Dr Adrienne Young1, Dr Peter Thomas2, Ms Prue McRae3, Ms Mikaela Wheeler4
1Nutrition and Dietetics, Royal Brisbane And Women’s Hospital, Herston, Australia, 2Physiotherapy, Royal Brisbane and Women’s Hospital, Herston, Australia, 3Internal Medicine, Royal Brisbane and Women’s Hospital, Herston, Australia, 4School of Human Movement and Nutrition Sciences, St Lucia, Australia
Physical environment and equipment play a key role in promoting recovery and preventing harm in hospital. For example, having the necessary space and appropriate equipment to sit out in a chair can improve function and meal intake, and prevent pressure injuries. In a tertiary metropolitan hospital in Queensland, Australia, consumer and staff feedback indicated a lack of and/or defective patient tables and chairs at the bedside. In line with the new Comprehensive Care Standard, an integrated and interdisciplinary approach was taken by Physiotherapy and Nutrition and Dietetics to audit the current state of patient chairs and tables, and make recommendations to hospital executive. Two physiotherapists conducted a hospital-wide audit of chairs, noting defects posing potential harm to patients and/or staff (e.g. skin tears, pressure injury, injury from manual handling). A random selection of 59 tables was audited by a dietetic student and the patient themselves. A scale of 1-5 (5 = “great difficulty”) was used by each assessor to rate stability, moveability (wheels, adjusting height up and down), and ease of using the lever. Only twelve patients participated in the audit; others declined due to previously observing/experiencing difficulties moving tables. Of 381 chairs audited, 127 (33%) were deemed to be defective; common defects included torn vinyl (chair base, arm rest) and broken frame. The moveability of tables was problematic for patients (median rating for wheels: 4, adjust up: 5, adjust down: 5) and dietetic student (wheels: 3, adjust up: 3, adjust down: 4); patients also found the lever mechanism difficult to use (median: 4). Defects in basic patient equipment was observed to be common, with significant potential impact on patient care and outcomes. Data from this interdisciplinary audit have been used to secure recurrent budget for equipment maintenance and replacement, and research funding to co-design improvements to patient bedside environment.
Dr Adrienne Young is an Accredited Practicing Dietitian, and is currently Principal Research Fellow, Allied Health Professions at the Royal Brisbane and Women’s Hospital. Her PhD research on improving nutritional intake of older medical inpatients has been of interest nationally and internationally, with Adrienne awarded the Health Practitioner Researcher of the Year at the Royal Brisbane and Women’s Hospital research symposium in 2018, and New Researcher Award at the International Congress of Dietetics in 2012. Adrienne has continued to research in the area of malnutrition in older people, with recent work also focused on workforce development to prepare allied health professionals to translate research into their practice.