Scarborough Health Network (SHN) recently expanded our End PJ Paralysis (EPJP) movement to six more inpatient units at the Centenary and General Hospitals, as part of our ongoing journey to address the serious consequences of prolonged bedrest in patients known as PJ paralysis! SHN hones a culture of mobility, positivity, and recovery, and incorporated End PJ Paralysis as part of this practice in April 2024.
The first EPJP pilot was in a Medicine unit at Centenary Hospital. Nurses and allied health staff participated in team huddles and roadshows learning about the deleterious effects of immobility and how the EPJP movement contributes to improved patient outcomes.
Since its implementation in the pilot unit, patient and staff feedback have reported a:
- 80% increase in patients being dressed in own clothing
- 16% increase in patients safely getting up and out of bed
- 19% decrease in on-unit falls
- 45% increase in staff education on long term bedrest harm to certain patients
Based on these positive results, SHN was able to expand this best practice to other transitional care and medicine units.
What is PJ paralysis?
PJ paralysis refers to the detrimental physical and mental impacts of remaining in bed for extended periods without engaging in mobility or changing out of hospital gowns. The consequences can be severe, including:
- Increased weakness and muscle loss
- Constipation and malnutrition
- Extended hospital stays
Research indicates that patients experiencing PJ paralysis face:
- A fivefold increase in the need for institutional care upon discharge
- A 48% rise in the need for assistance with daily activities one month after leaving the hospital
- A 60% increase in functional decline among senior patients following hospitalization
End PJ Paralysis is a global movement that started in 2018 by Professor Brian Dolan of the United Kingdom’s National Health Service, with the thought that “pajamas make you perceive yourself as unwell.”
By promoting mobility and engagement, hospital staff aim to reduce these risks, enhance recovery, and improve mental well-being. The goal is to get patients up, dressed, and moving—an approach that has proven to contribute to better patient outcomes.
As part of this initiative, staff across the new units with EPJP are receiving training and participating in collaborative efforts to integrate EPJP practices into their patient care routines.
The new units’ teams recently landmarked their successful implementation of EPJP through kickoff events held throughout October and November. Staff wore robes and PJs in the unit to decenter the notion that being in leisure clothes in the hospital means you’re sick or will stay sick. At the end, staff shed their PJ robes and celebrated the “get up and moving” element of EPJP!
SHN teams getting involved
Unit leadership and Professional Practice engaged staff in discussions about the effects of PJ paralysis and provided training on how to safely and effectively help patients implement mobility into their routines. The insights gained from the first EPJP pilot are being used to refine our approach and formalize training as a standard practice across SHN.
Our health network looks forward to further implementing and improving best practices to enhance our patients’ experience where it’s needed most. Together, we are working toward making meaningful difference in patient care and recovery.