Intermediate Care Unit End PJ Paralysis Campaign

Intermediate Care Unit End PJ Paralysis Campaign featured image

In Sussex Community we have 14 intermediate care units with a bed base of 327. Within our units we offer a period of rehabilitation and recovery for older adults, often with moderate to severe levels of physical frailty.

In a bid to tackle deconditioning, Sussex Community NHS Foundation Trust launched its first ever End PJ Paralysis campaign, in July 2022. The aim being to reduce immobility, dependency, and sense of isolation by increasing their movement, independence, and social interaction - improving their physical health, mental wellbeing and – ultimately – their dignity.

Evidence shows deconditioning has a negative effect on their mental health and can, in turn, increase the length of stay, reduce quality of life, increase functional impairment and cause pre-mature death.

The covid 19 pandemic had a huge impact on the provision of inpatient rehabilitation, in part due to acuity of patients, environmental changes and widespread service pressures. Mid 2022 felt like a good time to refresh our rehabilitation standards – which started with resetting in terms of promoting independence and movement on all our units.

July 2022 saw the launch week for the campaign, where resources were printed, laminated, and sent out to all 14 wards. The trust intranet page advertised the launch with links to all the resources in electronic format.

During the campaign we asked staff to:

  • During welcome meetings, ask families and carers to bring in day clothes and

    shoes to help patients feel ready for rehabilitation and returning to a level of

    independence needed to return home.

  • Encourage every patient who is well to get up, get dressed and get active.

  • Discuss with patients what they want to achieve and ask them what activities,

    exercises, and tasks they can do themselves to help them achieve their goals.

  • Help patients complete ‘I can...’ wipe-clean boards to record their progress.

  • Display ‘mobility milestone posters’, which record headline distances, to help

    patients reach new mobility goals.

Display posters to share the message with patients, relatives, and colleagues.Over the 6 months of data collection, it demonstrated that all individual units were scoring consistently well or made significant improvements since their pre- implementation data.

The chart below shows a 10% increase in number of patients sat in the chair for lunch and a 29% increase in the number of patients dressed in their own clothes.

Reports from staff subjectively, were that they have noticed a difference in how patients engage when dressed in their own clothes and that practice changed to routinely asking families to bring in clothes for their loved one.

Each month data was collected, certificates were sent out to units to celebrate the best performing and most improved units. Wards really liked this recognition for all their hard work.

We worked with our digital and performance teams to include an End PJ Paralysis section to the existing comfort round template on our electronic documentation system

We also continue to provide refresher End PJ Paralysis education sessions to units, to maintain momentum in units who require a refresh.


Steffi Bailey
Clinical Transformation Lead
Sussex Community NHS Foundation Trust [email protected]

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