Montgomery County Infirmary Day Hospital

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Montgomery County InfirmaryDay Hospital

• Operational Procedure
• Mondays and Thursdays
• Evidence Based
• Up to 8 users (depending on wheelchair
  access)
• Full multi-disciplinary approach
• 6 Week rehab programme
• All users reviewed by MDT weekly.

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Day Hospital Good Practice

• The National Service Framework for Older People
  focuses on
• Providing person-centred care promoting older
  people's health and independence.
• Intermediate care
• Aim to provide integrated services to promote
  faster recovery from illness, prevent unnecessary
  acute hospital admissions, support timely
  discharge and maximise independent living.

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Referrals from

• Hospital Wards
• GP
• Consultant
• Primary Care Team
• District Nurse
• Social Services

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Example of Conditions Seen In Day Hospital

• Orthopaedic
• Rheumatoid Arthritis
• Osteo-Arthritis
• Total hip replacements
• Fractures
• Neurological
• C.V.A
• M.S.
• Parkinsons
• Cognitive Problems
• Patients with a history of Falls.
• General poor mobility.
• Cardiac and Chest conditions.

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Multi-Disciplinary Team
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Improvements for the future

• Transport.
• Medical Cover.
• Audit process.
• Opening a third day.
• Improve Profile.
• Improve physical environment.
• Develop facility user group for the venue.

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The Role of Physiotherapy

• 1) Maintenance exercises for half an hour at each
  session given by a Physiotherapist Technical
  Instructor III.
• 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'.

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The Role of Occupational Therapy

• Full assessment of the service users ability
  focusing on
• Environment
• Occupations
• Performance
• Group work where appropriate purposeful
  activities

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The Role of the Nursing team.
Staff Nurse is the team leader

• Ongoing assessment of service users.
• Promoting communication within the MDT, involving
  family and carers
• Effective referral system
• Development of junior staff
• Providing a stimulating environment
• Undertaking evidence based practice
• Team working

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• 2) Individual assessment.
• 3) Appropriate individual treatment
• Stroke rehabilitation (as well as O.P.
  Physiotherapy)
• Maintenance of progressive Neurological
  conditions (eg. Parkinsons, M.S.)
• Balance re-education
• Gait re-education and progression of walking
  aids.
• Specific strengthening and mobilising exercises.
• Pain relief (I.F.T. and heat) and Wax
• 4) Attend M.D.T. meetings.
• 5) Re-assessments - and refer to O.P.
  Physiotherapy if necessary.

At present we are unable to refer to Community
Physiotherapists or Re-ablement as this is not
available in this area
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• Individual Treatment Programme including
• Kitchen assessment and practice
• Leisure activities
• Home visits
• Lead planning of the group sessions in the
  afternoons which includes
• sessions of
• Fall prevention
• Creative activities
• Quizzes
• Outside Speakers
• Leisure activities such as gardening

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.
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Role of the Healthcare assistant

• Planning preparation of environment for the
  day hospital service users.
• Assisting clients with mobility
• Rehabilitation under guidance of MDT
• Providing stimulation and orientation.
• Assist qualified nurse with baseline
  observations and glucose levels.
• Assist with activities of daily living