Lecture 1 Flashcards
Purpose of frames of references
Provide a more narrow view of how to structure interventions within our model of practice
Examples of frames of references: biomechanical
Focus on analysing movement required for a task and intervention to improve these person related factors
Examples of frames of references: sensori-motor
Approaches focused on insult to nervous system and impairments. Intervention aimed at improving these neurological skills
What is the purpose of acute settings?
To understand person’s current level of functioning and make decisions about discharge planning:
- Can they go home?
- Should they go to rehab?
- Should they go to residential care?
Disadvantage of acute settings
Time restrictions
Acute vs rehab settings
Acute: short time frame; screening tests; one off assessment
Rehab: more time; comprehensive assessment; multiple meeting times over intervention
Acute/ rehab vs community setting
Community:
- see clients in homes (what they do in their environments)
Sources of information
- Information about clients, families and their contexts
- Information about the practice context
- Information from empirical research
- Information from clinical experience
What is manual handling?
The use of force in lifting, lowering, pushing, pulling, carrying or otherwise moving, holding or restraining any person, animal or thing
What is people handling
Any workplace activity where a person is physically moved, supported, or restrained at a workplace
Ways that WRMD occur
- gradual wear and tear caused by frequent periods of muscular effort involving the same body parts
- sudden damage caused by unexpected movements, intense of strenuous activity
Direct risk factors in people handling
Directly stress/injure the body
Contributing and modifying factors in people handling
affect how the task is done
Direct risk factor examples
- Forceful exertions
- place high loads on body tissues - Working structures
- dynamic or static
- awkward or neutral - Repetition and duration
- frequency of repetitive task or action
- duration
Contributing factor examples
- Work area design
- Work environment
- Handling procedures
- Characteristics of the person (e.g. weight, size, communication, etc.)
Therapist’s role in people handling
- Assess patient prior to handling activity
- Perform safe handling techniques - back care principles
- Teach carers and staff safe handling techniques
Assessment in people handling
- Initially on admission to the ward or emergency department
- Pre-activity screening immediately prior to each patient handling activity
- Re-assessment when patients condition/needs change significantly
Assessment in people handling process
- Preparation
- Assessment (subjective and objective)
- Determine level of dependency/how much assistance they require (typically conducted by initial physio or nursing assessment)
- Assessment environment
- Interpret findings
- Develop patient handling plan if necessary (typically by nurse and/or physio as part of routine care)
What do you need to do in the preparation stage?
- Review medical chart
- Review related assessment
- Check bed chart - medications, pain relief
- Gather necessary equipment and personnel
- Prepare environment and self
Subjective assessment details
- Check environment as you approach client
- Talk to patient to determine
>pain, ROM, strength
>mental status, confusion
>communication concerns
Objective assessment details
- DVT check
- Neurological and respiratory as required
- Functional assessment
Level of dependency: independent
Can sit-stand, mobilise (+/- aid), transfer without manual assistance or verbal cues
Level of dependency: supervision (stand by assistance) needed
visual supervision and/or verbal cues to ambulate/transfer with/without the use of self-help aid
Level of dependency: assistance required
patient UNDERSTANDS and cooperates; physically able to perform part of the activity but manual assistance require to sit/stand
Level of dependency: dependent
patient unable to understand, cooperate of physically assist
What to assess in the environment
- Path of travel
- Hazards
- Hight of bed, bath, shower chair
- Check equipment - brakes, battery?
- Doorways, location of furniture
Safe handling techniques: BACKS
B: biggest muscles to the work A: abdominal muscles are braced C: curves of spine are in neutral position K: keep the load close to the body @: is it Safe?
