Innovation In Vascular Clinic
This document was uploaded by user and they confirmed that they have the permission to share it. If you are author or own the copyright of this book, please report to us by using this DMCA report form. Report DMCA
Overview
Download & View Innovation In Vascular Clinic as PDF for free.
More details
- Words: 841
- Pages: 22
Helen Kendall Pradeep Chockalingam
Intermittent claudication Evidence Background Getting started Aims of claudication clinic Location Assessment Follow up Impact on service Recommendations
Peripheral vascular disease/peripheral arterial disease
Affects 2 - 4.5% of the population
6% of patients over 85
60% of patients have bilateral symptoms
Oxygen supply to calf muscle decreased
Increased mortality
Systematic review
15 randomised trials
Small sample sizes
Supervised exercise beneficial with maximum improvement shown
Clinic commenced November 2003
Evidence based practice
2 clinics per week
2 exercise classes per week (running as 7 week block)
Consultants
Service manager
Sponsorship
Business case
Vascular support nurse
Improve symptoms
Decrease morbidity and mortality
“Stop smoking and start walking”
Hospital based
Outpatients department
Ambulance
Phlebotomist
Physiotherapist
Patients referred from Consultants, GPs, Nurse Practitioners and Podiatrists
Exercise class at Gateshead Leisure Centre
History taking
Risk factors
Physical examination
ABPI
Bloods
Physiotherapist
6 weeks
12 weeks
24 weeks
1 year
Yearly (with access to sooner appointment)
Decrease in the number of bypass operations
Decrease in the number of angioplasties
Patient satisfaction high
2 patients have asked to see a doctor
Increase clinics to cope with demand
Employ another nurse to assist in clinic
Increase exercise classes
Run exercise classes in 2 areas as some patients have a long way to travel
Regular exercises improves the walking ability and delays the onset of claudication pain.
Exercise is an integral part of P.A.D treatment.
Supervised exercise is superior than the home based exercise programme. (Hirsch AT et al 2006, Leng GC et al 2000 & Bendermacher BLW et al 2006)
Introduced new Evidence Based Objective & Subjective outcome measures.
Produce an audio C.D to standardise the test.
Created a wall poster.
New electronic database.
Sensitive, Safe, Simple & Cost effective.
6 MWT is the best alternative to the Treadmill Test & equally sensitive.
Treadmill test may not reflect daily activity.
More acceptable by Older people as walking is a day to day activity.
Suitable for the community setup.
(Enright PL et al 2003, Scherer SA 2004, Ohtake PJ 2005, Montgomery PS et al 1998)
Use only standardised encouragements at regular intervals. (ATS Statement 2002)
It is impossible to use the same phrase every time and by different examiners.
Examiner may miss to count the lap when
looking for the time or giving regular encouragements.
Simple and Standardised
Disease specific.
Simple and straight forward.
Easy to complete compared to SF-36.
Informative and able to assess the patients point of view.
Able to assess other limiting factors. (Regensteiner JG et al 1990, Scherer SA 2004)
Visual aids reach audience much easier than other means and cost effective.
To explain the importance of exercise to the patients and the ill effects of smoking.
To encourage patients to exercise and give-up smoking.
To encourage patient to attend the supervised exercise programme.
Microsoft Excel electronic database.
Easy to use.
Collect and analyse data quicker & accurate.
Automatic calculations.
Evidence based and most appropriate for this group of patients.
Sensitive, Safe and Simple.
Well tolerated by the patients and cost effective.
Able to collect and analyse various data at one time.
Able to assess patients perception of other mobility limiting factors.
ATS Statement 2002: Guidelines for the Six-Minute Walk Test: American Journal of Respiratory and Critical Care Medicine Vol 166. pp. 111-117.
Bendermacher BLW et al 2006; Supervised Exercise Therapy versus Non-Supervised Exercise Therapy for Intermittent Claudication; The Cochrane Database of Systematic Reviews; Iss-2, No CD005263.pub2
Enright PL et al 2003; The 6-min Walk Test: A Quick Measure of Functional Status in Elderly Adults. Chest; Vol 123; Page 387-398.
Hirsch AT et al 2006; ACC/AHA Guidelines for the management of Patients with Peripheral Arterial Disease (Lower Extremity, Renal, Mesentric, and Abdominal Aortic): Journal of the American College of Cardiology; Vol-47, No-6, 1239-1312.
Leng GC et al 2000; Exercise for Intermittent Claudication; The Cochrane Database of Systematic Reviews; Iss-2, No: CD000990 Montgomery PS et al 1998: The Clinical utility of a Six-Minute Walk Test in Peripheral Arterial Occlusive Disease Patients; J Ame Geri Society; Vol- 46, No-6, 706-711. Ohtake PJ 2005; Field Tests of Aerobic Capacity for Children and Older Adults; Cardiopulmonary Physical Therapy Journal; Vol 16, N23, Page 5-11&40 Regensteiner JG et al 1990; Evaluation of Walking Impairment by Questionnaire in Patients with Peripheral Arterial Disease; Journal of Vascular Medicine and Biology. Vol- 2, No-3, Page 142-152. Scherer SA 2004; Research Corner: Functional Outcome Measurements for Patients with Peripheral Arterial Disease; Cardiopulmonary Physical Therapy Journal; Vol 15, No3, Page 2328.
