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Crutch-training film produced in therapy gym
The physical therapy staff at Crozer Chester Medical Center in Upland, PA, save an average of 10 to 15 minutes per patient by using a crutch training video to reinforce one-on-one training.
"We were looking at ways to save time and found that our therapists were spending a tremendous amount of time in crutch training. My philosophy is to spend money upfront to save money in the long run," says Bonnie Breit, administrative director of rehabilitation services for Crozer Keystone Health System.
Watching the video doesn’t replace crutch training by the physical therapy staff. Instead, patients may watch the video before seeing a therapist to get an idea of what they will be working on, or they may watch it as a reinforcement tool when they are leaving."It’s not meant to eliminate the need for physical therapy. It’s used for pre-education, for reinforcement of crutch training, and for patients with cognitive issues who can watch it over and over," she adds.
Initially, the hospital planned to buy a video, but an Internet literature search and calls to professional organizations such as the American Physical Therapy Association located only written resources. Hospital officials decided to make their own.
"We thought that having a video would empower patients and help us educate patients more effectively. The video saves staffing time and gives patients an action to watch, rather than trying to learn from a piece of paper," says Patti Wardius, PT, clinical manager for physical therapy at Crozer Keystone Health System. The hospital paid a professional filmmaking firm $4,000 to produce the video.
The legal department advised rehab staff that as long as the information in the video is correct, the hospital has no liability if a patient falls after seeing it. As an additional precaution, the video instructs patients to check with their physician or physical therapist if they have questions about using crutches.
Also, the video is never used as a stand-alone tool. A staff member always works with patients on crutches.
Having the video doesn’t eliminate staff contact with patients, but it does help when therapists have to treat several patients at a time in the emergency room or outpatient setting, Wardius says. The hospital also has a loaner program for the video so patients can take it home.
Here are three of the ways the hospital uses the crutch-training video:
1. Pre-admission testing.
Patients who are expected to ambulate with crutches after surgery are fit with them during the pre-admission testing and sent home to practice instead of having to undergo training after surgery, says Larry Flenner, PT, senior physical therapist for acute care at Crozer Chester Hospital.
"Normally, when someone comes in for surgery, they have no idea what is involved in using crutches. We use the video in pre-admission testing to get a jump-start on what will happen after their surgery," he says.
Patients who still feel uncomfortable on crutches can borrow a copy of the video and use it to practice at home, he adds.
2. The emergency room.
The emergency room techs usually provide crutch training for patients with sprains or broken bones who are to be discharged to home, but occasionally, when the patient load is heavy, a technician may not be available.
"Sometimes a nurse who wasn’t familiar with crutch training would have to do it. The video gives them an educational tool that helps ensure consistent training," Flenner says.
3. Late-afternoon surgical patients.
Patients who don’t undergo pre-admission testing, experience complications from surgery, or have their surgery late in the day may need crutch training when the therapy staff have gone for the day.
Now, the nurses in the short-procedure surgical unit have a tool to use to train the patients before they go home.