MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'acute care'. Sat, 03 Sep 2011 02:55:15 +0100 http://www.medworm.com/index.php?rid=5130666&cid=t_226328_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F15%2Ftransforming-community-services-transformational-guides%2F Scan or click to download 'Transforming Community Services: Ambition, Action, Achievement Transforming Rehabilitation Services' Title: Transforming Community Services: Ambition, Action, Achievement Transforming Rehabilitation Services The Skinny: Guide for use by frontline clinicians, commissioners and providers a based around a framework of ambition, action and achievement: Clearly setting out your ambition Taking action to deliver the ambition using the best available evidence (high impact changes) Demonstrating and measuring achievement (using quality indicators) The guidance also includes six transformational attributes which practitioners and teams need to demonstrate in order to meet the requirements of the high performing practitioner-partner-leader roles. Publisher: DH ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5130666 Mon, 15 Aug 2011 08:09:01 +0100 5130666 http://www.medworm.com/index.php?rid=4872503&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2011%2F05%2Frandom-thoughts-of-insomniac-ot.html Can't sleep and it's before six a.m. on a day I have off. Awesome. But here are some of my thoughts on things that have been happening recently.First off, and rather obviously to anyone who has been with me in person, I am under a lot of stress lately. For an OT, I certainly exhibit a lot of poor patterns in dealing with stress when it gets to a high level. I retreat into comfortable things, procrastinate on other tasks (hello blog), and have a thousand questions running through my head all the time. I'm also increasingly more distracted, which feeds back into the procrastination. I've been waking up around 5 for the past several weeks, but for the most part I just stay in bed in a semi-dozing anxiety spree until the alarm actually goes off. Very stressed. Likely to get worse before it get... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=4872503 Fri, 27 May 2011 09:49:00 +0100 4872503 http://www.medworm.com/index.php?rid=4549947&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2011%2F03%2Fwho-gets-to-go-home-3-short-case.html One of my biggest responsibilities from a hospital standpoint is providing discharge recommendations. Hospital stays are notoriously short and it is a priority of the case management staff and doctors to determine discharge location, for which they recruit OTs and PTs to assist. But determining discharge readiness and placement is more of an art than a science, no flow chart can be easily developed to guide a novice through the process. So here are 3 case examples of similar patients and situations, whom I saw on the same day, and my rationale for their discharge locations. All three of the individuals were over 80 years old, with moderate dementia. They were all admitted with altered mental status caused by pneumonia and concurrent urinary tract infections. They were all living with famil... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=4549947 Fri, 04 Mar 2011 23:58:00 +0100 4549947 http://www.medworm.com/index.php?rid=4361322&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2011%2F01%2Fadventures-in-serial-casting-part-ii.html This article listed known indicators and contraindications to tx along with the level of evidence for each, however, a confounding variable to this information is that some factors that were exclusion criteria for some studies were inclusion criteria for others. Given the wide variability, comparison of RCTs was unable to be performed in this review. Timing is a decision that has wide variability in each study. Saracco Preissner states (but does not reference) that there is no indication how long after injury casting is effective or when a person is too far removed from injury to benefit. It is stated that "most" advocate casting sooner for increased effectiveness, but again this is unreferenced. Length of time wearing the cast was highly variable as well, with the most relevant results be... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=4361322 Tue, 18 Jan 2011 02:41:00 +0100 4361322 http://www.medworm.com/index.php?rid=4322705&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2011%2F01%2Flooking-forward-to-2011.html Goodbye 2010. I don't have the energy for a LONG year in review, but...I will touch on a few ups and downs of the year.Firstly, let me thank all readers. I really appreciate the comments (that aren't plugging fake universities or spam in other languages) because I like to see that there has been an effect from my efforts. I don't look at the stats often, but glancing today, I see that since I started tracking in 2008, pageloads have increased by 20,000- more than 300%! WOW! And the cross-posts in the sister blog on OT Connections have brought in an extra 50-350 viewers each time, with one anomaly (thank you 1-minute update). It's really exciting to see how this blog has grown and spread, and gets me thinking about some plans for the future (more on that later). So a BIG THANK YOU to each o... