THIS PRESENTATION INCLUDES DEFINITION, INDICATIONS, CONTRAINDICATIONS, AIMS, GOALS, PR TEAM, AND COMPONENTS OF THE PULMONARY REHABILITATION. THIS PRESENTATION IS MADE ONLY FOR LEARNING AND GUIDANCE PURPOSE.
DEFINITION
Pulmonary rehabilitation is a restorative and preventive process for patients with chronic respiratory disease. It is defined as a “multi-disciplinary program of care for patients with chronic respiratory impairment that is individually tailored and designed to optimize physical and social performance and autonomy.”
Consequences of Respiratory Disease
Peripheral Muscle dysfunction
Respiratory muscle dysfunction
Nutritional abnormalities
Cardiac impairment
Skeletal disease
Sensory defects
Psychosocial dysfunction
ASSESSMENT
At the start of the pulmonary rehabilitation program, your medical history will be obtained and your fitness level will be assessed, usually by doing a walking test. From this assessment, an exercise program will be set for you at your fitness level.
Another assessment will be completed at the end of the program.
Chart Review
Patient examination
medical history
Family history
Social history
Signs & symptoms
Patient Interview (1)Use of tobacco, alcohol, and nonprescription drugs
• Usual activity level, including employment, recreation, and home
• Regularity of exercise, including availability of equipment at home)
2)The nutritional evaluation should include the following:
• Weight• Height• Calculation of BMI• Documentation of recent weight change
Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient tailored therapies that include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors”
Pulmonary rehabilitation is the use of exercise, education, and behavioral intervention to improve how people with chronic lung disease function in daily life and to enhance their quality of life. Pulmonary rehabilitation is a program designed for people who have chronic lung disease.
THIS PRESENTATION INCLUDES DEFINITION, INDICATIONS, CONTRAINDICATIONS, AIMS, GOALS, PR TEAM, AND COMPONENTS OF THE PULMONARY REHABILITATION. THIS PRESENTATION IS MADE ONLY FOR LEARNING AND GUIDANCE PURPOSE.
DEFINITION
Pulmonary rehabilitation is a restorative and preventive process for patients with chronic respiratory disease. It is defined as a “multi-disciplinary program of care for patients with chronic respiratory impairment that is individually tailored and designed to optimize physical and social performance and autonomy.”
Consequences of Respiratory Disease
Peripheral Muscle dysfunction
Respiratory muscle dysfunction
Nutritional abnormalities
Cardiac impairment
Skeletal disease
Sensory defects
Psychosocial dysfunction
ASSESSMENT
At the start of the pulmonary rehabilitation program, your medical history will be obtained and your fitness level will be assessed, usually by doing a walking test. From this assessment, an exercise program will be set for you at your fitness level.
Another assessment will be completed at the end of the program.
Chart Review
Patient examination
medical history
Family history
Social history
Signs & symptoms
Patient Interview (1)Use of tobacco, alcohol, and nonprescription drugs
• Usual activity level, including employment, recreation, and home
• Regularity of exercise, including availability of equipment at home)
2)The nutritional evaluation should include the following:
• Weight• Height• Calculation of BMI• Documentation of recent weight change
Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient tailored therapies that include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors”
Pulmonary rehabilitation is the use of exercise, education, and behavioral intervention to improve how people with chronic lung disease function in daily life and to enhance their quality of life. Pulmonary rehabilitation is a program designed for people who have chronic lung disease.
