- Email: [email protected]
Electromagnetic Energy Exonerated
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integrated care pathway which followed Protocols for Elderly Care patients into the community, which would Graham Morgan RGN, senior nurse be an important link between hospital adviser at the Central Middlesex Hospital, and community staff. In answer to practicalquestions from the said that it was generally agreed that audience, Mrs Johnson admitted that a patient focused care was appropriate in patient with mixed pathology could cause orthopaedics, but in medicine it was a problem, and it was easier to start with difficult, and with elderly patients it would a surgical approach and fit other pathways be impossible. The problem was compounded by medical training which did not around that. The main concern of the audience was help doctors to become good team that the speakers had painted a picture of members. On the positive side, team ethos was groups throughout the country all working on the same type of project, thus vastly stronger among these who cared for duplicating the work involved. If a national elderly patients, although the paperwork standard could be devised there would did not reflect this. His aim had been be a ready-made framework which could to reduce documentation. He started by asking the people involved be modified to meet local requirements. To Mrs Johnson’s reply that individual in care to agree on the obstacles ie what pathways were needed because different prevented people from going home. They consultants worked in various ways, the agreed on criteria for discharge, and wrote audience seemed to think that an optimum one set of protocols which replaced all standard practice should also be estab- other systems. The protocols were neither prescriptive lished for them. The chairman, Elizabeth Murray, said nor compulsory. They were kept by doctors that addressing the task at national level in their office, by physiotherapists in their could be explored by Clinical Interest department, and by nurses at the foot of the patients’ beds. These plans of care and Groups. The Department of Health Clinical records (with variance when appropriate) Outcomes Group is developing guidelines were used for clinical audit, which confor clinical conditions which should be firmed the best practice and could lead to changes when necessary. made available nationwide.
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‘Physiotherapists Are Not Interested contact their local branch through the in Back Pain!’ MADAM - The National Back Pain Association is the only registered charity which is devoted to back pain. The headquarters is in Teddington, and the charity has 35 branches distributed throughout the country. Some branches operate evening hydrotherapy sessions, others run weekly exercise classes, and most have regular evening lectures with a wide variety of outside speakers. Local branches of the NBPA provide a golden opportunity for physiotherapiststo become involved; utilising their skills as practitioners, educators and ergonomists in the prevention and management of back pain. It was deeply depressing to hear at an NBPA branches conference day in November that some local branches ‘cannot get their local physiotherapists interested’ in helping with their branches. One branch said its members found their physiotherapists ‘totally disinterested’, and had sought the help of the local osteopaths! As a profession, we pride ourselves in our holistic, caring approach to back pain. Surely we must take this opportunity to promote our skills and knowledge, and demonstrate our interest and expertise in back pain to this highly motivated, national audience, instead of turning our back on them! We urge all MCSPs able to help to
Physlotherapy, Aprlll994, vol80, no 4
National Back Pain Association, The Old Office Block, Elmtree Road, Teddington, Middlesex TW11 EST (tel 081-977 5474). Lisa Smith MCSP Southampton, Hants Stephanie Saunders MCSP Twickenham, London
Electromagnetic Energy Exonerated MADAM - I wish to express concern over a recent report produced by the Medical Audit Unit of the Royal College of Obstetricians and Gynaecologists. This document summarises a number of procedures in obstetrics and recommends their efficacy in current practice. It also lists ‘procedures which are particularly wasteful of resources’ and ‘which appear to be of little or no benefit’. Included in this section is post-delivery perineal treatment with ultrasound or continuous or pulsed electromagnetic energy. It appears that this statement is based on one single piece of research my own (Grant et a/, 1989). Iwish to point out that we looked at two specific treatment parameters only, and we did not consider ‘continuous electromagnetic energy’. In no way did our findings discredit the use of ultrasound or pulsed electromagnetic energy per se. I consider it essential that my colleagues
-
The protocols have replaced physiotherapists’ notes and are acceptable as legal documents provided they report variance. Mr Morgan emphasised that the protocols were largely a rationalisation of established practice. ‘Before they were instituted we did not stare at each new patient wondering what to do and sucking our thumbs.’
Soft Tissue Injuries Kate Sheehy MCSP of London showed a chart which she and Elizabeth Kelly had devised for use in a private practice which treated many clients with sports injuries. The chart showed anticipated recovery pathways for soft tissue injuries, a process leading to the goal of recovery being achieved or not achieved. There was no change in the notes which physiotherapists but the chart made progress made easily visible. During the afternoon members worked on specific questions in groups, with a final feedback session. The message of the day might be surnmarised by Graham Morgan’s quotation from Maureen McDowall: ‘Always remember that no one delivers care in isolation.’
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working in the field of obstetrics and gynaecology are aware of this, and are also familiar with the results of the above research. At the Royal Berkshire Hospital we no longer use those treatment parameters which were found to be ineffective. Jeanne Mclntosh MCSP ,’ Royal Berkshire Hospital Reading
Reference Grant, A, Sleep, J, Mclntosh, J M and Ashurst, H (1989). ‘Ultrasound and pulsed electromagnetic energy for perineal trauma. A randomised placebocontrolled trial’, British Journal of Obstetrics and Gynaecology, 96, 434 - 439. ~~
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New Leaflet on Strokes As part of its Physiotherapy and.. . . series the Society has recently produced a leaflet to explain the help and advice chartered physiotherapists can offer people who have had a stroke, and how patients should go about obtaining physiotherapy. The leaflet was producedjointly by the CSP and The Stroke Association. Each organisation has issued the leaflet in its own standard format. Copies are available, the first 50 free of charge, from the Public Relations Department at the CSP. Subsequent copies will cost 20p each. Please send a self-addressed adhesive label when ordering supplies.
