCompetence in grip strength measurement using the standardised protocol. Supervised practical session of measuring grip strength of a colleague Group discussion. Handgrip strength is a non-invasive marker of muscle strength, and low grip strength in hospital inpatients is associated with poor healthcare outcomes including longer length of stay, increased functional limitations, and mortality. Grip strength measurement is not routinely used in clinical practice. The aim of this study is to evaluate the feasibility of implementing grip strength measurement into routine clinical practice. Grip strength is a key component of the diagnosis of sarcopenia, a common progressive and generalised loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life, and death [12]. Low grip strength (reduced muscle strength) is associated with poor current and future health including increased falls [14], increased risk of osteoporosis and fracture [15], coronary heart disease, and stroke [16], increased allcause mortality [17], and reduced health-related quality
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