This is a journal article critique on a research which is entitled " INSPIRATORY MUSCLE TRAINING TO ENHANCE RECOVERY FROM MECHANICAL VENTILATION; A RANDOMIZED TRIAL"
Patient guide: What should I expect from pulmonary rehabilitation?NHS Improvement
This guide explains the concept of PR and how to get referred to a programme, plus what happens at the classes and after the programme finishes
Patient guide December 2012
Cardiac Rehabilitation has been defined as:
Coordinated, multifaceted interventions designed to optimize a cardiac patient’s physical, psychological, and social functioning so that they may, by their own efforts, resume and maintain as normal a place as possible in the community
This is a journal article critique on a research which is entitled " INSPIRATORY MUSCLE TRAINING TO ENHANCE RECOVERY FROM MECHANICAL VENTILATION; A RANDOMIZED TRIAL"
Patient guide: What should I expect from pulmonary rehabilitation?NHS Improvement
This guide explains the concept of PR and how to get referred to a programme, plus what happens at the classes and after the programme finishes
Patient guide December 2012
Cardiac Rehabilitation has been defined as:
Coordinated, multifaceted interventions designed to optimize a cardiac patient’s physical, psychological, and social functioning so that they may, by their own efforts, resume and maintain as normal a place as possible in the community
You’ve heard the expression “Army Strong”? In fact, all the military branches need strong troops—and cardiovascular
(sometimes called aerobic) fitness is important for optimal military performance. Ruck marches, PT runs, combat
swimming, and diving all require especially strong, efficient heart and lung capacity.
Best Exercises for Health and Weight Losscheriftalal
Think a single type of exercise will take care of all your
needs? These tips can help you build a comprehensive
fitness plan to improve your health and waistline.
Best exercises for health and weight losscheriftalal
Think a single type of exercise will take care of all your
needs? These tips can help you build a comprehensive
fitness plan to improve your health and waistline.
Tips for physiotherapist how to become a physiotherapistNoman Ahmed
Physiotherapy is a treatment procedure where a patient’s mobility and function are restored through prevention, rehabilitation and different fitness activities. Physiotherapists help a patient to speed up their recovery. To kickstart your career as a Physiotherapist, you might need a hands-on approach to promote helping others through movement, reducing pain and restoring function. A passion for helping out people through an understanding of muscle, bone, and ligament structure and making a commitment to patient health will be inspiring fuel to become a Physiotherapist.
For more detail click here: https://www.alphaacademy.org/tips-for-physiotherapist-how-to-become-a-physiotherapist/
20221112 Over the Horizon Challenges to GP partnership.pptxamirhannan
Talk delivered at the British Association of Pakistani General Practitioners in Nottingham 12th November 2022 exploring the Partnership model and what can we do to improve things
20220314 patient access to records and Understanding from April 2022amirhannan
This was a zoom call done on 14th March 2022 detailing why we at Haughton Thornley Medical Centres (HTMC) started to give patients full access to their GP electronic health record and understanding in 2004, what we did and still do, how we did it, what the challenges are that we are facing now in General Practice, the importance of the Partnership of Trust, the practice-based web portal www.htmc.co.uk, how we support understanding by sign-posting to trusted information from the practice, our explicit consent process, what we mean by Responsible Sharing, a description of the consent process that all patients wanting access to their records must complete, some dos and dont's when writing in the notes, how to deal with 3rd Party data (not just redaction), what other providers can do to help when sending notes to GP surgeries including do you need to send everything?, an introduction to the Information Governance strategy for Greater Manchester Combined Authority that has recently been ratified and finally a dedication to Ingrid Brindle who recently passed away and was the Chair of Haughton Thornley Patient Participation Group
20220314 Patient access to records and understanding from April 2022amirhannan
This was a zoom call done on 14th March 2022 detailing why we at Haughton Thornley Medical Centres (HTMC) started to give patients full access to their GP electronic health record and understanding in 2004, what we did and still do, how we did it, what the challenges are that we are facing now in General Practice, the importance of the Partnership of Trust, the practice-based web portal www.htmc.co.uk, how we support understanding by sign-posting to trusted information from the practice, our explicit consent process, what we mean by Responsible Sharing, a description of the consent process that all patients wanting access to their records must complete, some dos and dont's when writing in the notes, how to deal with 3rd Party data (not just redaction), what other providers can do to help when sending notes to GP surgeries including do you need to send everything?, an introduction to the Information Governance strategy for Greater Manchester Combined Authority that has recently been ratified and finally a dedication to Ingrid Brindle who recently passed away and was the Chair of Haughton Thornley Patient Participation Group
Dr Krishna Kasaraneni - Primary Care Networksamirhannan
Dr Krishna Kasaraneni talks about the challenges and opportunities of Primary Care Networks and what this means for General Practice and the wider healthcare system
20190712 Health Records Citizens and Genes - Amir Hannanamirhannan
Dr Amir Hannan introduces the conference and its aims with a story from his practice about a couple wanting access to their electronic health records, sharing the latest data from the GP survey and what progress we still need to make to enable many more people to be able to access their electronic health records and gain a better understanding of their healthcare needs
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
2. • Provides Pulmonary Rehabilitation Programmes
in clinics, leisure centres and at home.