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=4322705 Sat, 08 Jan 2011 03:00:00 +0100 4322705 http://www.medworm.com/index.php?rid=4281558&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F12%2Fits-christmas-miracle.html So at rounds today, I was rushing in late and trying to get my computer set up to look things up. They had already started on the first patient (not one of mine) and wanted to know if OT and PT agreed on discharge plans. I asked for a minute to get everything settled, and in that time, the resident looked up the notes and had the answers. I was shocked! I said, "wow, I didn't think you guys ever read our notes!" and got rousing responses from around the table (resident, PA, social work and case management) who stated that they DO read them (even if it's just the summary paragraph at the bottom). It was like a present with a big red bow. (Source: Occupational Therapy Notes) Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=4281558 Thu, 23 Dec 2010 00:44:00 +0100 4281558 http://www.medworm.com/index.php?rid=4001826&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F09%2Fneuro-floor-humor.html Saw this was today's Crankshaft comic and couldn't help cracking a smile. If you come into a hospital with a headache, be prepared for neuro checks Q4!Working on the neuro floor means that I have to suppress my natural propensity to be a worrywart- I start thinking about word finding problems, clumsiness/tripping, and hope that I'm not ignoring signs of a tumor or aneurysm! It's hard to listen to all my patients' stories of symptom onset w/o getting a little paranoid.Just finished a biography of neurosurgeon Keith Black who has very compelling personal narrative and his life story is certainly an object lesson in encouraging the learning interests of your children. He described that his parents got him a dissection kit and chemistry set from a young age and encouraged curiosity in a number... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=4001826 Sat, 25 Sep 2010 23:06:00 +0100 4001826 http://www.medworm.com/index.php?rid=3868933&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F08%2Ftips.html So this is just a very brief thought I had over dinner tonight. OT is by definition a service profession, we are paid to provide a service to others. Waitstaff who provide good service receive (in theory) increased compensation from their customers, and those who provide subpar service are not as well compensated. However, OT is basically "flat-rate" pay, with some increased compensation for experience, but no financial recognition of competence or above average performance. (at least in my experience- is anyone being compensated for specialty certification or other signs of advanced practice??) The only fiscally-related judgment of competence is whether you continue to be employed. We've had a lot of cuts at our hospital lately, particularly in the employee recognition department, and I t... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3868933 Mon, 16 Aug 2010 01:28:00 +0100 3868933 http://www.medworm.com/index.php?rid=3833587&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F08%2Fadventures-in-serial-casting-part-i.html Image from BBCI recently worked on serial casts for a patient with brain injury to improve PROM and tone of the ankle. Here is the case study which will be followed by an entry of some of my own research into the topic.Pt. is a ~60 y.o. female s/p multiple CVAs who was referred to OT for splinting assessment while in the neuro ICU. Pt. was connected to typical ICU monitors plus arterial line, was breathing comfortably on room air. She presents at a Rancho 3-4 level, depending on the day. Her L foot demonstrates increased tone, plantarflexion, and inversion. I was not able to passively stretch her ankle into neutral position and she demonstrated no AROM. I did not splint her per normal protocols (pre-fabricated multi-podus boot or individualized foot boot constructed from splinting material... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3833587 Sat, 07 Aug 2010 13:21:00 +0100 3833587 http://www.medworm.com/index.php?rid=3808858&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F08%2Fbye-bye-july.html So July should probably just be labeled the month that got out of control.I had an additional 5 days off on top of regular weekends, (I did work a holiday) and had lots of days switched from normal schedule. It makes for an interesting new rotation when life is all topsy-turvy. I'm not sure that my coworkers would say the same, but don't worry buds I'll be back with a vengeance in August.So I switched to neuro coming off my vacation, had some personal issues come up mid-month and then capped off by entertaining friends last week. In addition to trying to make some changes in my personal life and reading extra novels, that has made less time to update on here. (sidenote- I read The Eyre Affair by Jasper Fforde and am completely hooked on the Thursday Next novels) But there's been plenty of ... