Can Ending Pyjama Paralysis Help to Reduce the Incidence of Bed Sores?

Britain’s chief nursing officer thinks that getting elderly patients dressed and out of their hospital beds each day would help to reduce a number of health problems inherent in immobility, including bed sores.

A pilot scheme has already run for 70 days in which patients were encouraged to get out of bed every day, get dressed and move around as much as possible.

The scheme is going to be expanded across NHS hospitals everywhere in the country after it was found that the results were encouraging. The patients who are the subject of the scheme are mostly those who remain in hospital after emergency treatment or operations.

Professor Jane Cummings initiated the pilot scheme after studies revealed that unnecessary immobility was responsible for a number of health problems. Ten days in hospital bed-bound could lead to a reduction in muscle mass by as much as ten percent, according to the studies. Bed sores have long been known to be caused by too long exposure to friction, when an elderly or disabled person remains prone in one position for a long time.

The pilot scheme involved 10,000 patients in wards across Britain in May and June this year. The results from the scheme showed a significant reduction in bed sores, falls and an increase in the satisfaction level of the patients themselves. It was calculated that over 700,000 fewer days less in hospital were needed as a result of the project.

Prof. Cummings dubbed the temptation to stay in bed ‘pyjama paralysis.’ She said that wearing bed clothes or night dresses in bed “reinforced feeling unwell and slowed down recovery times.”

It has also been reported that time spent unnecessarily bed bound can lead to an increase in the time spent in residential care homes as they haven’t sufficiently recovered to go back to their homes.

At Salford Royal Hospital, which was one of the first of the hospitals where the pilot scheme was trialled, the staff organized group meals for patients, set up activities and brought in therapy dogs for a visit. The hospital’s ward managers said that the fall rate, the number of falls made by patients when moving around away from their bed, dropped from twelve to two per month after the scheme had been put in operation.

Professor Cummings said that ending ‘pyjama paralysis’ should become the new ‘gold standard’ in hospitals for recovering elderly patients. A Visiting Professor of Nursing, Professor Brian Dolan, said he was thrilled to see staff at the trial hospitals respond to the campaign to get patients up and moving in their own clothes, rather than in pyjamas or night clothes. He said that three out of five elderly patients who were bed bound in hospital had no medical reason for staying in bed.

He said that when patients are able to wear their own clothes in hospital it helped them to regain their dignity, enhanced their safety and enabled them to retain a sense of their own identity. It was better for hospital staff, too.

Obviously, ending pyjama paralysis isn’t for everyone. There are many patients and elderly residents of nursing homes and disabled people who cannot get up, or at least much less frequently and who need more assistance to do so. The danger of developing bed sores as well as other health complaints that are associated with bed prone conditions will remain.