• Also provides home physiotherapy visits for all
conditions including follow up Total Hip & Knee
surgery
2
Adult Community Physiotherapy
Service
3. • Approx. 40 referrals per month
• Is usually held at two venues – Ashton &
Glossop
• Sometimes arranged & provided at other
locations in Tameside & Glossop
• Can be provided in own homes if appropriate
4. …can improve your muscle strength and
endurance, so you can use the oxygen you
breathe more efficiently
…. Can improve your general fitness and help you
to cope better with feeling breathless.
.... Can improve your quality of life as you are able
to do more.
Tameside and Glossop accept referrals for
respiratory conditions other than COPD
5. Any Healthcare Professional can refer
you to our programme using our
referral form
If you have been in Hospital for an
exacerbation or flare up of your COPD
And/or
You feel impaired by a your respiratory
disorder…
◦ ….you may benefit from our Programme
6. Pulmonary rehabilitation leads to
◦ improvements in quality of life
◦ Improvement in exercise capacity
◦ reduces breathlessness
◦ N.B Pulmonary Rehabilitation may not be
suitable for all patients and conditions. The
doctor or nurse referring may indicate any
conditions on the referral form.
7. We will send you a letter when we receive the
referral – please call us to opt in!
Assessment appointment then offered
Attend the course twice a week for 6 weeks
Sessions usually 2 hours in duration
Encouraged to continue with exercises at home during
the programme
Reassessment appointment
◦ Encouraged to continue with exercises and use new
knowledge to manage your breathing condition
◦ May refer you to other services to continue with
exercises and management
8. Exercise Borg
Sit To Stand
Pull Ups
Step Ups
Bicep Curls
Bike
Arm Abductions
Walk
At each session we dedicate the first hour to exercises that
increase strength & stamina-
9. Education Sessions
Exercise and breathing
conditions
Live active info session
Breathing Control talk
Breathing Control quiz
Healthy Eating
Anxiety management, Goal
setting etc
Inhalers & Self management plan
Planning Pacing and
prioritising
Inhaler tech
Pharmacist
Living with a resp Condition
Living with a respiratory
condition Quiz
Relaxation
Pulmonary Rehabilitation
The second hour to one of our education talks listed
below…..
Pulmonary rehabilitation
Pulmonary rehabilitation should be made available to all appropriate people with COPD including those who have had a recent hospitalisation for an acute exacerbation.
Pulmonary rehabilitation should be offered to all patients who consider themselves functionally disabled by COPD (usually MRC grade 3 and above). Pulmonary rehabilitation is not suitable for patients who are unable to walk, have unstable angina or who have had a recent myocardial infarction.
For pulmonary rehabilitation programmes to be effective, and to improve concordance, they should be held at times that suit patients, and in buildings that are easy for patients to get to and have good access for people with disabilities. Places should be available within a reasonable time of referral.
Pulmonary rehabilitation programmes should include multicomponent, multidisciplinary interventions, which are tailored to the individual patient's needs. The rehabilitation process should incorporate a programme of physical training, disease education, nutritional, psychological and behavioural intervention.
Patients should be made aware of the benefits of pulmonary rehabilitation and the commitment required to gain these.
Quality standards
The following quality statements are relevant to this part of the interactive flowchart.
Chronic obstructive pulmonary disease in adults quality standard4Pulmonary rehabilitation for stable COPD and exercise limitation
5Pulmonary rehabilitation after an acute exacerbation
Sources
The NICE guidance that was used to create this part of the interactive flowchart.
Chronic obstructive pulmonary disease in over 16s: diagnosis and management (2010) NICE guideline CG101
