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.

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.

Hospital Wards

GP

Consultant

Primary Care Team

District Nurse

Social Services

Referrals from

Example of Conditions Seen In Day Hospital

Orthopaedic Rheumatoid ArthritisOsteo-ArthritisTotal hip replacementsFractures

Neurological C.V.AM.S. ParkinsonsCognitive Problems

Patients with a history of Falls.

General poor mobility.

Cardiac and Chest conditions.

Multi-Disciplinary Team

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.

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'.

The Role of Occupational Therapy

Full assessment of the service users ability focusing on

Environment

Occupations

Performance

Group work where appropriate – purposeful activities

The Role of the Nursing team.

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

Staff Nurse is the team leader

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

Individual Treatment Programme includingKitchen assessment and practiceLeisure activities

Home visits

Lead planning of the group sessions in the afternoons which includes sessions of:

Fall preventionCreative activitiesQuizzesOutside 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.

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