Health services research

Abstract

Scope: Sedentary behaviour and bed rest in hospital are associated with multiple complications and worse health outcomes in older people. There is evidence that early mobilisation of those patients improves not only health outcomes but also general wellbeing and satisfaction with healthcare. This aspect of care is frequently compromised due to the time pressures experienced by clinical staff. We undertook a systematic literature review of studies that included volunteers helping mobilise older inpatients. Search methods: We searched Cochrane, Medline, Embase, CINNAHL, Amed and Google databases using MeSH headings and keywords within six key themes: inpatients, older, exercise, delirium, falls and volunteers. The abstracts were screened first independently then jointly by two reviewers. Full texts of relevant articles were retrieved. Reference lists were reviewed. Hospital based studies, projects or programmes in which volunteers (+/staff members) were used to assist mobilisation in medical inpatients aged over 65 were included. Multi – intervention trials were included if mobilisation was part of the protocol. We excluded studies limited to a single disease such as stroke or Parkinson’s disease. Results: 1677 papers were identified and the titles and abstracts were screened. Only four studies fulfilled the search criteria and were included in the final review. Multiple scientific abstracts related to one controlled study which included volunteer assisted mobilisation as part of the delirium prevention multi-intervention (HELP).Three observational studies were identified only on Google but were poorly evaluated or still on-going. The data available indicated a positive effect of volunteers on patient and staff satisfaction with care. Conclusions: There is a lack of randomised controlled trials of volunteer assisted mobilisation of older inpatients. When adopted as part of delirium prevention programme volunteers contributed to improved outcomes. There is insufficient evidence to provide guidance on the use of volunteers specifically to deliver mobility assistance to older inpatients.