940 Mobility in Acute Care Surgery Patients - Are We Neglecting the Basics?

Introduction Immobility is a harmful yet preventable issue in healthcare. Complications such as DVTs and pressure ulcers require intervention, leading to a prolonged hospital stay. NICE guidelines on trauma rehabilitation suggest tailored exercise rehabilitation programmes as soon as possible after traumatic injuries. However, these guidelines are rarely quantified. Our aim was to assess mobility of surgical patients admitted under the General Surgery (GS) and Major Trauma (MT) teams at a London Teaching Hospital and Major Trauma Centre. Method We conducted separate cross-sectional studies on each respective ward. Patients were observed for 3 weeks at 2-hourly intervals commencing at 0800 until 1800 for GS and 1000 to 1600 for MT. They were classified under the following: Bed, Chair, Absent, Mobile. Individuals unable to mobilise were identified through review of notes and excluded. Data-points are a bed surveyed at each time point. Results Datasets were combined, and 1309 data-points analysed. Results showed severe lack of mobilisation, with only 4.8% MT and 0.9% GS patients mobilising. Statistical analysis indicated no significant difference between both groups at all time points. Although suitable to mobilise, 98 patients remained in bed over a cumulative 221 days. There was increased tendency to mobilise during lunchtime and visiting hours. Conclusions Immobility is prevalent and preventable in acute-care surgical patients. Our study demonstrates that despite guidelines recommending early mobilisation, these are patient-specific and not adhered to. Potential causes include lack of healthcare and physiotherapy staff to assist patients. Patient-specific goals are required to avoid physical, social, and financial costs of acute surgical immobility.