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integrated care pathway which followed Protocols for Elderly Care patients into the community, which would Graham Morgan RGN, senior nurse be an important link between hospital adviser at the Central Middlesex Hospital, and community staff. In answer to practicalquestions from the said that it was generally agreed that audience, Mrs Johnson admitted that a patient focused care was appropriate in patient with mixed pathology could cause orthopaedics, but in medicine it was a problem, and it was easier to start with difficult, and with elderly patients it would a surgical approach and fit other pathways be impossible. The problem was compounded by medical training which did not around that. The main concern of the audience was help doctors to become good team that the speakers had painted a picture of members. On the positive side, team ethos was groups throughout the country all working on the same type of project, thus vastly stronger among these who cared for duplicating the work involved. If a national elderly patients, although the paperwork standard could be devised there would did not reflect this. His aim had been be a ready-made framework which could to reduce documentation. He started by asking the people involved be modified to meet local requirements. To Mrs Johnson’s reply that individual in care to agree on the obstacles ie what pathways were needed because different prevented people from going home. They consultants worked in various ways, the agreed on criteria for discharge, and wrote audience seemed to think that an optimum one set of protocols which replaced all standard practice should also be estab- other systems. The protocols were neither prescriptive lished for them. The chairman, Elizabeth Murray, said nor compulsory. They were kept by doctors that addressing the task at national level in their office, by physiotherapists in their could be explored by Clinical Interest department, and by nurses at the foot of the patients’ beds. These plans of care and Groups. The Department of Health Clinical records (with variance when appropriate) Outcomes Group is developing guidelines were used for clinical audit, which confor clinical conditions which should be firmed the best practice and could lead to changes when necessary. made available nationwide.
-
‘Physiotherapists Are Not Interested contact their local branch through the in Back Pain!’ MADAM - The National Back Pain Association is the only registered charity which is devoted to back pain. The headquarters is in Teddington, and the charity has 35 branches distributed throughout the country. Some branches operate evening hydrotherapy sessions, others run weekly exercise classes, and most have regular evening lectures with a wide variety of outside speakers. Local branches of the NBPA provide a golden opportunity for physiotherapiststo become involved; utilising their skills as practitioners, educators and ergonomists in the prevention and management of back pain. It was deeply depressing to hear at an NBPA branches conference day in November that some local branches ‘cannot get their local physiotherapists interested’ in helping with their branches. One branch said its members found their physiotherapists ‘totally disinterested’, and had sought the help of the local osteopaths! As a profession, we pride ourselves in our holistic, caring approach to back pain. Surely we must take this opportunity to promote our skills and knowledge, and demonstrate our interest and expertise in back pain to this highly motivated, national audience, instead of turning our back on them! We urge all MCSPs able to help to
Physlotherapy, Aprlll994, vol80, no 4
National Back Pain Association, The Old Office Block, Elmtree Road, Teddington, Middlesex TW11 EST (tel 081-977 5474). Lisa Smith MCSP Southampton, Hants Stephanie Saunders MCSP Twickenham, London
Electromagnetic Energy Exonerated MADAM - I wish to express concern over a recent report produced by the Medical Audit Unit of the Royal College of Obstetricians and Gynaecologists. This document summarises a number of procedures in obstetrics and recommends their efficacy in current practice. It also lists ‘procedures which are particularly wasteful of resources’ and ‘which appear to be of little or no benefit’. Included in this section is post-delivery perineal treatment with ultrasound or continuous or pulsed electromagnetic energy. It appears that this statement is based on one single piece of research my own (Grant et a/, 1989). Iwish to point out that we looked at two specific treatment parameters only, and we did not consider ‘continuous electromagnetic energy’. In no way did our findings discredit the use of ultrasound or pulsed electromagnetic energy per se. I consider it essential that my colleagues
-
The protocols have replaced physiotherapists’ notes and are acceptable as legal documents provided they report variance. Mr Morgan emphasised that the protocols were largely a rationalisation of established practice. ‘Before they were instituted we did not stare at each new patient wondering what to do and sucking our thumbs.’
Soft Tissue Injuries Kate Sheehy MCSP of London showed a chart which she and Elizabeth Kelly had devised for use in a private practice which treated many clients with sports injuries. The chart showed anticipated recovery pathways for soft tissue injuries, a process leading to the goal of recovery being achieved or not achieved. There was no change in the notes which physiotherapists but the chart made progress made easily visible. During the afternoon members worked on specific questions in groups, with a final feedback session. The message of the day might be surnmarised by Graham Morgan’s quotation from Maureen McDowall: ‘Always remember that no one delivers care in isolation.’
-
working in the field of obstetrics and gynaecology are aware of this, and are also familiar with the results of the above research. At the Royal Berkshire Hospital we no longer use those treatment parameters which were found to be ineffective. Jeanne Mclntosh MCSP ,’ Royal Berkshire Hospital Reading
Reference Grant, A, Sleep, J, Mclntosh, J M and Ashurst, H (1989). ‘Ultrasound and pulsed electromagnetic energy for perineal trauma. A randomised placebocontrolled trial’, British Journal of Obstetrics and Gynaecology, 96, 434 - 439. ~~
~~
New Leaflet on Strokes As part of its Physiotherapy and.. . . series the Society has recently produced a leaflet to explain the help and advice chartered physiotherapists can offer people who have had a stroke, and how patients should go about obtaining physiotherapy. The leaflet was producedjointly by the CSP and The Stroke Association. Each organisation has issued the leaflet in its own standard format. Copies are available, the first 50 free of charge, from the Public Relations Department at the CSP. Subsequent copies will cost 20p each. Please send a self-addressed adhesive label when ordering supplies.