Early mobility after fragility hip fracture: a mixed methods embedded case study

Abstract Background Following a hip fracture up to 60% of patients are unable regain their pre-fracture level mobility. For hospitalized older adults, the deconditioning effect bedrest and functional decline has been identified as most preventable cause ambulation loss. Recent studies demonstrate that this adult population spends greater than 80% time in bed during hospitalization, despite being ambulatory before fracture. We do not fully understand why there continues be such high rates sedentary times, given evidence demonstrates is early mobility recommendations have available for over decade. Methods A descriptive mixed method embedded case study was selected phenomenon after fragility surgery. In study, main one post-operative unit with history recommendation implementation, units were recovering from repair. Data multiple sources provided an understanding activity initiation patient participation. Results Activity monitor data eighteen participants demonstrated mean 23.18 h. Median upright 24 min, median number steps taken 30. Qualitative interviews healthcare providers two categories themes; themes external person unique person. four factors can influence mobility; patient’s status, cognitive medical unpredictability, preconceived notions held by patients. Conclusions There multi-level require consideration implementation best practice interventions, namely, systemic, provider related, related. An increased risk poor outcomes occurs compounding factors, low mobility, impairment, mismatch expectations. The reports several variables important considerations facilitating Communicating expectations addressing physical psychological readiness essential. Our findings used develop meaningful patient-centred interventions address risks outcomes.