Archive: CSM 2012: Acute Care Programming

  • This is archived programming for CSM 2012. See current programming.

    Browse Acute Care sessions by day. Return to the main topic menu.

    Wednesday, February 8 | Thursday, February 9 | Friday, February 10 | Saturday, February 11 

    * Should you choose to preselect sessions during the registration process, please be advised that preselection is not a guarantee of a seat. Attendees are asked to preselect to better determine room size and all efforts will be made to accommodate sessions in the largest rooms possible. All attendees are encouraged to show up to sessions early. Attendees are also encouraged to select alternative sessions in the event their first choice is full. 

    Wednesday, February 8 (Preconference)

    Serial Casting for Contracture Management of Upper and Lower Extremities

    Time: 8:00 am-5:00 pm (See Program for Room)

    Speakers: Lesley Palmgren, PT, MPT, Jennifer Askevold, MS, Carrie Laker, PT, DPT, CWS

    Level: Basic

    Preconference Pricing: Standard Plus 

    CEUs: 0.8 ( 8 contact hours/CCUs)

    Serial casting is an effective treatment in the prevention, correction, and management of contracture. Its use has been documented in the neurologically impaired and burn patient populations across the continuum of care. Clinicians will learn the principles of and indications for serial casting, how to apply casts, and strategies for preventing contracture after serial casting. In addition, attendees will have the opportunity to cast the most common areas of contracture: the ankle, elbow, and hand. The presenters will demonstrate application of cast materials, cast removal, and bi-valving, followed by guided hands-on application by participants. Registration will be limited to ensure availability of materials and ample time for all participants to apply, remove, and bivalve each of the demonstrated casts.

    Upon completion of this course, you'll be able to:

    • Cite the most current evidence to support the use of serial casting.
    • Describe the potential range of motion and functional goals of upper-extremity and lower-extremity serial casting.
    • Identify clinical indications and contraindications for serial casting.
    • Perform pre-cast and post-cast evaluation of a patient.
    • Apply and remove casts, as well as bi-valve casts for use as splints.
    • Utilize different treatment strategies to prevent contracture following casting, when they are indicated.
    • Apply a cast for each of the following: ankle dorsiflexion, elbow extension, MCP dorsal block, and resting hand positions.

    Thursday, February 9

    The Vision of Physical Therapy Services in the Emergency Department: Making It a Reality

    Time: 8:00 am-10:00 am (See Program for Room)

    Speakers: Susie Deusinger, PT, PhD, FAPTA, Debbie A. McDonnell, PT, DPT, Pamela M. Wendl, PT, DPT, Beth Crowner, PT, DPT, NCS, Tamara L. Burlis, PT, DPT

    Level: Intermediate 

    Hospital emergency departments (ED) are key venues for providing health care services. Many patients present to EDs with non-life-threatening conditions that physical therapists can effectively manage. This course describes a physical therapy service in a large urban hospital that expands the traditional role of PTs. PTs clearly can screen patients and determine appropriateness of care, independently treat many musculoskeletal conditions and help to determine the etiology of multiple conditions. This session will examine the culture of hospital EDs, suggest ways that triage processes can include physical therapy, and analyze ways to ensure best practice. The speakers will 1) review their own ED practice, 2) analyze case examples, 3) explore sustainable business models, and 4) describe a pro bono outpatient service for under-insured ED patients to receive follow-up care. In addition, the presenters will discuss preliminary data from outcomes testing of patients with back pain using a new triage process that they hypothesize will enable patients to be treated more quickly and less expensively and avoid frequent returns to the ED for the same condition.

    Upon completion of this course, you'll be able to:

    • Understand the philosophy, knowledge base, and requisite characteristics of the PT for implementing a fully integrated model of physical therapy in the ED.
    • Recognize vehicles for creating a contemporary partnership with other essential professionals involved in the practice and delivery of care in the ED, including triage options physical therapy could create to improve access and delivery of care.
    • Compare elements of alternative business pro formas that may be employed to implement a physical therapy service in the ED.
    • Analyze select cases seen in the hospital ED to determine appropriate intervention and disposition directions.

    Rehabilitative Needs of the Burn Survivor, Part 1

    Time: 8:00 am-10:00 am (See Program for Room)

    (Joint Program: Clinical Electrophysiology and Wound Management)

    Speakers: David J. Lorello, PT, DPT, Sam K. Yohannan, PT, MS, Derek O. Murray, PT

    Level: Multiple Level 

    Physical therapists are essential to the functional recovery of patients with burn injuries. This course will give the therapist the fundamental skills needed to treat the patient with burn injuries through all phases of wound healing. Attendees will learn burn wound physiology and evidence-based, obtainable goals using the latest advancements in dressings, therapy implications for various surgical techniques, and the importance of positioning the affected joint.

