Implementation of a Frailty Care Bundle for older adults in acute care

During hospital admission, older patients often reduce their walking activity and nutrition intake due to illness. However, research suggests that inflexible hospital routines, lack of patient awareness and limited nursing attention are also factors. Long periods of inactivity combined with suboptimal nutrition cause leg muscle weakness that accelerates frailty, delays recovery and reduces physical functioning (e.g. walking, self-care) once discharged.

Continuing to walk and optimising nutrition during hospitalisation helps to preserve muscle strength and promotes recovery.

Our aim is to implement a 'Frailty Care Bundle' (FCB) that emphasises best practice in caring for older patients. We will use an evidence-based behavioural change strategy involving patients, families and ward staff to embed the following principles into daily nursing care: early patient mobility and nutrition assessment, patient goal setting, mobilisation assistance (min 3-times a day), nurse mealtime assistance, protein snacks, education and family involvement (where appropriate).

The intervention will use a Practice Facilitator to work intensively with ward staff. The Practice Facilitator will support staff to examine current practice, identify opportunities for improvement and overcome barriers to implementing FCB principles to deliver consistently high-quality care.

The intervention will be tested in three different types of hospitals on six wards (2 per site) to identify what works best in different hospital settings. We will collect data before and after (pre-post) the intervention looking at patient outcomes (i.e. daily number of steps walked measured using accelerometer, length of stay) and staff outcomes (staff knowledge and attitudes and staff uptake of the FCB in practice). The SouthSouthWest Hospital Group and the Office Nursing and Midwifery Service Director are our partners in this bid and will help us spread the learning to other front-line staff and hospitals. A well implemented FCB can reduce hospital risk for older patients and enable earlier discharge.

Award Date
30 June 2019
Award Value
Principal Investigator
Professor Corina Naughton
Host Institution
University College Cork
Applied Partnership Awards