View source for The role and function of Primary Care Teams in Ireland

=== <u>'''''4. Caseload for a&nbsp;primary care physiotherapist'''''</u>  ===

'''''<br>'''''<b>Schedule</b><br>A primary care physiotherapist will usually spend 3 days a week working in their clinic and 2 days on home visits to patients. If possible patients are brought to the clinic allowing less time being spent travelling and more equipment being available for assessment and treatment in the clinic . Included is their weekly meeting with other members of the multi-disciplinary team. Some of this time is also given to health promotion in their community, such as school visits. 

<br>'''Caseload '''<br>Caseload is varied and work in all the different areas, mostly they deal with musculoskeletal injuries in patients who have recently been discharged from hospitals. 

<br>Examples of the work done in particular areas:<br>-'''Neurology: '''<br>Review of patient at home following discharge from acute services post CVA. Provide advice for patients and their families regarding manual handling, safe and effective transfers from place to place, positioning and reviewing home exercise programmes provided by physiotherapist in acute services. 

-'''Health Promotion:'''<br>Promoting things like healthy eating, exercise, back care advice, posture and cardiovascular health in their communities. E.g. In Castleisland, Co. Kerry, there was found to be a high incidence of prostate disease among men in their 50’s and 60’s. It was founds that many of these men would not visit their G.P regularly. The primary care team decided to hold meetings at the weekly cattle mart to give them access to their target audience. They provided health advice to these men and allowed them to take blood tests. 

-'''Care of the Elderly:'''<br>Gout re-education, mobility advice and education and prescription of walking aids, falls prevention advice and tips for a safe environment, advice regarding osteoporosis, staying active and referral to O.T for assistive devices such as reaching devices also arrangement of home help for elderly. Much of the home visits are to elderly patients with the home of making their ADL’s easier. 

'''Case Study:'''<br>A recently discharged patient from acute services 5 days post op following&nbsp;total hip replacement was referred tp physiotherapy, 70 year old male.<br>Patient was discharged early due to presence of primary care team in living area. Walking with elbow crutches at present.<br> 

<br>What the physiotherapist did: 

<br>-Reviewed his home exercise programme and advised on its importance.<br>-Reviewed hip precautions and spoke to wife about it, gave handout as patient had misplaced his total hip replacement booklet.<br>-Assessed the environment and advised on adequate lighting and removing rugs from floor to decrease risk of falls.<br>-Reviewed patient walking on stairs, made sure it was safe.<br>-Liased with O.T regarding bath chair for shower, other required equipment.<br>-Advised patient on time scale regarding weaning to one elbow crutch.<br>-Arrranged follow up appointment in clinic in 6 weeks to progress home exercise programme and review mobility progress. 

After one month from appointment patient was mobilising independently and was discharged from physiotherapy. 

<br>'''Primary care vs community physiotherapy'''<br>''Similarities:''<br>working with patients in community <br>-referrals from G.P., consultant, acute services <br>-need to be aware of gaps in own knowledge, and when appropriate onward referral is required 

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''Differences:''<br>-bigger focus on health promotion in primary care 

-&nbsp;increased G.P referrals secondary to primary care team<br> 

&nbsp;-closer links to o<span id="fck_dom_range_temp_1273865702648_858"></span><span id="fck_dom_range_temp_1273865702650_630"></span>ther members of MDT, weekly meetings 

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