Handgrip strength is a non-invasive marker of muscle strength and low grip strength in hospital inpatients is associated with poor healthcare outcomes including longer length of stay, increased functional limitations and death. Measuring grip strength is simple and inexpensive and it can be used in hospitals to identify high-risk older patients, with low grip strength values, who could benefit from appropriate early intervention. However, grip strength measurement is not routinely used in clinical practice. The aim of this study is to evaluate the feasibility of implementing grip strength measurement into routine clinical practice. This study is a mixed method design combining qualitative, quantitative and economic elements based in medical wards for older people in University hospital Southampton.
So far we have defined baseline practice in these medical wards in relation to routine identification of older inpatients at risk of poor healthcare outcomes and their current nutritional and mobility care. We have conducted interviews/ focus groups with 22 health professional staff working with older inpatients (medical, nursing, dietetic, and therapy staff), and completed an audit of 60 patients’ clinical records to complement the qualitative data.
Since November, we have trained 117 nurses, healthcare assistants, and student nurses to measure grip strength and use the grip strength care plan. The training sessions integrated well within the daily routine of staff who reported that they were fun and lively.
Currently we are monitoring and evaluating the routine implementation of grip strength by assessing the acceptability, adoption and coverage of routine grip strength measurement, and the basic costs of implementation. This study will report in early 2017 and is led by Dr Kinda Ibrahim