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3808858 Mon, 02 Aug 2010 01:20:00 +0100 3808858 http://www.medworm.com/index.php?rid=3621976&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F06%2Fyikes.html Holy cow... it's been almost a month since conference. Where has the time gone? I would say that I want to go back... but the time since the conference has been pretty rough as evidenced by the scarce/nonexistent updates. And at such a terrible time, after handing out those nice business cards haha. So, some brief updates. - I took no time off after the conference, and that was not smart. Next year, I take a day to recuperate and absorb info. I still need to print out handouts- both for sessions that I attended and others that looked interesting- and then compile my notes. - I went to some great sessions and met more "famous" OTs than ever before. I think that the quality of presentations was very high this year. - I hope to get a submission in so that I might present next year in Phila... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3621976 Wed, 02 Jun 2010 01:14:00 +0100 3621976 http://www.medworm.com/index.php?rid=3542905&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F05%2Freflection-of-week.html A few reflections from the past week, which has been very hard.First off, I would just like to say that the AOTA conference was great, but I was very foolish to stay for the entire time and then head right back to work the next day. Because as fun as it is, it is also exhausting, and I didn't get any time to process the new information before heading right back into my crazy daily life. I was looking forward to today, my day off, to do some of that. However, I neglected to remember that we're traveling AGAIN this weekend. So that has added to the stress, and I won't really get a "me day" to process stuff until next Saturday. Very difficult on a personal level, and also because I would like to do some recaps about the cool sessions I attended and to give a glimpse of conference awesomeness ... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3542905 Fri, 07 May 2010 14:52:00 +0100 3542905 http://www.medworm.com/index.php?rid=3524467&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F05%2Falmost-over.html Our conference time is almost at an end...Saturday was a long day, but still had some highlights. I got some good videos and pictures, which will all be uploaded to the OT Connections Conference Gallery either at the airport or Monday after I get home. So if you're not already on OT Connections... get there! I have been talking especially to acute care practitioners at conference trying to get them involved w/ OTC because I feel that we are very isolated in our practice and need to connect so we can determine what is best practice and what is just "facility tradition." It's hard after conference to maintain the same energy and excitement, and I feel that using OTC can help keep that feeling alive longer in the face of everyday work.Time to go to my last workshop... these Sunday sessions ar... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3524467 Sun, 02 May 2010 11:12:00 +0100 3524467 http://www.medworm.com/index.php?rid=3456900&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F04%2Fwelcome-to-first-ever-otnotes-podcast.html Welcome to the First-Ever OTNotes podcast! Featuring Kelly Casey, Occupational Therapist from The Johns Hopkins Hospital in Baltimore, who is presenting multiple topics at the AOTA Conference. (Get it? That's why we're using the special "speakers-only" badge for this entry) The audio is 22 minutes, please forgive the technical quality and instead focus on the awesome discussion points offered. Here are some links to helpful information in case you're not taking notes: Kelly's Topics: Thu, Apr 29, 9:00 - 10:30 AM Short Course 105 Culture Change In Acute Care: An Interdisciplinary Approach to Creating Respect For Therapies Thu, Apr 29, 1:00 - 3:00 PM Poster 207 Movement Towards The Centennial Vision: Steps Of Post-professional And Entry Level OTDs Fri, Apr 30, 2:00 - 3:... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3456900 Fri, 09 Apr 2010 18:30:00 +0100 3456900 http://www.medworm.com/index.php?rid=3416389&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F03%2Fcrazy-life.html Been going through some crazy busy times lately.So, work kinda blew up recently (2 weeks ago? I don't know it's getting hard to keep up), going from a manageable, reasonable, daily activity to a "what the heck happened here" type experience. Earliest I left all week was 1 hour overtime. YIKES. Here's a little recap. Got my first Level 1 student, and I think we had a pretty good week. Tried to arrange for some interesting stuff everyday (hard to do when we started the week with 5/5 pts having severe dementia). Most amusing moment may have been the kitchen assessment with the man who required step by step instructions and multiple interventions for safety. He wanted to make oatmeal by pouring milk into the oats canister, then tried to fill the pot with water while the pot still had a lid on ... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3416389 Sun, 28 Mar 2010 23:46:00 +0100 3416389 http://www.medworm.com/index.php?rid=3354601&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F03%2Fpre-ci-jitters.html I'm getting my first Level 1 student and trying to beat a case of the pre-CI jitters.I'm growing out of the "new practitioner" label. I'm on my second job, practiced in multiple settings (sometimes daily) and I'm pretty sure that I pay "big girl" OT prices for AOTA membership now. But of course there are still "firsts," and I am now, finally, getting my first real OT student. I've played hostess to several job-shadow candidates before, but those were usually just for a couple hours. Most of those also came from the local high school and had to rotate through multiple healthcare jobs and were not particularly interested in OT. I missed out on students at my last job because state law required that you have 1 year experience before being a supervisor (or Clinical Instructor... same dif) and ... