Ambulation in Long Term Care

Pattiecake · Nov 23, 2004

Have you tried a walkathon with a reward system for distances walked?

How about a primary care concept? The residents in the first 4 rooms are my PC residents. The next 4 are yours. While providing the care for the last 4 residents in the unit, I will also make sure that MY RESIDENTS (the first 4 ) get the walks they need, by either finding the time to do it myself, or hounding nancy nurse to make sure it happens while they are in her care.

Just some thoughts.

pat

ktwlpn, LPN · Nov 23, 2004

we have a restorative nursing dept which consists of a team of cna's whose responsibilty is the restorative amb and excercise programs (we have about 200 residents) You can start with just one full and one part time cna-Ours do not work weekends or holidays (neither does our clinic and transportation cna's-this gives all the cna's oppurtunity for job growth-but there is not much turn over in those depts)

CoffeeRTC, BSN, RN · Nov 23, 2004

Reevaluate the actual need for Wheel chairs. Seems like EVERYONE gets a wheel chair when admitted. Have PT OT screen or evaluate them and work with ones who need it. Then have resorative include them in their programs.

How bout ambualte to dinning...get rid of WC in the dining room. Have the residents walk in and sit in real chairs. Also ambualate to bathroom prn.

I like the idea of a marathon! Primary nursing thing wouldn't work in our facility.

donmomofnine · Nov 24, 2004

Reevaluate the actual need for Wheel chairs. Seems like EVERYONE gets a wheel chair when admitted. Have PT OT screen or evaluate them and work with ones who need it. Then have resorative include them in their programs.
How bout ambualte to dinning...get rid of WC in the dining room. Have the residents walk in and sit in real chairs. Also ambualate to bathroom prn.
I like the idea of a marathon! Primary nursing thing wouldn't work in our facility.

Wheelchair reduction program is working wonders in my facility!:balloons: Also, walk to dine program. For residents who must be wheeled to the dining room, they are transferred to a dining chair. There is no easy way to make this happen. You must talk, talk, talk and remind, remind, remind! Then continually monitor! The old habits are ingrained and it takes lots of time and encouragement to form new ones! We just had a pizza party for the nursing assistants to celebrate a small success in ambulation! It's difficult to keep these programs alive, but SO beneficial for the residents!!

ComicRN · Nov 25, 2004

Thank you so much to everyone who has replied!! Great ideas so far and I will take them all into consideration. If anyone has anything more to add, I'd love to hear it.

Thanks again - Jan

lovingtheunloved, ASN, RN · Nov 26, 2004

We have restorative aides that do the ambulation. The CNAs on the floor try to ambulate as many as we can to help out. And if someone in a WC is getting ants in their pants, we ambulate them. Most of our residents can't ambulate without assistance and have restraints ordered, so getting rid of the wheelchairs wouldn't work. We'd be doing neuros and nothing else.

dizzejan · Dec 10, 2004

restraints!!! yiikes!!....my facility is restraint free.oops.different thread..i have found that rewarding my cna's with food and trinkets work wonders.......it is amazing how creative they will get when good ol' fashion cookin is involved..and best of all the residents benefit ..i have a few that even make the gals and guys split the rewards!!! go figure...a conspiracy...lol :rotfl:

lovingtheunloved, ASN, RN · Dec 11, 2004

I work with dementia patients. Some of them are simply not safe without restraints. I'm talking a seatbelt or body buddy or something like that. There's a few I have that I'd give about 45 seconds without their restraint and they'd be on the floor. What kind of people do you work with that your facility is restraint-free?

proudmommielpn · Dec 11, 2004

That's what I would like to know lovingtheunloved! I worked in LTC for 4 years and when you work with dementia patients you have no choice but to restrain or keep sending to ER with broken bones, or concussions. We also had Restorative, they walked everyone down one hall one day and then move on to the next hall and so on. But when like someone said having someone get "ants in their pants" get 'em up and walk them. The CNA's also had one each to walk to and from dining. We would push the WC behind them in case they tired. I am not a big fan of restraints but you gotta use them when necessary to provide safe care for your patients or residents.

BHolliRNMS · Dec 11, 2004

i work in a 120 bed ltc and we just dc'd our last restraint. It takes a lot of creativity to keep people safe. you have to learn what each individual likes. Ex...we have one lady who liked to read...she is very demented...but she will sit and "read" for hours.

We also have modified a merrywalker to enable another resident with paresis to be able to unlatch it if needed. Getting residents active is important. We started out focusing on one resident at a time...made a c/plan to decrease the amt. of time spent in the wc by transferring during meals, supervised group activities, during restorative exercise program, etc. before you know it, you are no longer using the wc. remember that wcs are suppose to be used only for locomotion...not for sitting.

proudmommielpn · Dec 11, 2004

We used "merry walkers" also, but some restraints you just can't get rid of.