Authors: (including presenting author): :
MY Chang (1), TK Wong (2) , WH Cheng (2), CY Chung (2), WL Hui (2), WL Wong (1), TS Yau (1) , MH Fan (1) , KL Cheung (1), YT Chan (1), TY Fu (2), MY Lee (1) , YY Fan (1), KL Wong (1)
Affiliation: :
1. Cardiac Medical Unit, Grantham Hospital 2. Department of Physiotherapy, Grantham Hospital
Keyword 1: :
Heart Failure
Keyword 2: :
Mobilization
Keyword 3: :
Fall prevention
Introduction: :
The number of inpatient fall incidents and the severity of these incidents in Cardiac Medical Unit persistently increased from 2022 to 2024. There was lack of structured program and documentation to evaluate heart failure patient’s fitness to mobilization.
Objectives: :
1. To initiate an early and safe mobilization program for patients admitted with Acute Heart Failure
2. To recondition Acute Heart Failure patients from restricted mobilization and prolong bedrest
3. To decrease fall incidents among patients admitted with Acute Heart Failure through a structured assessment and mobilization training program
Methodology: :
A multidisciplinary program consists of Doctors, Nurses and Physiotherapists were developed to achieve a joint decision for mobilization of heart failure patients,
Patients admitted to the Cardiac general ward with heart failure and the following inclusion criteria were recruited to SMP: on inotropic therapy, on intravenous diuresis and for guideline-directed medical therapy titration.
Doctors assess patient's heart failure condition and formulate treatment plan. Nurses assess and monitor patient’s physical condition, detect worsening of symptoms, implement fall prevention measures, provide heart failure and fall prevention education, and assist patient’s activities of daily living according to the suggested stage by Physiotherapist. An inhouse Patient Fall prevention video were tailor made to Heart failure patients. Physiotherapists assess patient’s mobility level, design appropriate training program, assign patient to different stage of mobilization process, and educate patient on fall prevention and transfer skills.
Result & Outcome: :
Total 127 heart failure patients were recruited from Jul 2024 to Mar 2025
M: 78 (61%) F: 49 (39%) Average age : 68.5 (M) 72 (F) Average LOS: 17.7 days
Patient fall incident rate has a 80% reduction after 9 months implementation from 1% to 0.2%.
Among patients discharged to home (n=91), there was a 60% increase in stage 4, which is the group with highest mobility level.
Overall, more than 90% interviewed patients agreed that the program improves their mobility and physical condition, as well as allows them to mobilize safely in ward.
