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IPE tutorial - Coggle Diagram
IPE tutorial
re enablement facilities
Meals on wheels
age action
educate family
smoking cessation
COPD outreach
Primary care physio (pt can travel to primary care clinic for ongoing rehab)
Community intervention team
ICPOP (ambulatory outreach team)
Pulmonary rehab
Who might we refer to and why?
Dietician
look at diet texture
supplementation
MUST tool
risk of malnutrition
SLT
Swallow assessment (risk of aspiration
Communication tools while on BIPAP
Smoking cessation
Respiratory Clinical nurse specialists
Tissue viability nurse specialist
PHN on discharge
Discharge Co-ordinator
Role of disciplines
Nursing
ID other sources of infection i.e. urine sampe
risk assess (neuro chart / GCS, falls risk, weight, MUST
review vitals (sp02, NEWS, Sepsis
Fluid balance
Mobilisation (skin bundle, risk of pressure ulcer, Braden / Waterlow
Oral care (nebs)
Diet
Assess Falls risk
Physio
Subjective exam (cough, SOB, Wheeze, Pain), Shx (type of accomodation, stairs, steps, rails, ADL's etc)
Objective exam (transfers, mobility, chest assessment (auscultation, chest expansion, cough strength), falls assessment (? tinetti outcome assessment)
interest in smoking cessation
ID previous physio intervention
OT
review any previous physio notes,
initial interview (Identify baseline norms) Functional norms for patient, mood, cognitive impairment, hearing, sight, fatigue)
Physical assessment
4AT (could be completed by any profession, need to know patients baseline cognition etc)
rapid screen test for delirium
review Frailty (rockwood frailty scale)
Assess for requirement for pressure sore management
Review Falls risk: patient may need falls alarm
Review transfers and functional mobility
When more well, review ADL's
may be opportunity for joint assessments i.e. joint gait assessment, transfer assessments, review of skin integrity etc)
Interventions
Nursing
Encourage mobilisation, when appropriate
Refer to clinical nurse specialist
Monitor skin bundle
ongoing monitoring of skin integrity / skin bundle
+/- barrier creams, positioning, pressure relieving devices (air mattress, Prevlon boots etc)
Assist with washing and dressing
Encourage eating
Sputum sample
Refer to smoking cessation
Monitor O2 Therapy
Monitor catheter
OT
Prescribe appropriate seating (high back, feet on ground, ? pressure relieving cushion)
Advice on seating e.g. fatigue management , consider chair that may be height adjustable or tilt to address issues with pelvic tilt)
Progressive Washing and dressing practice / rehab
Transfers practive, include manual handling strategies as appropriate
Energy conservation strategies during functional tasks
Physio
Sputum clearance techniques
Active cycle of breathing technique (mix of deep breathing and huffing)
Adjuncts (PEP / Flutter)
Educate patients regarding self management (inhaler technique, pacing, positioning for SOB management)
functional rehab (transfer practice, gait re - education)
Address acquired weakness
prescribe bed / chair based exercises
Provide mobility aids/ use manual handling equipment as required
Discuss potential nebs with medics (carbocyctine, saline) may align chest clearance techniques with meds)
give advice on BIPAP settings
Factors that effect safe discharge home
Physio
check functional capacity is suitable for home
ensure transfer functionality appropriate for home
Nursing
Organise transport home
link with d/c co-ordinator if required
Organise home O2 through resp nurse
check if pt needs any PHN / home help (may need to link with OT re: ADL assessment
ensure catheter is removed where possible
ensure lines and attachments removed