    Upon completion of this course, you'll be able to:

    • Understand the role of the PT in the care of the patient with burn injuries.
    • Assess a burn wound, including depth, size, and mechanism of injury.
    • Explain the phases of burn wound healing.
    • Apply common dressings used to treat burn wounds and the latest advancements in dressings.

    Rehabilitative Needs of the Burn Survivor, Part 2

    Time: 10:30 am-12:30 pm (See Program for Room)

    (Joint Program: Clinical Electrophysiology and Wound Management)

    Speakers: David J. Lorello, PT, DPT, Sam K. Yohannan, PT, MS, Derek O. Murray, PT

    Level: Intermediate 

    The transition of the burn survivor out of the acute care setting is a critical time where functional gains can be easily lost. Physical therapists are integral to ensuring that survivors are equipped for their discharge and prepared for their transition to the rehab or outpatient setting. Attendees will learn what goals and outcomes are obtainable. The speakers will include evidence-based guidelines for selecting treatment techniques to increase strength, improve range of motion, and manage scars.

    Upon completion of this course, you'll be able to:

    • Understand the needs of the burn survivor during the transition from the acute care setting.
    • Explain the pathophysiology of burn scar.
    • Address the rehabilitative needs of the burn survivor, including splinting and positioning and therapeutic exercise.
    • Apply the most recent burn research that relates to physical therapy.

    Clinician and Team Productivity in Physical Therapy Throughout the Rehabilitation Continuum of Care

    Time: 3:30 pm-5:30 pm (See Program for Room)

    Speaker: Edward A. Dobrzykowski, PT, DPT, MHS, ATC

    Level: Intermediate 

    PTs, PTAs, and their managers are challenged today by numerous external and internal factors that impact productivity and efficiency, such as types of patients seen and their acuity levels, equipment procurement time, care interruptions, ability to use aides/techs, and technical proficiency in documentation and chart review, among others. With the majority of acute care, skilled nursing facility, rehab, and home health patients seen under prospective payment model, there is a business need for expense management and continuous improvement of productivity. Clinicians have been challenged to implement electronic documentation, measure and improve outcomes, utilize new evidence, and consistently demonstrate superior customer service. Meeting these challenges requires significant personal change. The speakers will discuss, from a business perspective, the need for significant personal change and increased clinician accountability. This session will focus on defining and improving productivity and efficiency, sharing standards across the continuum of care, new strategies for improving efficiency, and change management tactics. There will be opportunity for group discussion to share successes and lessons learned.

    Upon completion of this course, you'll be able to:

    • Provide the business rationale to improve clinician efficiency via the context of prospective. payment, higher costs for health care delivery, and direct cost shifting to patients.
    • Define measures of productivity (efficiency) utilized in the rehabilitation continuum of care: acute care, skilled nursing, inpatient rehab, home health, and outpatient services.
    • Employ new methods and tactics for managing change.
    • Apply strategies to improve clinician efficiency from individual, team, and management perspectives.

    The Second Acute Care Section Lecture: Acuity, Autonomy, and the "Intelligent Conversation"

    Time: 6:30 pm-7:30 pm (See Program for Room)

    Speaker: Mary C. Sinnott, PT, DPT, MEd

    Level: Intermediate 

    Because of knowledge, evidence-based practice, and technological advances, patients who present with acute medical problems and experience major surgery are surviving at higher rates. However, due to economic pressures faced by all health care providers, there is a tendency to triage individuals to less-expensive care environments. These two issues are major influences on the practice of physical therapy today. This year's Lectureship will explore how the role of the physical therapist has evolved from pure intervention to consultation, triage, and interprofessional collaboration. Practice at this level must be defined by the physical therapist and not by the environment. In addition, PTs must fully exercise professional autonomy and engage in an intelligent conversation about what we contribute to the care of these individuals.

    Upon completion of this course, you'll be able to:

    • To be added

    Friday, February 10

    Furthering Acute Care Practice: Subject Matter Expert Task Force Forum

    Time: 8:00 am-10:00 am (See Program for Room)

    Speakers: Sharon L. Gorman, PT, DPTSc, GCS, Molly Crist, PT, DPT, Jennifer M. Ryan, PT, MS, DPT, CCS, Katherine S. Harris, PT, PhD, Karen Holtgrefe, PT, DHS, OCS, Wendy Johnson, PT, CCS, Ellen Wruble Hakim, PT, DScPT, MS, CWS, FCCWS, Mary Keehn, PT, DPT, MHPE, Paul Bernier, PT

    Level: Multiple Level

    This session provides an update on the petition to have acute care physical therapy recognized as a specialty area of practice, including updates concerning the status of acute care residency/fellowship education, physical therapist assistant (PTA) advanced proficiency in acute care practice, and acute care entry-level education recommendations. Come to hear where acute care practice is and what you can do, and to network with other acute care therapists and students.