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3354601 Thu, 11 Mar 2010 01:55:00 +0100 3354601 http://www.medworm.com/index.php?rid=3311961&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F02%2Facute-care-courses-at-aota-conference.html I feel that it's difficult to find OT courses on acute care topics. It's also hard to apply evidence from those courses to the everyday fast paced world. Here are some parts of the AOTA conference especially for Acute Care OTs (places where you're almost guaranteed to find me!)Links go to full course description on the Create Itinerary page for conference. PosterPO 623. The Role of Occupational Therapy With Pediatric Oncologic Patients Who Undergo Complex Orthopedic Procedures in the Acute Care SettingSat, May 1, 12:30 - 2:30 PM PosterPO 408. An Interdisciplinary Approach to Acute Care Using Standardized Patients and Human Patient SimulatorsFri, Apr 30, 3:00 - 5:00 PM PosterPO 226. Mind-Body Interventions for the Inpatient Acute Care Oncology PopulationThu,... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3311961 Fri, 26 Feb 2010 13:09:00 +0100 3311961 http://www.medworm.com/index.php?rid=3294833&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F02%2Fwhat-week.html What a long strange week it's been...It was a busy, and sometimes downright lousy week. I had 2 people that I was asked to see, cleared for home with family supervision, and then neither family would take them home. It is really sad to see someone who could be in an assisted living or adult day care go to a facility due to the lack of help at home. I hate being put in the middle of these family power plays where the caregiver child just doesn't want to do it anymore but won't say anything until the person is hospitalized. In a strangeness typical of this topsy-turvy week, I also had a lot of people insisting that they would take their parent home when they were very debilitated and largely dependent. The only bright spot for me was getting time to do some follow ups on Friday and changing ... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3294833 Mon, 22 Feb 2010 01:35:00 +0100 3294833 http://www.medworm.com/index.php?rid=3259301&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F02%2Fpatterns.html "What we call chaos is just patterns we haven't recognized. What we call random is just patterns we cant decipher. What we can't understand we call nonsense. What we can't read we call gibberish. There is no free will. There are no variables. There is only the inevitable."Chuck Palahniuk (That guy wrote Fight Club. Thank you Google.)I am a person who appreciates patterns. I often find myself examining tile floors to analyze the pattern or lack of. Routines, a valuable part of life, are just patterns of actions and behaviors. While my appreciation of patterns may just be deep enough to cross (slightly?) into the spectrum, it has also proved interesting at work.I've only been working since 2007, so I don't have scores of case examples yet, but I have been interested to see the patterns in ho... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3259301 Wed, 10 Feb 2010 02:08:00 +0100 3259301 http://www.medworm.com/index.php?rid=3201927&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F01%2Faimless-thoughts.html Took a bit of an OT break with a vacay to Las Vegas and reading some novels instead of OT stuff pretty much since Thanksgiving. Now I'm back and ready to play! Been working on a few entries off and on, but this is mostly unstructured. My NBCOT was due to be renewed this year, which caused a minor panic attack the other day. Not that I've been slacking on licensure or anything, I've been going to conferences, but there was a wrinkle I didn't anticipate. I graduated in May '07, but didn't test until Aug '07. My original state license did not require first year graduates to submit continuing ed to be recertified. And unlike the first 2 years of my OT schooling, I didn't pick up any CEUs in my final year due to silly things like fieldwork, graduation, getting married, etc. Somewhere in the ba... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3201927 Sun, 24 Jan 2010 03:05:00 +0100 3201927 http://www.medworm.com/index.php?rid=3146227&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F01%2Fstarting-new-year.html New Year, but Same Old? Starting a new year in January really cramps my style. Like Caulfield in Frazz, I usually can't make resolutions at that time, and like most all people who actually set resolutions, I usually don't keep them either. Would I like to exercise more? Yes... but not in 20* weather. Would I like to eat better? Yes... but not when there's delicious comfort food leftovers in the fridge. Would I like to set detailed achievable goals for myself? No way! I get paid for that! I thought this was a cute little goal tracker, thought of some ways to use this personally/professionally, but I know myself. I'd start getting little red x's and it would be the last time I ever went to the site.I am a little apathetic about this current new year business. I am back on the medicine floor ... