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INTERIM PROSTHESES

INTERIM PROSTHESES. A Pilot trial Westmead / Rankin Park Peter Davis and Craig Evans. Interim Prostheses Trial:. BACKGROUND ALS Review recommendation:

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INTERIM PROSTHESES

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  1. INTERIM PROSTHESES A Pilot trial Westmead / Rankin Park Peter Davis and Craig Evans

  2. Interim Prostheses Trial: BACKGROUND • ALS Review recommendation: “the provision of mechanical interim prostheses (manufactured by a prosthetist) be implemented as standard practice in NSW amputee services.” • Integrate acute prosthetic service delivery using private and public prosthetic services

  3. Interim Prostheses Trial: GOAL To provide inpatient prosthetic care to clients with a lower limb amputation at John Hunter Hopsital / Rankin Park Centre and Westmead Hospitals. This service will include the provision of interim mechanical prostheses made by a prosthetist.

  4. Interim Prostheses Trial: DURATION 6 months up to 2 years data collection

  5. Interim Prostheses Trial: SITES JHH/RPC Employ additional public prosthetist WESTMEAD Contract services from private company Reflects current / possible service provision

  6. Interim Prostheses Trial: Trial MAY exclude: • Medically unstable. • MMSE < 25. • Dementia • Non-ambulatory for a > 12 months Data not collected but still gets interim prosthesis

  7. Interim Prostheses Trial: OUTCOME MEASURES Basic demographic data • Age • Gender • Insurance status • Milestone dates Functional Scales and measures (see over) Variance

  8. Interim Prostheses Trial:

  9. Interim Prostheses Trial: Funding of Interim Prosthesis Trial Patient assessed by team and script filled out for interim limb Form faxed to ALS for sign-off Hard copy sent in post ALS to fax back approval Interim is made with agreed componentry Invoice of ‘Interim Trial’ labour + componentry + occasions of service is sent to ALS monthly ALS to pay APC/Hunter invoice and then invoice NSW Health Department for all ‘Interim Trial’ costs.

  10. Interim Prostheses Trial: PHASES • PRE OPERATIVE • Pre-amputation consultation (if poss.) • Team members involved • ACUTE POST-OP • Milestone dates • Rigid dressing • Usual inpatient Rx

  11. Interim Prostheses Trial: PHASES • INPATIENT REHAB • Team determines readiness for interim • Interim fitted within 36 hours of casting • Measures of stump volume weekly • Discharge home • No. of Interventions by team members

  12. Interim Prostheses Trial: PHASES • OUTPATIENT REHAB • Adjustments and additional sockets as required • No. of interventions • DEFINITIVE PROSTHESIS • Stable volume & team decision = definitive script and manufacture • Outcome measures at approp. times

  13. Interim Prostheses Trial: CONCLUSION OF TRIAL • Data collated and reviewed • Possible publication • Recommendations for acute prosthetic services

  14. Interim Prostheses Trial: Comments please…

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