title: The use of volunteers to help older medical patients mobilise in hospital: a systematic review.
abstract: OBJECTIVE
  To review current evidence for the use of volunteers to mobilise older acute medical in-patients.
  
  
  BACKGROUND
  Immobility in hospital is associated with poor healthcare outcomes in older people, but maintaining mobility is frequently compromised due to time pressures experienced by clinical staff. Volunteers are established in many hospitals, usually involved in indirect patient care. Recent evidence suggests that trained mealtime volunteers had a positive impact on patients and hospital staff. It is unclear whether volunteers can help older inpatients to mobilise.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  We searched Cochrane, Medline, Embase, CINAHL, AMED and Google databases using MeSH headings and keywords within six key themes: inpatients, older, mobility/exercise, delirium, falls and volunteers. Full texts of relevant articles were retrieved and reference lists reviewed.
  
  
  RESULTS
  Of the 2428 articles that were identified, two scientific studies and three reports on quality improvement initiatives were included in the final review. One study included volunteer assisted mobilisation as part of a delirium prevention intervention (HELP). The second study has not reported yet (MOVE ON). The contribution of volunteers in both is unclear. Three quality improvement initiatives trained volunteers to help mobilise patients. They were not formally evaluated but report positive effects of the volunteers on patient and staff satisfaction.
  
  
  CONCLUSIONS
  This review has identified a lack of scientific evidence for the use of volunteers in mobilising older medical inpatients, but quality improvement initiatives suggest that volunteers can be employed in this role with reports of staff and patient satisfaction: this is an area for further development and evaluation.
  
  
  CONCLUSIONS
  This review outlines the evidence for the involvement of volunteers in maintaining patients' mobility, identifies mobilisation protocols that have been used, the need to train volunteers and for formal evaluation of volunteers in this role. Prospero registration number: CRD42014010388.
authors.affiliation: Academic Geriatric Medicine, University of Southampton, Southampton, UK. a.baczynska@soton.ac.uk.|NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK. a.baczynska@soton.ac.uk.|University Hospital Southampton NHS Foundation Trust, Southampton, UK. a.baczynska@soton.ac.uk.|NIHR CLAHRC Wessex, University of Southampton, Southampton, UK. a.baczynska@soton.ac.uk.
authors.forename: Alicja M
authors.initials: AM
authors.lastname: Baczynska
authors.affiliation: Academic Geriatric Medicine, University of Southampton, Southampton, UK.|NIHR CLAHRC Wessex, University of Southampton, Southampton, UK.
authors.forename: Stephen Er
authors.initials: SE
authors.lastname: Lim
authors.affiliation: Academic Geriatric Medicine, University of Southampton, Southampton, UK.|NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK.|University Hospital Southampton NHS Foundation Trust, Southampton, UK.|NIHR CLAHRC Wessex, University of Southampton, Southampton, UK.|Newcastle University Institute of Ageing and Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Avan A
authors.initials: AA
authors.lastname: Sayer
authors.affiliation: Academic Geriatric Medicine, University of Southampton, Southampton, UK.|NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK.|University Hospital Southampton NHS Foundation Trust, Southampton, UK.|NIHR CLAHRC Wessex, University of Southampton, Southampton, UK.
authors.forename: Helen C
authors.initials: HC
authors.lastname: Roberts
mesh_terms: D000368:Aged; D006758:Hospital Volunteers; D006760:Hospitalization; D006801:Humans; D062407:Meals; D009043:Motor Activity
keywords: ambulation; hospital; inpatients; mobilisation; mobility; older; systematic review; volunteer; walking