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3146227 Wed, 06 Jan 2010 01:52:00 +0100 3146227 http://www.medworm.com/index.php?rid=3101084&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2009%2F12%2Fadditional-clock-drawings.html Sometimes I think these clock drawings are revealing, sometimes just plain confusing.This one is from a man with dementia. I don't remember much else about the case since it was awhile ago. I do remember leaving him tucked in bed, call bell in hand, last words out of mouth "call the nurse, don't get up on your own" and before I could wash my hands he was already up on his feet on the way to the bathroom. I don't remember what time I asked for, but I have to assume that it was 7:40 and we get the numbers instead of hands.This was my first experience with the Montreal Cognitive Assessment, which is becoming my preferred pencil/paper tool. However, it does start off with alternating trailmaking and has a 5 words after 5 minutes recall section, both of which are rather difficult for many peopl... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3101084 Fri, 18 Dec 2009 02:37:00 +0100 3101084 http://www.medworm.com/index.php?rid=3056916&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2009%2F12%2Ffighting-frustration-and-fatigue.html This has been a hard 2 weeks.It is my impression that the hospital staff was stressed and unpleasant last week due to the impending holiday and just wanting to leave work and go eat copious amounts of gravy laden food. However, they seemed to bring their bad moods BACK with them after Thanksgiving, which is just not fair. Get a grip people- it's holiday season for everyone, not just you. I'm working Christmas day, so that leaves 16 more working days before I can really rest. I'm already so tired... spent this a.m. in a fog since I fell asleep on the bus, and then was ok until I walked through my apt door where I have now crumpled into a semi-lifeless blob. My eyes and brain are fatigued... I can't even begin to think about learning more about Google Wave even though I have OT buddies on th... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3056916 Fri, 04 Dec 2009 00:57:00 +0100 3056916 http://www.medworm.com/index.php?rid=2993946&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2009%2F11%2Fsome-sad-times.html My time at work has been sad lately.My current rotation has been a mighty mishmash of cardiopulmonary pts on intensive and progressive care units, orthopedic pts, and frequent floating back to the neuro floor and ICU. In short, my pts have been much more acutely ill than on my other rotations.It's very depressing seeing pts on multiple admissions for severe COPD or CHF exacerbations. People who are far past where cardiopulmonary rehab can be beneficial. I've had several pts travel back and forth from the regular floor to the ICU, but I have a couple that I'm concerned aren't likely to come out. I've had to get much more diligent about checking with nurses even for follow up sessions since my pts fluctuate considerably from day to day. Got as close as I care to get to a pt coding... me thro... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=2993946 Sat, 14 Nov 2009 22:00:00 +0100 2993946 http://www.medworm.com/index.php?rid=2862761&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2009%2F10%2Ftis-season-for-changing.html 3 months has gone by, neuro rotation is over.This month, I begin on a new floor, the last "new" floor possible (NICU/peds does not count into the rotation). So I will now be working with cardiopulmonary pts, some in ICUs, and orthos. I don't find any of these superbly interesting but hope to find some fun stuff to do. Little worried from a productivity standpoint since I suspect we'll be taking a lot of rest breaks, lots of breaks to check vitals, and probably a lot of advance planning to separate OT/PT sessions into morning/afternoon. I haven't ventured fully into the ICUs yet... we are starting an effort for early mobility and decreased sedation (similar to this) so that will be interesting but it is also stressful to make sure that I know enough about what is going on and protecting my ... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=2862761 Sun, 04 Oct 2009 22:17:00 +0100 2862761 http://www.medworm.com/index.php?rid=2782337&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2009%2F09%2Fmy-first-wiihab.html So our hospital has a Wii (actually 2, one lives solely in the burn unit) which I have thought was interesting since I didn't know how well it could be used in acute care. I missed the inservice but figured I could go ahead with my session since I have a Wii at home and am somewhat familiar with the games.The way I see it, for the Wii to be used in acute care, you have to have a client who is sticking around for a few days, has the required cognitive capabilities to understand the system, and has deficits that can be addressed using the system. We currently have 3 games- the basic sports game, Wii Play, and Wii Fit. The first client that I had who would have been appropriate (since the program starting) was a cute little lady who was extrememly active prior to her stroke- walking 3 miles a... