If you were the medical director of a coronavirus hospital what physical activity would you recommend for Med surg inpatients?
This would depend on a great many factors, including things like the ward setup, nursing ratios, isolation capabilities, availability of PPE and inpatient physical therapists, and many others.
If activity were limited to within patient rooms (which it likely would be in the current environment), then it would involve in-room mobilization. This would involve patients being out of bed in a chair as much as possible when at rest, and supervised activity that could involve things like getting up and walking around the room with sets of repeat chair sit-to-stands multiple times per day (ideally around mealtimes).
There are numerous challenges with this, of course. For example, whether there would be limitations on who/how many can enter rooms (e.g., PTs), and if so would then depend on nurses who would already be entering the room for another purpose (medication administration, vital sign check, lab draws, etc.) – and this then depends on adequate nursing ratios. Patients are also frequently whisked off for other tests / procedures / imaging studies that can interfere with the best laid plans (see this article: https://jamanetwork.com/journals/jam…rticle/2729374 )
As usual: things are complicated.
Hey brother, thanks for the reply and sorry for my delayed response. I’ve been pretty busy running said coronavirus hospital. We are opening another 30 beds tomorrow to give us ~70 total beds, 24 of which are in the ICU.
we are fortunately able to have PT work with patients in the hallway and because it is a hospital dedicated to coronavirus we can walk patients in the hallway. Because patients are cohorted here we can use our PPE much more efficiently
I’ll have our team work in sit to stands and walking into mandatory activity for all the patients on the floor. We are doing passive range of motion and early mobility for our patients in the unit. From my standpoint deconditioning is a huge problem because many of our patients remain hospitalized for so long.
thanks for your input
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@Austin_Baraki thought you would be happy to know that I just made sit to stands a quality metric for inpatients at our COVID hospital
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That is awesome!