'PJ paralysis': Why advocates are pushing to get patients out of pyjamas
So, I went ahead and straight to the website of the actual campaign (<a href="https:&#x2F;&#x2F;www.endpjparalysis.com&#x2F;" rel="nofollow">https:&#x2F;&#x2F;www.endpjparalysis.com&#x2F;</a>) because numbers like &quot;41% reduction in bed sores, 30% reduction in falls&quot; are pretty hard to take at face value from what reads like a press release.<p>&quot;Latest Data&quot; tracks how many people&#x2F;wards they&#x27;ve gotten to opt into their 70-day challenge, not supporting data.<p>Their &quot;Stories&quot; page is just that - stories. If you&#x27;re interested in a poem by a nurse, dive in. The top of the page, however, has a link to a Medscape interview with the CNO (<a href="https:&#x2F;&#x2F;www.medscape.com&#x2F;viewarticle&#x2F;898975#vp_2" rel="nofollow">https:&#x2F;&#x2F;www.medscape.com&#x2F;viewarticle&#x2F;898975#vp_2</a>). Does the CNO have any supporting data? No.<p>&gt;  Medscape UK: It appears a very simple thing but it seems to be having a health effect.<p>&gt; Prof White: Absolutely right. I&#x27;ve got lots of stats to share with you. The one that struck me when I came to look at this, it says that research has shown that 60% of immobile patients have no clinical reason that requires bed rest, and that for people over 80, spending 10 days in bed ages their muscles by 10 years, and that older adults living at home will take 900 steps a day compared to only 250 steps in hospital.<p>&gt; Healthy patients in a bed begin to weaken immediately. After one day of admission and after just 24 hours of bed rest you can lose between 2% and 5% of your muscle power.  This is something that happens almost immediately. It&#x27;s not surprising then when you have patients that often end up in care homes instead of going home. And if you stay in bed any length of time you are more prone to things like thrombosis, delirium, infectious diseases like pneumonias, depression, loss of confidence, constipation, and incontinence. It&#x27;s undignified as well, all of that, so it&#x27;s really compelling when you start looking at what the statistics and the evidence tell you.<p>That is, they don&#x27;t have any support that this intervention gets people moving more, just that <i>moving more is good for patients</i>.<p>The &quot;Resources&quot; page &quot;Everything you need to know&quot; packet. It&#x27;s nothing but information on how to enro - no! There&#x27;s a references section! But wait, it&#x27;s nothing but a list of articles on the dangers of deconditioning. Nothing to support that putting people in street clothes has the benefits being touted in the parent article.<p>There&#x27;s literally nothing on the entire site to support their claims. At all.<p>If I sound like I&#x27;m starting from the base position of &quot;I want my patients in a gown,&quot; and it&#x27;ll take actual data of patient benefit to change my position on that, it&#x27;s because I am. I&#x27;ll never forget running codes, rapid responses, and time in the trauma bay during my training. Getting fast access to the body of a patient in distress is critical; taking trauma shears to a patient and stripping them down takes a fair amount of time. If all my rapids and codes were in full dress and had to be cut out every time we ran a code, I guarantee we&#x27;d be measuring the impact of this policy in deaths. It doesn&#x27;t surprise me that this campaign is for self-selected wards; I&#x27;m pretty much taking for granted that any ward with any level of actual acute patients isn&#x27;t doing this.<p>Never mind that for your everyday physical exam - not your outpatient exam, for someone healthy and mobile enough to get to the office, but an inpatient exam - quite a few patients are unable to, you know, mobilize well. That&#x27;s one thing for a physical therapist or a nurse, as the campaigners in the article are, who largely don&#x27;t need anyone to move well enough to give them unfettered access to the body. But me? I actually need to get in there. For many patients, having to be mobile enough to disrobe from full dress every morning would be a problem. And a lot of docs don&#x27;t have the time to wait for that - many get an hour to an hour and a half or so to finish our rounds in the morning. If you add a 5 minute delay on each patient just to get them disrobed, you&#x27;ve nearly doubled the time it takes to complete rounds. Frankly, if you want to change the healthcare system economics to pay hospitals to allow us an extra 5 minutes with each patient, I&#x27;d be grateful, but I&#x27;d also rather not spend it on them struggling with their clothing. I&#x27;d rather be speaking to them and&#x2F;or examining them.