Moving forward: Barriers and enablers to mobility in a sub-acute setting

Mrs Prue McRae1, Dr Alison Mudge1, Mr  Paul Bew2, Mr  Jofferson Ylarde2

1Royal Brisbane and Women’s Hospital, Brisbane, Australia, 2Brighton Health Campus, Brighton, Australia

Aim: Studies measuring mobility levels of older patients in sub-acute settings have described low levels of mobility outside of scheduled therapy time but few have explored the barriers and enablers to mobility in this setting.

Method: This prospective observational study conducted in a purpose-built rehabilitation facility used mixed methods to identify current inpatient mobility levels and patient and staff perceptions of barriers and enablers for mobility.  Mobility levels were measured using activity mapping across two wards (a rehabilitation and restorative care ward). Barriers and enablers were identified by a validated staff survey (n=85; 52 nursing, 29 allied health professionals, 4 other) and semi-structured patient interviews (n=24).

Results: On average, patients spent less than 10% of day time upright and mobile; spent less than one third of day-time out of their bedrooms and even less on the week-end. Staff agreed that mobilisation benefited patients, had leadership support, and agreed they had knowledge and skills to mobilise the patients. Barriers included workload concerns; unclear responsibility between disciplines; team communication; fear of personal injury; and patient resistance. Patients reported mobility was important for their recovery; and having permission; assistance; equipment and meaningful activities enabled mobility. Barriers included lack of assistance; physical symptoms and their emotional state.

Significance of the findings to allied health: Understanding the barriers and enablers to mobility can inform strategies to enhance mobility levels in this vulnerable patient group.