#ExpOfCare Blog: An #EndPJParalysis Chorus!

Monday 20th March 2017 by @AnnMarieRiley10

From a tweet to an #EndPJparalysis chorus

by Prof Brian Dolan & Ann-Marie Riley


Prof Brian Dolan is Director, Health Service 360, Honorary Professor of Leadership in Healthcare, University of Salford, Manchester and Visiting Professor of Nursing, Oxford Institute of Nursing, Midwifery and Allied Health Research. @brianwdolan

Ann-Marie Riley is Deputy Chief Nurse, Nottingham University Hospitals NHS Trust @AnnMarieRiley10


Sometimes the simplest things start with a tweet, become a resonating tune, and before you know it, turns into a full blown chorus of ‘yes, let’s #EndPJparalysis'


The tweet sent from Brian Dolan to Ann-Marie Riley and Tim Gillatt on November 6 2016 was ‘nursing was born in the Church and raised in the Army, so leaving patients in pyjamas is their ‘uniform’ #Letsfixthat. Within a few days #Letsfixthat became #EndPJparalysis and a movement was born.


The premise of #EndPJparalysis is remarkably simple and is about enabling hospitalised patients to get up, dressed and moving in order to prevent deconditioning. This is important because 65% of patients admitted to hospital are >65 years old and a person over 80 who spends 10 days in a hospital bed will lose 10% of muscle mass. This could be the difference between going home and going to a home.


Where carers and family come in is it enables them to feel they are contributing in an even more meaningful way to the care of their loved ones by bringing in daywear, shoes and toiletries. This means patients can get around more easily and could make it the toilet – rather than using a commode.


The enhancement of patient’s dignity is also paramount.  As one colleague of ours noted, ‘no woman wants visitors when she’s not even wearing lippy or her bra’. So it raises the legitimate question, why have we got a campaign going when, as so many seasoned nurses point out, getting patients out of bed in the morning is what we used to do anyway.


We don't have answers or make a judgement on that, however we do know #EndPJparalysis is something that has been embraced widely by nurses, doctors and allied health colleagues. We are also beginning work with the ambulance community in Yorkshire so they can test the concept of bringing in patients’ clothing to hospital if they are likely to be admitted anyway. We trust their judgement to do the right thing always.


And in trust lies the secret of #EndPJparalysis. It’s not a project, it has no KPIs and spreadsheets or tick boxes. What it does have is a resonance that it’s the right thing to do and is about trusting clinicians where they work to interpret #EndPJparalysis as they see fit. It’s also gained the blessings of patients and their carers, the latter who love that their relative is up and dressed when they come into see them.


The essence of #EndPJparalysis is that it forces us to hold a mirror to our practice and reflect against the evidence, it forces us to put the patient at the centre of our actions and it empowers patients and their families to challenge some our practice. It has united like-minded people who are selflessly sharing work for the wider benefits of patients.


That’s the funny thing the melodies of Twitter. Sometimes you suggest something that simply chimes and #EndPJparalysis does just that. It would seem that with >22 million twitter impressions since 1 January 2017, that the choir is only clearing its throat for a full chorus of change!





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26 March 2017 17:59
very good read and really highlights the need for change.

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