    Upon completion of this course, you'll be able to:

    • Describe the status of petitioning ABPTS for recognition of acute care as a specialty in physical therapy practice.
    • Explain the importance of entry-level acute care recommendations and residency/fellowship education in moving acute care practice forward.
    • Describe the progress toward having acute care as an area of advanced proficiency for the PTA.
    • Discuss professional challenges related to these topics.

    ICU Equipment, Lines, and Tubes: Lifeline or Tripline?

    Time: 8:00 am-10:00 am (See Program for Room)

    Speaker: Christiane Perme, PT

    Level: Multiple Level

    Physical therapists working with patients in the intensive care unit (ICU) face a complex challenge. These patients have limited mobility due to life support and monitoring equipment, multiple medical problems, and muscle weakness. However, for selected patients in ICU, early mobility and walking enhances functional outcomes by optimizing cardiovascular/pulmonary and neuromuscular status. This session describes and explains ICU equipment, lines, and tubes. By being familiar with this essential information, clinicians can most appropriately manage their adult ICU patients and have a positive impact on their patients' recovery.

    Upon completion of this course, you'll be able to:

    • Identify and state the functions of basic equipment, lines, and tubes used in the ICU.
    • Identify different modes of ventilation and ventilator settings.
    • Synthesize information for use in clinical and academic practice.

    Standardized Treadmill Training: Raising Expectations for Gait Training Post Stroke

    Time: 10:30 am-12:30 pm (See Program for Room)

    (Joint Program: Geriatrics, Research, Neurology)

    Speakers: Karen J. McCain, PT, DPT, NCS, Patricia S. Smith, PT, PhD, NCS

    Level: Intermediate

    Despite the progress made understanding gait recovery after stroke, as well as the impact of interventions such as locomotor treadmill training, many questions remain unanswered. Research has often been constrained to application of novel interventions in the subacute or, more commonly, the chronic phase of recovery, with nonstandardized prescriptions for timing and dosing. The current and forecasted models of health care delivery mandate that the therapy community define reproducible, evidence-based interventions that have the best potential to maximize function. This session presents an evidence-based prescription for locomotor treadmill training that begins in the acute phase of recovery after stroke. A clearly defined, controlled application of ESTT (early standardized treadmill training) will be discussed in the context of the best available evidence. Not only will the intervention be defined, but the relevant neuroanatomy, neuroplasticity, and motor learning evidence will be reviewed to provide a clinical framework for gait training after stroke. Video of patients trained using this protocol will be included, along with data regarding gait velocity, falls, and assistive device use. Finally, the integration and progression of the intervention across the rehabilitation continuum will be discussed.

    Upon completion of this course, you'll be able to:

    • Explain the importance of using the evidence to develop effective clinical interventions.
    • Delineate the basic contributions of neuroanatomy, neuroplasticity, and motor learning to the recovery of gait after stroke.
    • Apply a defined and tested treatment protocol to initiate with patients in the acute phase of recovery after stroke.
    • Describe the progression of the approach across the continuum of care.

    *OVER CAPACITY -- Success With Early Mobility in Critical Care

    Time: 3:30 pm-5:30 pm (See Program for Room)

    Speaker: Amy Pawlik, PT, DPT, CCS

    Level: Multiple Level

    The increasing body of literature about early mobility in critical care is securing this intervention as a necessary component to consider in the management of patients experiencing critical illness. Recent research describes improvements in patient outcomes when physical therapy and occupational therapy interventions are paired with daily interruption of sedation in patients who are mechanically ventilated. These outcomes include increased functional independence, decreased neurocognitive complications of critical illness including the presence of ICU-acquired delirium, and decreased hospital and ICU length of stay. Despite the mounting evidence to support this intervention, the implementation of an early mobility program in many ICUs can be difficult. Barriers such as coordinating care to hold sedation, ensuring competency of intervening therapists, determining equipment needs, and gaining support of nurses, physicians, and hospital administration can challenge therapists who hope to change practice in their ICUs. This session aims to identify short- and long-term complications encountered by survivors of critical illness, describe early mobility as an intervention to prevent and manage the negative sequelae of critical illness, identify the physical therapist's role in an early mobility team, and address potential barriers to implementing an early mobility program in the ICU.

    Upon completion of this course, you'll be able to:

    • Explain the incidence of critical illness and the resultant functional and cognitive impairments.
    • Discuss recent interventions found to improve patient outcomes.
    • Describe essential components to consider when creating successful early-intervention programs.
    • Address potential barriers that may arise when developing an early-intervention program in the ICU including coordinating care to hold sedation, ensuring competency of intervening therapists, equipment needs, and gaining support of nurses, physicians, and hospital administration.

