Dutch physiotherapists believe patients are ‘Better out of Bed’
In a hospital in Nijmegen, the Netherland’s oldest city, a revolution in patient care is underway.
Two determined, energetic and enthusiastic physiotherapists at Radboud University Medical Center have been challenging a long-held healthcare norm that puts patients into beds and instead are encouraging people admitted to hospital to stay as active as possible.
Working with the nursing teams, doctors and hospital administrators, Shanna Bloemen and Yvonne Geurts recorded steps patients took each day; redesigned hospital corridors to make them more interesting to walk in; and signposted the way to social areas with drinks machines on each floor to entice coffee-addicts. All this because research and experience shows that too much bedrest for patients results in loss of muscle, bone density, and appetite and is linked to incontinence, infections and depression. This ‘deconditioning’ process can happen surprisingly quickly, even with young patients, but especially for the elderly.
“It is about changing the mentality that hospitalisation means bedrest,” Shanna told us on a recent visit to introduce them to INGA Wellbeing’s adapted clothing, which enables patients to dress independently and move even with IV lines, drains and monitors.
“In Dutch, the phrase that we use to mean going to hospital actually uses the word ‘lying’ in it. It is embedded in our culture that patients will lie in bed when they are sick. But they should not … unless they are really, really sick or of course, to sleep. Staying active is really important for their recovery, especially for older people.”
Shanna and Yvonne’s campaign – known as ‘Beter Uit Bed’ or in English as ‘Ban Bedcentricity’ – shares the same aim as ‘endPJparalysis’ a nurse-led campaign to get patients ‘up, dressed and moving’ that began in the UK and has now spread to Ireland, Canada, New Zealand and Australia. While the impact of ‘endPJparalysis’ has been breadth – signing up as many hospital wards as possible to spread the message widely – Shanna and Yvonne have concentrated on depth by tackling as many of the barriers to activity as possible within one hospital.
“Ban Bedcentricity aims to eliminate unnecessary inactivity for patients in the hospital in a multidisciplinary and hospital-wide manner. We change the mindset of patients and caregivers, create an interesting environment to encourage activity and provide materials to support patients,” said the duo, who recently won the hospital’s innovation award and were cited as having installed a new mindset that looks at what the patient CAN do rather than what they can’t!
“We want patients to get out of their beds, into clothes and into a chair during the day, or ideally walking around. We had artwork and interactive touch displays installed in the corridors so that it would be fun to walk up and down, and coffee machines and comfortable seating areas give patients somewhere worthwhile to walk to.”
Indeed, when you visit the hospital, one of the things that strikes you straight away are the many posters promoting the benefits of continued activity, many with graphs and data showing the many positive results that the campaign has already had.
So the advice to patients from Shanna and Yvonne is clearly: “Be as active as you can during your hospital stay! Use your bed when you want to sleep or rest. Try to sit in a comfortable chair, especially when you’re eating. Walk around as much as you can and don’t treat your bed as “your place” in the hospital!”
For them, INGA Wellbeing’s range of normal-looking adapted clothing for patients contributes to the breath of fresh air sweeping through hospital wards, empowering people to dress and undress themselves independently even with IV lines, drains and monitors and ensuring that they keep their dignity and feel confident walking in the corridors.
“No-one wants to walk about in a hospital gown. It makes you feel like a patient and therefore you think you need to stay in bed. INGA Wellbeing clothes ensure patients don’t lose sight of who they are and what they are capable of and enables them to feel in control and stay active during their hospital stays. This is so important for their emotional, mental and physical wellbeing,” they said.