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Subject: Patient Education POC |
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1. Topic-
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Safe Assisted Wheelchair Transfers & Incorporation of Standing Activity
at Home. |
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2. Content-
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Training designed to teach safe, proper body mechanics assisted
transfer training to caretaker for a 14 yr old child with athetoid
CP s/p spinal instrumentation who once was able to independently transfer
into stander and now requires assistance. To assist with adherence
issues of adding this to family's daily/weekly routines at home. Precautions
to standing and transfers will be presented and personalized towards
patient and aging caregiver. |
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3. Goals: Aims/Outcomes-
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1.To independently perform a safe (including proper body mechanics),
assisted wheelchair to stander patient transfer at home.
2. Adherence by patient and caregiver to a standing program at home.
3. Understand standing precautions.
4. Become aware of each person's autonomy and daily rhythms. |
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4. Objectives-
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1.Recognize and identify 3 main barriers to performing, at home,
wheelchair to stander transfers.
2.Describe 4 out of 5 reasons to discontinue standing program.
3.Discriminate 3 reasons when its not safe to perform transfer or
engage in standing activities.
4. Decide the best 3 times to add standing activity to weekly home
schedule.
5. Adhere to set schedule 50% of the time.
6. Recall wheelchair and stander setup prior to transfer training.
7. Perform setup, and use proper body mechanics during assisted transfer
from wheelchair to stander, independently. |
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5. Materials and Aids-
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Power point presentation viewed via clinic laptop and downloaded
to patients I pad. Written handouts on importance of standing/changing
positions for a wheelchair user, precautions, activity adherence form.
Pre and post-tests (family and patient empowerment questionnaires,
instruction evaluation, transfer checklist). |
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6. Procedures/Methods-
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A. Introduction-
1.Ask patient and caretaker to write (journal) down a typical 'day
in the life'. Fill out empowerment questionnaires. (10min.) (obj.
# 1,4,5).
2.Give handout on importance of standing and changing positions for
wheelchair users, discuss and personalize the handout. (5min). (obj.
#3,5).
3. Give out written standing precaution list and personalize it by
asking patient and caretaker to add to it, discus issues such as caretakers
health at times can interfere with safe transfers to the stander.
(5 min.) (obj. # 2).
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B. Development-
1.Watch PP with embedded video on body mechanics demo, equipment
setup demo, patient transfer demo. (15 min.) (obj. # 6,7)
2.Instructor demonstration of setup and transfer with patient. (5
min.) (obj. # 6,7)
3.Instructor demonstration of setup and transfer with caregiver as
the patient.(5 min.) (obj. # 6,7). |
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C. Practice-
Setting: Clinic-quit room.
1.Role playing: Caretaker as patient in wc (clinics spare transport
wc). Patient verbally directs caretaker and instructor through steps
of safe transfer. (5 min.) (obj. # 6,7).
2.Role playing: Patient in wc. Caretaker verbally directs instructor
and patient through steps of safe transfer. (5 min.) (obj. # 6,7).
3.Patient and caretaker practice transfers with supervision. (5 min.)
(obj. 6,7). |
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D. Independent Practice-
1.Patient and caretaker continue to practice.
2.Instructor makes at least 2 video recordings of transfer practice
using patient's I pad.
(5-10 min.) (obj. #6,7). |
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E. Accommodations (Differentiated Instruction)-
Total time needed: 1.5 hours in clinic. Home visit 1 hour.
1.For the older adult learner: quiet room, adequate lighting, ample
room for 3 people, equipment, including table for laptop viewing.
Large font on PP and handouts. Written instructions and video recording
to assist memory.
2. Safety items: shoe and braces for child, shoes suggested for adult.
Gait belt required.
3. Language to match literacy level/grade level.
4.Media presented to match adult learner and teenage interests (use
of technology-Ipad).
5.Additional practice session at home to evaluate generalization of
skills and assess environment which may need adjusting. |
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F. Checking for understanding-
1.Patient and caretaker recite precautions to standing. (2 min).
(obj. #2,3).
2.Self-Critique of transfer video on Ipad. Both patient and caretaker
will take turns judging their performance, noting strengths and things
to improve upon. (3 min). (obj. # 6)
3. Use transfer training/body mechanics checklist to assess performance.
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G. Closure-
1.Discussion: re-emphasis the importance of standing. (1min.).
2.Review the 'day in the life' scenarios and discuss. (5 min.).
3. Establish times to incorporate standing in daily/weekly routines
considering each person's schedule and autonomy and commit to a schedule.
(2 min.).
6. Patient and caretaker to fill out instruction feedback forms. (2
min.).
7. 2 weeks later, repeat family and patient empowerment questionnaires
(filled out at home and brought in during next clinic visit). |
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7. Evaluation-
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1.Home visit 2 weeks later to assess progress, adherence, generalization
of skills and environment, make modifications if needed.
2.Review patient/caretaker instruction feedback.
3. Review patient and caretaker empowerment pre and post test scores,
feedback to patient and caretaker on changes if any.
4. Re-assess if refresher training is necessary. |
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8. Teacher Reflection-
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1. Sequencing of training effective?
2. Critique Power Point for clarity
3. Did materials match the learners levels, interests, cultural aspects,
generational aspects, family needs. |
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