title: A feasibility study of implementing grip strength measurement into routine hospital practice (GRImP): study protocol.
abstract: BACKGROUND
  Handgrip strength is a non-invasive marker of muscle strength, and low grip strength in hospital inpatients is associated with poor healthcare outcomes including longer length of stay, increased functional limitations, and mortality. Measuring grip strength is simple and inexpensive. However, grip strength measurement is not routinely used in clinical practice. The aim of this study is to evaluate the feasibility of implementing grip strength measurement into routine clinical practice.
  
  
  METHODS
  This feasibility study is a mixed methods design combining qualitative, quantitative, and economic elements and is based on the acute medical wards for older people in one hospital. The study consists of three phases: phase 1 will define current baseline practice for the identification of inpatients at high risk of poor healthcare outcomes, their nutrition, and mobility care through interviews and focus groups with staff as well as a review of patients' clinical records. Phase 2 will focus on the feasibility of developing and implementing a training programme using Normalisation Process Theory to enable nursing and medical staff to measure and interpret grip strength values. Following the training, grip strength will be measured routinely for older patients as part of admission procedures with the use of a care plan for those with low grip strength. Finally, phase 3 will evaluate the acceptability of grip strength measurement, its adoption, coverage, and basic costs using interviews and focus groups with staff and patients, and re-examination of clinical records.
  
  
  CONCLUSIONS
  The results of this study will inform the translation of grip strength measurement from a research tool into clinical practice to improve the identification of older inpatients at risk of poor healthcare outcomes.
  
  
  BACKGROUND
  Clinicaltrials.gov NCTO2447445.
authors.affiliation: Academic Geriatric Medicine, Mailpoint 807, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD UK ; NIHR CLAHRC: Wessex, Faculty of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ UK.
authors.forename: Kinda
authors.initials: K
authors.lastname: Ibrahim
authors.affiliation: NIHR CLAHRC: Wessex, Faculty of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ UK.
authors.forename: Carl
authors.initials: C
authors.lastname: May
authors.affiliation: Academic Geriatric Medicine, Mailpoint 807, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD UK ; Medicine for Older People, Mailpoint 63, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD UK.
authors.forename: Harnish P
authors.initials: HP
authors.lastname: Patel
authors.affiliation: Medicine for Older People, Mailpoint 63, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Baxter
authors.affiliation: Academic Geriatric Medicine, Mailpoint 807, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD UK ; NIHR CLAHRC: Wessex, Faculty of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ UK ; Medicine for Older People, Mailpoint 63, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD UK ; Institute of Ageing and Institute of Health and Society, Campus for Ageing and Vitality, Newcastle University, Newcastle, NE4 5PL UK.
authors.forename: Avan A
authors.initials: AA
authors.lastname: Sayer
authors.affiliation: Academic Geriatric Medicine, Mailpoint 807, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD UK ; NIHR CLAHRC: Wessex, Faculty of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ UK ; Medicine for Older People, Mailpoint 63, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Roberts
keywords: Clinical practice; Grip strength; Hospital; Implementation; Inpatients; Older