    Saturday, February 11

    The Obesity Epidemic: Considerations for the Physical Therapist, Part 1

    Time: 8:00 am-10:00 am (See Program for Room)

    Speakers: Lee Ann Eagler, PT, DPT, Sara Knox, PT, DPT

    Level: Intermediate

    An alarming 33.8% of Americans over the age of 20 are classified as obese (defined as a body mass index of greater than 30) according to the National Institutes of Health. Obesity is having a significant impact on our society and is now considered an epidemic. Substantial increases are occurring in health care costs due to obesity and its associated co-morbidities. Caring for this portion of our society goes beyond the skills of one physical therapist and requires the involvement of the entire physical therapy team, the entire medical team, and the facilities where the patients are being seen. However, many health professionals are not prepared to care for this particular patient population. Certain consideration must be given when evaluating and treating the patient who is obese, such as the options and availability of bariatric equipment and exercise prescription. In the first part of this course, the speakers will examine these considerations and explore viable solutions to existing barriers to treating the patient who is obese, with regards to prognosis, durable medical equipment, and exercise prescription.

    Upon completion of this course, you'll be able to:

    • Describe the current epidemiology and related costs of obesity in the United States of America.
    • Identify physiological changes and co-morbidities specific to the patient who is obese.
    • Identify barriers in the mobilization of the bariatric patient.
    • Discuss considerations in determining the prognosis of patients who are obese.
    • Describe mobility techniques that incorporate patient and physical therapist safety.
    • Discuss special considerations when treating the bariatric patient across the continuum of care.
    • Identify options in bariatric equipment.

    The Obesity Epidemic: Considerations for the Physical Therapist, Part 2

    Time: 10:30 am-12:30 pm (See Program for Room)

    Speakers: Sara Knox, PT, DPT, Lee Ann Eagler, PT, DPT

    Level: Intermediate

    Multiple national initiatives have been established to address the obesity epidemic. All initiatives recommend an increase in regular activity. While initiatives are being administered, barriers decrease the obese patients' ability to participate, and many facilities are implementing minimal lift policies to decrease injuries to workers in the health care settings. Despite these barriers, physical therapists are ideally suited to assist these patients with safe activity changes and functional mobility training. Part 2 of this course will address how the physical therapist can break the barriers and provide quality care to the patient who is obese across all practice settings while minimizing risk of injury. Discussion will cover environmental, functional, and psychological barriers as well as treatment considerations for endurance, strength, and balance. Finally, the obesity epidemic is just that, an epidemic. In order to make changes for the future of our society, physical therapists also must be involved in health initiatives that are occurring nationwide.

    Upon completion of this course, you'll be able to:

    • Discuss current national health initiatives and the physical therapist's role in these initiatives.
    • Identify barriers in the mobilization of the bariatric patient.
    • Describe mobility techniques that incorporate patient and physical therapist safety.
    • Prescribe appropriate exercise interventions for the patient who is obese.
    • Evaluate the trends of minimal lifting policies and their impact on physical therapists.
    • Discuss special considerations when treating the bariatric patient across the continuum of care.
    • Assess environmental design relative to the care of the bariatric patient.

    Understanding Mechanical Ventilation and the Implications for Physical Therapy Intervention

    Time: 3:30 pm-5:30 pm (See Program for Room)

    Speaker: Jennifer Zanni

    Level: Multiple Level

    Recent literature has demonstrated that early rehabilitation and mobilization of patients in the intensive care unit (ICU) is safe, feasible, and has led to improved short-term outcomes in this patient population. Physical therapists providing care to patients in the ICU need to have a thorough understanding of common ICU equipment and hemodynamic monitoring systems. For those patients requiring mechanical ventilation, the physical therapist must demonstrate an ability to recognize and interpret ventilator settings as well as identify common clinical challenges and possible solutions. This course will provide background information regarding mechanical ventilation systems and settings; enabling the physical therapist to apply appropriate clinical decision-making strategies to each individual patient they encounter who requires mechanical ventilation. The speakers will discuss the change in ICU culture-promoting mobility instead of immobility-as well as strategies to promote a team approach to the early mobility of patients who are mechanically ventilated. Clinical case studies will be used when relevant.

    Upon completion of this course, you'll be able to:

    • Identify types of airways and indications and precautions of each.
    • Identify common modes of ventilation and describe the assistance that each mode provides.
    • Interpret common alarms associated with mechanical ventilation and indicate an action for each.
    • Describe possible complications associated with mechanical ventilation.
    • Discuss and synthesize common weaning parameters and methods.
  • ADVERTISEMENT
  •