Hello All,
I am writting this post to get some feed back from other OT's that treat
acute status post total knee and hip replacements. I think I actually will
talk just about total knee arthroplasty since this seems to be my area of
confusion.
In my hospital there is a five day pathway for TKR. OT's go in on
day 3 of the pathway. Each day there are certain goals that we are suppose
to do with the patient and then "check" them off in the pathway. For
example, on day three contact gaurd with commode transfer and independence
with lower extremity bathing after set up are some of the goals we have to
work on. By day five patients are suppose to be independent with lower
extremity dressing with adaptive equipment and be independent with personal
self care.
I guess feel that there is not really a need for OT with TKR. I
feel that once pt gets enough knee rom and hip flexion strength they will
not need any adaptive equipment. In my experience I have found if a pt can
get to 85-90 degress they dont need any AE. A majority of the time the knee
patients by day 3 have already gone to the bathroom with cna's. I guess I am
rambling so I will cut to the chase. I really feel dislike treating TKR
because I feel there outcome would not change if they did or did not recieve
OT in the acute care setting. Maybe a part of my dislike is because I am
going by the pathway (groan) to determine my goals, not very
person-centered. Yes there are exceptions, the older patients some times do
need AE and ADL/transfer training but they seem to be the exception.
I would love to here from other OT's who work in acute care and treat
TKR. Feel free to email me personaly or you can keep it on the list. I have
other questions, gripes, comments about OT in acute care that I would love
to talk about.
Take care,
Mike Butterfield
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