Mobility Decline Prevention
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Modules - Mobility Decline Prevention
FIT OVERVIEW
But we'll be honest with you: Notwithstanding its benefits and cost-efficient design, FIT still takes considerably more time to administer than usual care, and this can be a big barrier to its implementation.
Let's look briefly at how FIT works, then discuss time management.
FIT is designed to be implemented four times daily, every two hours, between 8:00 a.m. and 4:00 p.m., five days a week. The procedure is as follows:
- During each of the four daytime care episodes, CNAs prompt incontinent residents to toilet, and change those who are wet.
- Before or after this incontinence care, CNAs encourage residents to walk, or if nonambulatory, to wheel their chairs and to repeat sit-to-stands up to eight times.
- During one episode per day, each resident, usually while in bed, is given upper body resistance training (arm curls or arm raises).
- Before and after each care episode, residents are offered beverages to increase their daily intake of fluids.
How long does all this take? Approximately 20 minutes per episode when we count travel time plus the time needed to provide both exercise and incontinence care (2). Here's the breakdown: 3 minutes for travel time; 7 minutes for incontinence care; 10 minutes for exercise. We also know, from an eight-month evaluation during which we implemented FIT in four nursing homes, that on average, residents participate in three of the four FIT sessions per day. So when we do the math, we figure it takes about an hour a day per resident to implement FIT.
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