Question

Gertrude - 92 year old woman - bilateral TKR, lives in 2nd floor apartment/duplex, caregiver for “elderly” neighbor who lives downstairs, avid cyclist/gardener, supportive grandchildren, prepared meals/stocked freezer prior to surgery, no complaints of pain, sitting at EOB in acute care hospital 2nd day post-op. Got a call from the RN on the ortho floor to alert you of case.

1. Where does the referral come from?

2. What type of assessments (screening, evaluation etc) did they perform or do they need to perform?

3. What are the members of the interdisciplinary team?

4. What is the role of OT/OTA in establishing treatment plan (including level/frequency of supervision)?

Answer 1

ANSWER 1: referral come from ACUTE CARE HOSPITAL and the EOB department.

ANSWER 2: As the patient has bilateral TKR so she needs assessment and investigation:

• physical examination
• overall health checkup
• X rays
• serological test.
• MRI and CT scan
• knee fluid aspiration

ANSWER 3: THE MEMBERS INCLUDE IN TKR ARE:

• Ortho surgeon
• doctors,
• doctor (physician) assistants,
• OT team
• radiation and lab department
• OT technician
• nurses,
• nursing assistants
• social workers,
• case managers,
• physical and occupational therapists.

ANSWER 4 : ROLE OF OTA ( occupational therapist ) ARE:

• Treat patients by using therapeutic and self-care activities designed to improve function under the direction of the occupational therapist (OTR)
• Monitor a patient’s activities to make sure they are performing them correctly and to offer encouragement
• Document patient’s weekly progress in appropriate records
• Instruct patients, their families, and any other caregivers in skills and techniques of the patient’s treatment program, under supervision of the Occupational Therapist
• Occupational therapy’s role in fall prevention is multi-factorial and includes physical interventions, environmental modifications, and behavioral adaptations
• these should include adaptating or modifying the home environment to mitigate identified hazards and facilitate greater participation in daily activities, exercise (particularly balance, strength, and gait training), and promotion of the safe performance of daily activities.
• The OTA may select and modify the therapeutic activities as long as they are within the client’s goals. The OT is responsible for supervising the OTA and conducting regular meetings to reevaluate treatment and guide the client’s treatment.
• The OTA may provide the client with appropriate materials and resources (such as referral to community programs) for post-discharge support from treatment.
• SUPERVISION starts from the admission of the patient in hospital by OTA. He has to start his work from the very begining and daily without a fail.