Montgomery County Infirmary Day Hospital


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Montgomery County Infirmary Day Hospital

  1. 1. Montgomery County Infirmary Day Hospital <ul><li>Operational Procedure </li></ul><ul><li>Mondays and Thursdays </li></ul><ul><li>Evidence Based </li></ul><ul><li>Up to 8 users (depending on wheelchair access) </li></ul><ul><li>Full multi-disciplinary approach </li></ul><ul><li>6 Week rehab programme </li></ul><ul><li>All users reviewed by MDT weekly. </li></ul>
  2. 2. Day Hospital Good Practice <ul><li>The National Service Framework for Older People focuses on: </li></ul><ul><li>Providing person-centred care promoting older people's health and independence. </li></ul><ul><li>Intermediate care </li></ul><ul><li>Aim: to provide integrated services to promote faster recovery from illness, prevent unnecessary acute hospital admissions, support timely discharge and maximise independent living. </li></ul>
  3. 3. <ul><li>Hospital Wards </li></ul><ul><li>GP </li></ul><ul><li>Consultant </li></ul><ul><li>Primary Care Team </li></ul><ul><li>District Nurse </li></ul><ul><li>Social Services </li></ul>Referrals from
  4. 4. Example of Conditions Seen In Day Hospital <ul><li>Orthopaedic </li></ul><ul><li>Rheumatoid Arthritis </li></ul><ul><li>Osteo-Arthritis </li></ul><ul><li>Total hip replacements </li></ul><ul><li>Fractures </li></ul><ul><li>Neurological </li></ul><ul><li>C.V.A </li></ul><ul><li>M.S. </li></ul><ul><li>Parkinsons </li></ul><ul><li>Cognitive Problems </li></ul><ul><li>Patients with a history of Falls. </li></ul><ul><li>General poor mobility. </li></ul><ul><li>Cardiac and Chest conditions. </li></ul>
  5. 5. Multi-Disciplinary Team
  6. 6. Improvements for the future <ul><li>Transport. </li></ul><ul><li>Medical Cover. </li></ul><ul><li>Audit process. </li></ul><ul><li>Opening a third day. </li></ul><ul><li>Improve Profile. </li></ul><ul><li>Improve physical environment. </li></ul><ul><li>Develop facility user group for the venue. </li></ul>
  7. 7. The Role of Physiotherapy <ul><li>1) Maintenance exercises for half an hour at each session given by a Physiotherapist Technical Instructor III. </li></ul><ul><li>This is a Chairobics Class following the Extend programme of `Movement to music for the over 60's or the less able of any age'. </li></ul>
  8. 8. The Role of Occupational Therapy <ul><li>Full assessment of the service users ability focusing on </li></ul><ul><li>Environment </li></ul><ul><li>Occupations </li></ul><ul><li>Performance </li></ul><ul><li>Group work where appropriate – purposeful activities </li></ul>
  9. 9. The Role of the Nursing team. <ul><li>Ongoing assessment of service users. </li></ul><ul><li>Promoting communication within the MDT, involving family and carers </li></ul><ul><li>Effective referral system </li></ul><ul><li>Development of junior staff </li></ul><ul><li>Providing a stimulating environment </li></ul><ul><li>Undertaking evidence based practice </li></ul><ul><li>Team working </li></ul>Staff Nurse is the team leader
  10. 10. <ul><li>2) Individual assessment. </li></ul><ul><li>3) Appropriate individual treatment: </li></ul><ul><ul><li>Stroke rehabilitation (as well as O.P. Physiotherapy) </li></ul></ul><ul><ul><li>Maintenance of progressive Neurological conditions (eg. Parkinsons, M.S.) </li></ul></ul><ul><ul><li>Balance re-education </li></ul></ul><ul><ul><li>Gait re-education and progression of walking aids. </li></ul></ul><ul><ul><li>Specific strengthening and mobilising exercises. </li></ul></ul><ul><ul><li>Pain relief (I.F.T. and heat) and Wax </li></ul></ul><ul><li>4) Attend M.D.T. meetings. </li></ul><ul><li>5) Re-assessments - and refer to O.P. Physiotherapy if necessary. </li></ul>At present we are unable to refer to Community Physiotherapists or Re-ablement as this is not available in this area
  11. 11. <ul><li>Individual Treatment Programme including </li></ul><ul><li>Kitchen assessment and practice </li></ul><ul><li>Leisure activities </li></ul><ul><li>Home visits </li></ul><ul><li>Lead planning of the group sessions in the afternoons which includes </li></ul><ul><li> sessions of: </li></ul><ul><li>Fall prevention </li></ul><ul><li>Creative activities </li></ul><ul><li>Quizzes </li></ul><ul><li>Outside Speakers </li></ul><ul><li>Leisure activities – such as gardening </li></ul>The activities are all planned following the users completing leisure activity check lists so that the programme is suitable and appropriate to the service user.
  12. 12. Role of the Healthcare assistant <ul><li>Planning preparation of environment for the day hospital service users. </li></ul><ul><li>Assisting clients with mobility </li></ul><ul><li>Rehabilitation under guidance of MDT </li></ul><ul><li>Providing stimulation and orientation. </li></ul><ul><li>Assist qualified nurse with baseline observations and glucose levels. </li></ul><ul><li>Assist with activities of daily living </li></ul>