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University of Hertfordshire Department of Allied Health Professions/Physiotherapy Facilitating learning in specific clinical specialities

Amputee Rehabilitation The successful student will have a knowledge and understanding of :The commonly encountered vascular investigations, procedures, and post op management of the patient who has undergone amputation surgery The implication of underlying pathologies on the physiotherapy management of the patient who has undergone amputation surgery The psychological effects of amputation The reasons for and the implications of, the different levels of amputation surgery The implications of wound healing, infection, phantom sensation and pain on the rehabilitation of the patient The decision making process of prosthetic provision and prescription The importance of pre amputation assessment and consultation The role of the physiotherapist in the MDT in the acute and rehabilitation settings (prosthetists and rehabilitation engineers) Basic prosthetics socket fit, sock fit & components The principles of biomechanics in relation to the use of prosthetics in the rehabilitation of the patient who has undergone amputation Wheelchair service The successful student will have a knowledge and understanding of :The criteria and resources affecting wheelchair provision The provision of equipment wheelchair (manual and powered)/cushions The legislation in relation to provision and transportation of medical devices The appreciation of the role of other team members The interprofessional role of the wheelchair therapist The role of other team members rehab engineers/ wheelchair technicians/maintenance services/clinical scientists How special seating can be used in the management of disability, pressure care and posture.

UH Clinical Educators day - Wheelchairs/amputees. May 2003

surgery The successful student will have the skills and attributes that:Demonstrate safe and correct use of wheelchairs for patients who have undergone amputation surgery Demonstrate safe and correct methods of transfers Demonstrate assessment and management of residual limb oedema Demonstrate the appropriate use of compression therapy Demonstrate the appropriate use of early walking aids e.g. PPAM aid Enable them to develop, implement and progress an exercise programme specifically related to the level of amputation Demonstrate skills in prosthetic rehabilitation Demonstrate gait analysis and progression in patients who have undergone amputation surgery including the use of walking aids Demonstrate an holistic approach to the rehabilitation of the patient who is undergoing /has undergone amputation surgery Enable them to apply specific outcome measures related to the patient who has undergone amputation surgery The successful student will have the skills and attributes that enable them to :Undertake a risk assessment in relation to the legislation on the provision medical equipment (Medical Devices Directive) prescribe commonly encountered wheelchairs/cushions Undertake a patient need assessment in order to prescribe a wheelchair taking into account the patients age/disability/impairment/environment Provide equipment in order to maximise function of the wheelchair user Educate the user and carers in the safe use of equipment provided Communicate local and national policies to clients and agencies with respect to wheelchair provision

UH Clinical Educators day - Wheelchairs/amputees. May 2003

Issues Wheelchair service Level of responsibility Telephone prescription

Solutions Monitor/countersign student decisions Student responsibility/interview techniques translate measurements to equipment provision. Develops Interpersonal skills Explain one off management and implications Planning and highlighting the positive aspects

Caseload management Students questioning is this physiotherapy? Resources/professional/environments Amputee rehabilitation Level of responsibility complexity of patient

Geographical location Poor basic knowledge Level of student Wording on assessment forms doesnt account for speciality placements Psychosocial/communication Pace/patient numbers MRSA

Monitor/countersign student decisions Treat with Educator Observe other professionals if Educator absent Communication with student early on in placement Realistic expectations of students Individual discussions with visiting academic tutors and Universities Communication with student early on in placement Don feel pressurised to change working practices when have students Universal precautions emphasised for all patients

UH Clinical Educators day - Wheelchairs/amputees. May 2003