Alberta Cancer Foundation

Four Things You Should Know About #EndPJParalysis

In a hospital, the sight of patients wearing hospital gowns is as common as medical professionals in their scrubs — but the #EndPJParalysis movement wants to change that.

The initiative began in the U.K. in 2016 and evolved out of a tweet by U.K.-based professor and health-care professional Brian Dolan calling for an end to pajamas as a patient uniform.

“Pajama paralysis” is when patients spend the majority of their stay in their hospital gowns and in bed, which can have a significant impact on their physical and mental health. The initiative aims to get patients up and out of bed and into their own clothes, ideally reducing hospital stays and improving outcomes.

In Alberta, the Leduc Community Hospital introduced the voluntary program in early 2018 and included a day where staff in two units wore their pajamas to work to better understand how patients feel when they’re encouraged to get up, get dressed and get moving. The experience was positive for both staff and patients, and since then, the #EndPJParalysis movement has continued to grow across the province. The initiative is now taking place in all five Alberta Health Services zones, including six hospitals with 15 units participating in Calgary — the Foothills Medical Centre and South Health Campus have also hosted their own staff pajama days.

“It doesn’t have to be prescriptive, and that’s a rare thing in health care,” says Paul Wright, interim director of quality improvement and patient safety at AHS. “It’s really about encouraging patients to get up and dress. Each unit can do it a little differently as long as they’re focusing on [the] principles of respect and dignity and getting patients up and moving.”

Pajama Paralysis Takes a Physical Toll

If a patient spends up to a week in bed relatively immobile, total muscle mass loss can be up to 20 per cent, which increases the risk of falling. A week spent immobile in bed can also mean up to a 10 per cent loss of aerobic capacity, affecting a patient’s ability to breathe deeply. For seniors, the potential impact is even greater — for every 10 days patients over the age of 80 are immobile during a hospital stay, their muscles age the equivalent of 10 years.

Pajama Paralysis Also Has a Mental Impact

The hospital gown can take on a symbolic meaning for those wearing it because it can be seen as institutionalizing patients. “Patients say [that] wearing a hospital gown, it’s hard for them to feel like they can question the medical team,” says Wright. “It can have psychological effects. When you do get dressed, you’re more likely to be successful and working on your care, your exercises, and your day-to-day plans while in hospital.”

Get Up, Get Dressed Goals for the Day

Before the initiative began, within the Calgary area, only 20 to 25 per cent of patients in participating units were up, dressed in their own clothing and active before 11 a.m. When the #EndPJParalysis initiative was introduced last year, AHS set a benchmark goal in the Calgary Zone to increase that number to 60 per cent. Now, that number has grown to 65 per cent.

Family Support

AHS is encouraging families to be partners in this patient-led initiative. Families can help support patients by bringing in loose, comfortable clothing, taking care of the laundry, bringing in walking aids such as a cane, and walking with the patient to different areas within the hospital during their stay.