Mobility Decline Prevention
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Modules - Mobility Decline Prevention
USE BUT DON'T RELY SOLELY ON CNA REPORTS
Start by collecting program assessment data.
The FIT daily logs completed by CNAs should tell you almost at a glance whether residents are improving their mobility, strength, and endurance with the FIT program. Our log includes columns for tracking each day's performance: the total minutes each resident walks or wheels, the number of sit-to-stands, and the number of arm curls or raises completed.
Click here to view and print a sample log.
We recommend collecting and reviewing FIT logs every two weeks. A nurse should scan the logs to see whether the numbers for a particular resident are gradually increasing; holding steady; or declining, which would signal the need for a reassessment.
Data from the FIT logs can also be used to calculate compliance rates. On what percentage of days in a given period did residents walk? Complete sit-to-stands? Do arm curls or raises? On what percentage of sessions in a given day did residents do some form of exercise? Information about compliance gives you insight into whether residents value the program.
As informative as they may be, DO NOT solely rely on the CNAs' written logs of exercise and incontinence activity to evaluate the FIT program. In several studies, we found that CNAs consistently recorded as delivered care that they in fact never provided (1-3). In fairness to the CNAs, we believe they did this largely because they truly lack the time required to provide the multitude of services that we-employers, regulators, family, and friends-ask them to deliver. But with performance expectations continuing to exceed most nursing homes' staff resources, it's best to use CNA reports only in conjunction with data gleaned from other assessment strategies such as resident reports, direct observations, or, in the case of prompted voiding, control checks.
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