Using Innovative, Evidenced-Based Strategies in a Rehabilitative Setting to Successfully Decrease Falls Attributed to Fitness Equipment

Purpose:
To provide a safe, state of the art rehabilitation facility, The Center for Cardiac Fitness (CCF) purchased new fitness equipment. With new equipment came unexpected environmental risks: falls r/t incorrect operating/mounting of equipment, navigation around equipment, and oxygen/medical device use.

Relevance/Significance:
CCF is utilized for varied rehabilitation, prevention, wellness programs: cardiac and pulmonary rehabilitation, cardiopulmonary maintenance, employee fitness, and Health for Life Primary Prevention Program. CCF volume has increased 250% over the last decade and patient volume continues to rise. CCF treats patients of all ages, average age of 62.75 years old; an age group at high risk to suffer fall related injuries. Research demonstrates regular exercise can help prevent many of these falls.

Strategy and Implementation:
Accredited by American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) since 1996, the CCF is staffed with experienced registered nurses, cardiologists, nutritionists, behavioral health specialists, and exercise physiologists working collaboratively addressing needs of cardiac rehabilitative patients. Clinical staff reviewed/analyzed root causes of falls at bi-weekly staff meetings, utilizing a post fall huddle worksheet. Staff also participate in trending data, improvement projects, and are held accountable for patient education/surveillance while using equipment. Keeping in line with The Center's overall goal of improving patients' physical and emotional health/strength, and to reduce risk factors associated with heart disease while also considering patient specific diagnoses, staff addressed environmental risks in the exercise environment through the use of innovative, evidenced based strategies supported by the CDC, WHO, and Rehabilitation Measures Database.

Evaluation:
CCF's fall rate in 2012 (0.42 falls/1000 visits) almost doubled from that of 2011(.246 falls/1000 visits); attributed to risks associated with new, state of the art fitness equipment. After implementation of previously noted strategies, CCF successfully decreased fall rates (2013- 0.256 falls/1000 visits, 2014- 0.199 falls/1000 visits) to lower than that of 2011.

Implications for Practice:
Rehabilitation programs need to offer fitness equipment meeting functional/educational needs of diverse program participants, while maintaining safety. With no comparable programs nationally, CCF used internal quality data to set goals. CCF can now participate in NDNQI/AACVPR's national registries.