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=2782337 Thu, 10 Sep 2009 18:06:00 +0100 2782337 http://www.medworm.com/index.php?rid=2705357&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2009%2F08%2Ftrying-for-better-week.html Goals this week are a little morbid.So I had multiple pt deaths last week, 2 expected, but 1 not. None due to receiving OT services or lack thereof but still not a pleasant thing. I did get one lady up to the chair about 5 hours before she coded, didn't do much else since her O2 sats were not stellar. So I've been a little depressed and I would just like for people to stay alive this week.Saw a cute-as-a-button 89 y.o. lady on Friday who had a pontine CVA (blessedly mild) but told me "I've never been sick all my life, so if I die it's ok" and I am just thinking NOOOOOOOOOO!!!!!!!!! The COTA saw her yesterday and she met all her OT goals, but after that she transfered into intermediate care for continually BAD blood pressures (222/101 etc) which is not good. Went in and talked to her today.... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=2705357 Mon, 17 Aug 2009 00:33:00 +0100 2705357 http://www.medworm.com/index.php?rid=2667758&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2009%2F08%2Fhow-to-prioritize-full-day-and-other.html 9 hours today, and it was JAM packed. So much so that it will span into tomorrow morning. Mondays are always difficult for me since every name and face is fresh. To top it off, we were shorthanded today which adds the task of prioritization into the mix. There are many methods for this, some of which are mutually exclusive, and some of which aren't applicable when you need them to bed. Regardless of what I choose, it is hard to pick and know that a certain amount will not get done.Here are a few of the ways that you can prioritize evals-- Pathway patients first- this is an overriding rule in my facility. Gastric bypass, new stroke, spinal surgery, and joint replacement patients are on a "pathway" and need to be seen on day 1.- Highest priority first- this is common sense, but we have a box... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=2667758 Tue, 04 Aug 2009 01:52:00 +0100 2667758 http://www.medworm.com/index.php?rid=2576905&cid=t_226328_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2009%2F07%2Ffirst-day-back.html First day back... first day on the surgery floor.It's hard returning from vacay anyway, but trying to get a feel for a brand new floor at the same time is double hard. Added into that is a factor I had not previously considered- July 1 marked the transition from classroom medical students to residents. So not only do I not know the ropes, but the people who are writing the orders don't know the ropes either. I didn't realize when I accepted a job at a teaching hospital that part of my job would be teaching doctors. But we are all teachers, and we are all students... I had a sad realization today when I realized that a PT student who was present before I left must have completed her rotation. Already in just three months there have been 3 different OT/PT students in the office that have com... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=2576905 Tue, 07 Jul 2009 02:00:00 +0100 2576905 http://www.medworm.com/index.php?rid=2570689&cid=t_226328_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FzIeL9Z2BXzA%2F I was reading through a short article entitled “CCHIT TASK FORCE TO FOCUS ON STIMULUS PACKAGE REQUIREMENTS” which is actually a bit misplaced since the article really seems to talk about the CCHIT Task Force for Long Term and Post Acute Care, but I digress. The thing that drew my attention was just reading through the process by which CCHIT puts together their criteria using task forces. I believe a number of people on my twitter feed are on or lead some of these CCHIT EHR task forces. I’d be interested to have a nice writeup from some of them on what it’s like to be on a CCHIT task force. How does it work? What’s the dynamic? If you’re willing to share, I’d love to hear more in the comments or drop me a note on my contact page. I also was trying t... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2570689 Thu, 02 Jul 2009 17:28:35 +0100 2570689 http://www.medworm.com/index.php?rid=2190438&cid=t_226328_86_f&fid=34461&url=http%3A%2F%2Fdigicmb.blogspot.com%2F2009%2F02%2Fzorg-20-first-congress-for-and-by.html "The Acute Care Region East and the University Medical Centre UNC St Radboud are organising the first Care 2.0 Congress. It is to be a gathering with an interactive programme about the possibilities the Internet can hold for the care sector for and by healthcare professionals" They do a great job at the Acute Care Region East. It seems they willingly decided to take this path of Web 2.0 integration in all Health Care aspects and this event is focussing on it. Some info in English The Zorg 2.0 Congress will be held on March 24, 2009. More info & registration: www.azo.nl/zorg20.htm (in Dutch) More background information about the acute care region Acute Zorgregio Oost at www.azo.nl Related articles by ZemantaNational Dialogue on Health IT Publishes Final Report (Uses Scribd in True ... DigiCMB blogs http://www.medworm.com/rss/comments.php?id=2190438 Mon, 16 Feb 2009 10:27:00 +0100 2190438