STARES 2 Intervention

S- A 73 year old female Day 0 post R) TKR. The patient has multiple attachments; IV, drain, PCIA, PNI, O2 insitu. The patient has no relevant PMHx and her social Hx is that she lives at home with her husband, level floors inside only one step into the house. Her operation went smoothly with the post op orders having changed as of yesterday (the day of patients surgery)from having CPM for 48hrs straight, sitting up for all meals and mobilising day 0. Now it is similar except no CPM at all, sit out of bed for all meals and bed and sitting exercise 3x daily.

T- Approximately 3 hours after being awoken from surgery she was to be stood and shown bed and seated exercises and to be sat out of bed for every meal. Patient to be mobilised with a Richard splint due to peripheral nerve infusion (PNI).

A- I introduced myself and my supervisor and explained the role of physio post-op TKR and about the plan for the next few days the patient will be in hospital. The patient had been told she was having the CPM('leg mover machine') and I had to explain the change in protocol by her surgeon. I then asked how she was feeling and checked her obs. She had many attachments so we had to organise them all as well as prepare a chair for her to sit in after. I began to teach and go through her bed e exercises. Then we put the Richard splint on her and sat her up on the edge of the bed to stand with a zimmer frame. The patient was then ambulated 2 A for the attachments and her safety to her chair where seated exercises where performed. Finally explained to a patient that we would return the next day to go through most of it again.

R- The patient managed all the exercises and the ambulation well despite only been out of her operation for 3 hours. Do to her slight drowsiness i would expect she would require further explanation the next day to ensure she took in all the information.

E- I think that I did well with this considering all the other factors that could have distracted me from the task at hand. I found that I was able to to talk to the patient well and made her feel comfortable working with me. Also the fact that the way her surgeon had changed the protocol she took it well and agreed to comply with whatever she was required to do. I feel that I was able to keep everything going and was able to ask for assistance from the nursing staff with attachments to keep the area clear and keep the patient safe. I think the main thing I could have done better is explain a little more on the importance on all these exercises, but other than that I feel I had control of the situation and was successful in my intervention.

S- Strategies:
- Talk to and observe the other physios methods with patients
- Make sure I know all my 'spiels' so i know that when I get into apatinet despite how different it turns out to be I have control of one aspect.
- research different surgeons protocols
- ask questions