Deliver delegated rehabilitation sessions

What is going on

Frank Dellabosca (LH-11876) is six weeks after a total knee replacement and is attending an eight-session rehabilitation program delegated to the allied health assistant by the physiotherapist, Liam Fotheringham. Sessions 5 and 6 are this week. The Allied Health Treatment Plan and Delegation Template sets the exercises, the dose, the stop and report criteria and states that Frank must not progress to stage 2 exercises before the physiotherapist reviews him on 23 September. At session 5 Frank tells you his knee was more swollen last night and asks to try the harder exercises because he wants to get back to work. On 5 September another patient became light-headed in a group session and pre-session checks are now mandatory.

Your brief

Deliver sessions 5 and 6 exactly within the delegation, complete and record the pre-session checks, respond correctly to the swelling report and the request to progress, document each session the same day in the patient record and send the physiotherapist a progress note after session 6.

Work through it

You do not need to do it all. Doing a few of these will show you what the work is like. Your ticks and notes stay on this device.

• Read the Allied Health Treatment Plan and Delegation Template for Frank and list the exercises, the dose, the stop and report criteria and the limits on your role.
• Complete the pre-session checks at session 5 (pain level, swelling, dizziness, blood pressure where required) and record them in the patient record.
• Decide how you respond to the report of increased swelling: whether the session proceeds, is modified or is stopped, and who you inform, and record the decision.
• Explain to Frank, in words you would actually use, why you cannot progress him to stage 2 exercises before the physiotherapist's review, and record the conversation.
• Deliver session 5 within the delegation and document the exercises, dose completed, patient response and any modification in the Patient Records and Appointments system.
• Deliver session 6, repeat the pre-session checks, and document the session the same day.
• Write a progress note to the physiotherapist summarising both sessions, the swelling report, Frank's goal to return to work and your observations ahead of the 23 September review.
• Review the 5 September light-headed episode in the Clinical Incident and Hazard Register and note one thing you did differently as a result.

What someone in this role would produce

• Two completed session records in the patient record with pre-session checks
• Written decision on the swelling report
• Progress note to the physiotherapist
• Reflection on the incident register lesson