Intermittent claudication Evidence Background Getting started Aims of claudication clinic Location Assessment Follow up Impact on service Recommendations
Peripheral vascular disease/peripheral arterial disease
Affects 2 - 4.5% of the population
6% of patients over 85
60% of patients have bilateral symptoms
Oxygen supply to calf muscle decreased
Increased mortality
Systematic review
15 randomised trials
Small sample sizes
Supervised exercise beneficial with maximum improvement shown
Clinic commenced November 2003
Evidence based practice
2 clinics per week
2 exercise classes per week (running as 7 week block)
Consultants
Service manager
Sponsorship
Business case
Vascular support nurse
Improve symptoms
Decrease morbidity and mortality
“Stop smoking and start walking”
Hospital based
Outpatients department
Ambulance
Phlebotomist
Physiotherapist
Patients referred from Consultants, GPs, Nurse Practitioners and Podiatrists
Exercise class at Gateshead Leisure Centre
History taking
Risk factors
Physical examination
ABPI
Bloods
Physiotherapist
6 weeks
12 weeks
24 weeks
1 year
Yearly (with access to sooner appointment)
Decrease in the number of bypass operations
Decrease in the number of angioplasties
Patient satisfaction high
2 patients have asked to see a doctor
Increase clinics to cope with demand
Employ another nurse to assist in clinic
Increase exercise classes
Run exercise classes in 2 areas as some patients have a long way to travel
Regular exercises improves the walking ability and delays the onset of claudication pain.
Exercise is an integral part of P.A.D treatment.
Supervised exercise is superior than the home based exercise programme. (Hirsch AT et al 2006, Leng GC et al 2000 & Bendermacher BLW et al 2006)
Introduced new Evidence Based Objective & Subjective outcome measures.
Produce an audio C.D to standardise the test.
Created a wall poster.
New electronic database.
Sensitive, Safe, Simple & Cost effective.
6 MWT is the best alternative to the Treadmill Test & equally sensitive.
Treadmill test may not reflect daily activity.
More acceptable by Older people as walking is a day to day activity.
Suitable for the community setup.
(Enright PL et al 2003, Scherer SA 2004, Ohtake PJ 2005, Montgomery PS et al 1998)
Use only standardised encouragements at regular intervals. (ATS Statement 2002)
It is impossible to use the same phrase every time and by different examiners.
Examiner may miss to count the lap when
looking for the time or giving regular encouragements.
Simple and Standardised
Disease specific.
Simple and straight forward.
Easy to complete compared to SF-36.
Informative and able to assess the patients point of view.
Able to assess other limiting factors. (Regensteiner JG et al 1990, Scherer SA 2004)
Visual aids reach audience much easier than other means and cost effective.
To explain the importance of exercise to the patients and the ill effects of smoking.
To encourage patients to exercise and give-up smoking.
To encourage patient to attend the supervised exercise programme.
Microsoft Excel electronic database.
Easy to use.
Collect and analyse data quicker & accurate.
Automatic calculations.
Evidence based and most appropriate for this group of patients.
Sensitive, Safe and Simple.
Well tolerated by the patients and cost effective.
Able to collect and analyse various data at one time.
Able to assess patients perception of other mobility limiting factors.
ATS Statement 2002: Guidelines for the Six-Minute Walk Test: American Journal of Respiratory and Critical Care Medicine Vol 166. pp. 111-117.
Bendermacher BLW et al 2006; Supervised Exercise Therapy versus Non-Supervised Exercise Therapy for Intermittent Claudication; The Cochrane Database of Systematic Reviews; Iss-2, No CD005263.pub2
Enright PL et al 2003; The 6-min Walk Test: A Quick Measure of Functional Status in Elderly Adults. Chest; Vol 123; Page 387-398.
Hirsch AT et al 2006; ACC/AHA Guidelines for the management of Patients with Peripheral Arterial Disease (Lower Extremity, Renal, Mesentric, and Abdominal Aortic): Journal of the American College of Cardiology; Vol-47, No-6, 1239-1312.
Leng GC et al 2000; Exercise for Intermittent Claudication; The Cochrane Database of Systematic Reviews; Iss-2, No: CD000990 Montgomery PS et al 1998: The Clinical utility of a Six-Minute Walk Test in Peripheral Arterial Occlusive Disease Patients; J Ame Geri Society; Vol- 46, No-6, 706-711. Ohtake PJ 2005; Field Tests of Aerobic Capacity for Children and Older Adults; Cardiopulmonary Physical Therapy Journal; Vol 16, N23, Page 5-11&40 Regensteiner JG et al 1990; Evaluation of Walking Impairment by Questionnaire in Patients with Peripheral Arterial Disease; Journal of Vascular Medicine and Biology. Vol- 2, No-3, Page 142-152. Scherer SA 2004; Research Corner: Functional Outcome Measurements for Patients with Peripheral Arterial Disease; Cardiopulmonary Physical Therapy Journal; Vol 15, No3, Page 2328.
Related Documents
Innovation In Vascular Clinic
June 2020 4
Clinic
May 2020 52
Infection Control In Clinic
May 2020 15
Vascular Access In Oncology Patients
April 2020 6
Innovation In Kinetix
July 2020 20