Implementation of grip strength measurement routinely among older inpatients on admission to hospital: identifying facilitators and barriers using Normalisation Process Theory (NPT)
Implementation of grip strength measurement routinely among older inpatients on admission to hospital: identifying facilitators and barriers using Normalisation Process Theory (NPT)
Background: Low grip strength in older inpatients is associated with sarcopenia, longer length of hospital stay, increased functional limitations and mortality. Measuring grip strength is simple, often used in research but not in routine clinical practice. This study evaluated the feasibility and acceptability of implementing grip strength measurement into routine clinical practice.
Methods and design: This study was conducted in five acute medical wards for older people in one UK hospital. Intervention design and implementation evaluation were based on Normalization Process Theory (NPT). The training program was developed to teach ward staff to measure grip strength. A mixed methods design assessed adoption, coverage, acceptability and basic costs of grip strength measurement implementation.
Results: 155 staff were trained to measure grip strength. 81% of female patients had low grip strength <16 kg (median 11kg) and 75% of male patients had low grip strength <27 kg (median 20kg). Adoption and the average weekly coverage of grip strength measurement varied between 25% and 80% across the 5 wards. Using NPT, implementation enablers identified included motivated ward champions, managerial support, engagement strategies, and staff shared-commitment. High turnover of staff and champions, lack of managerial buy-in and staff commitment were the main barriers to successful implementation. Both staff and patients found the grip strength test easy and potentially beneficial. The total cost was < £3800.
Conclusions: It was feasible, cheap and acceptable to train 155 staff to routinely measure grip strength. Most patients had low grip strength and were at high risk of sarcopenia and poor healthcare outcomes.
Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
Ibrahim, Kinda
(2017)
Implementation of grip strength measurement routinely among older inpatients on admission to hospital: identifying facilitators and barriers using Normalisation Process Theory (NPT).
In The European Union Geriatric Medicine Society (EUGMS).
(In Press)
Record type:
Conference or Workshop Item
(Paper)
Abstract
Background: Low grip strength in older inpatients is associated with sarcopenia, longer length of hospital stay, increased functional limitations and mortality. Measuring grip strength is simple, often used in research but not in routine clinical practice. This study evaluated the feasibility and acceptability of implementing grip strength measurement into routine clinical practice.
Methods and design: This study was conducted in five acute medical wards for older people in one UK hospital. Intervention design and implementation evaluation were based on Normalization Process Theory (NPT). The training program was developed to teach ward staff to measure grip strength. A mixed methods design assessed adoption, coverage, acceptability and basic costs of grip strength measurement implementation.
Results: 155 staff were trained to measure grip strength. 81% of female patients had low grip strength <16 kg (median 11kg) and 75% of male patients had low grip strength <27 kg (median 20kg). Adoption and the average weekly coverage of grip strength measurement varied between 25% and 80% across the 5 wards. Using NPT, implementation enablers identified included motivated ward champions, managerial support, engagement strategies, and staff shared-commitment. High turnover of staff and champions, lack of managerial buy-in and staff commitment were the main barriers to successful implementation. Both staff and patients found the grip strength test easy and potentially beneficial. The total cost was < £3800.
Conclusions: It was feasible, cheap and acceptable to train 155 staff to routinely measure grip strength. Most patients had low grip strength and were at high risk of sarcopenia and poor healthcare outcomes.
This record has no associated files available for download.
More information
Accepted/In Press date: 2017
Identifiers
Local EPrints ID: 417214
URI: http://eprints.soton.ac.uk/id/eprint/417214
PURE UUID: 3bec407f-7299-47c4-9760-eeccf6bf8eb4
Catalogue record
Date deposited: 25 Jan 2018 17:30
Last modified: 12 Dec 2021 04:02
Export record
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics
