Impact of the End PJ Paralysis interventions on patient health outcomes at the participating hospitals in Alberta, Canada.

Abstract

Multiple hospitals in Alberta implemented the End PJ Paralysis - a multicomponent inpatient ambulation initiative aimed at preventing the adverse physical and psychological effects patients experience due to low mobility during admission. To inform a scale-up strategy, this study assessed the impact of the initiative based on select process and outcome measures. Clinical and administrative data were obtained from the hospital Discharge Abstract Database, Research Electronic Data Capture (Redcaps), and Reporting and Learning System for Patient Safety. The variables explored were length of stay, inpatient falls, discharge disposition, pressure injury, patient ambulation, and patient dressed rates. We then used the Interrupted Time Series design for impact analysis. The analysis included discharge abstracts for 32,884 patients and the results showed significant improvements in outcomes at the participating units. The length of stay and inpatient falls were reduced immediately by 1.8 days (B₂=-1.80<i>, p</i> = 0.044, <i>95% CI [-3.54, -0.05]</i>), and 2.2 events (B₂=-2.22<i>, p</i> = 005, <i>95% CI [-3.75, -0.69])</i>. The percentage of patients discharged home increased overtime (B₂=.39<i>, p</i>=.006, <i>95% CI [.11, .66]</i>). Mobilization and dressed rates also improved. The findings imply the interventions safely mitigated the risk of immobility-induced complications, including deconditioning and hospital-acquired disability.