Changing tides in healthcare - Wounds, brain injury, and palliative medicine with Team 20
In the spring of 2018, NepalAbility sent another dedicated team to Nepal to support NepalAbility’s clinical partners. This group consisted of James Bardy, occupational therapist, registered nurses Anita Vanderwerf & Jill Petersen, and family physician Dr. Peter Derkatch.
United Mission Hospital Tansen (UMH)
The variety of the teaching curriculum at UMH was based on the expressed needs of the staff. Jill and Anita gave a lecture and training on wound care for the nursing staff, as well as an introduction to the Pressure Ulcer Scale for Healing (PUSH) tool for wound scoring. Dr. Derkatch gave a lecture and reference materials to a large group of physicians, surgeons and nurses on palliative care, its history and treatment approaches.. This topic was timely and well received as UMH had recently hired a dedicated palliative nurse to their team.
Meanwhile, in the rehabilitation department, 10 manual wheelchairs had recently been delivered, (in part due to the NepalAbility’s contributions). This prompted discussions of whether UMH Tansen could be a centre for coordinating and ordering wheelchairs for patients across Nepal. James conducted two well-received workshops on wheelchair prescription with the physiotherapy and nursing staff, with a focus on how to customize each wheelchair’s fit to its recipient.
The physiotherapists also attended a workshop with James on Vestibular/Oculomotor Screening (VOMS) for patients with concussion, as well as an introduction to cognitive assessments. The staff had expressed a need for additional learning in this area, with the goal to provide evidence based cognitive assessments to a broader range of patients. Like other countries in the region, this was also in response to the increase in trauma and brain injuries in Nepal, as the spread of communicable diseases continues to decline, but as the world moves to greater vehicle use and urbanization.
While in Tansen, the team visited the New Life Psychiatric Rehab Centre Facility, just a short drive downhill from UMH. This facility houses people with mental health challenges whose families are unable to support them. Most of the people there live with mental illness such as schizophrenia or bipolar disorders, alongside people with developmental delays who require daily support. A vast acreage has been developed with terraced rice fields and vegetable gardens, and the facility aims to be self-sustaining with power through methane from cow manure.
Green Pastures Hospital and Rehabilitation Centre (GPH)
Teaching and Learning: The focus of this visit wasaround trauma ehabilitation, identified as a primary need. James reviewed the use of outcome measures, and approaches for standardization to support the development of treatment protocols, best practices, and to advocate for funding. The team also offered some bedside teaching, and a repeat workshop on concussion and VOMS.
Dr. Derkatch furthered his discussions on palliative care with Dr. Ruth Powys, who has been championing palliative care both in Tansen and Pokhara. These meetings also lead to preliminary development of a national Nepali palliative strategy.
Finally, Anita & Jill conducted small group sessions on wound measurements with the nursing staff, as well as reviewed basic bowel and bladder routines to support implementation of practice protocols.
As always it was a privilege for the team to visit and provide their support to our clinical partners in Nepal Scroll down for more photos from this visit!
United Mission Hospital Tansen (UMH)
The variety of the teaching curriculum at UMH was based on the expressed needs of the staff. Jill and Anita gave a lecture and training on wound care for the nursing staff, as well as an introduction to the Pressure Ulcer Scale for Healing (PUSH) tool for wound scoring. Dr. Derkatch gave a lecture and reference materials to a large group of physicians, surgeons and nurses on palliative care, its history and treatment approaches.. This topic was timely and well received as UMH had recently hired a dedicated palliative nurse to their team.
Meanwhile, in the rehabilitation department, 10 manual wheelchairs had recently been delivered, (in part due to the NepalAbility’s contributions). This prompted discussions of whether UMH Tansen could be a centre for coordinating and ordering wheelchairs for patients across Nepal. James conducted two well-received workshops on wheelchair prescription with the physiotherapy and nursing staff, with a focus on how to customize each wheelchair’s fit to its recipient.
The physiotherapists also attended a workshop with James on Vestibular/Oculomotor Screening (VOMS) for patients with concussion, as well as an introduction to cognitive assessments. The staff had expressed a need for additional learning in this area, with the goal to provide evidence based cognitive assessments to a broader range of patients. Like other countries in the region, this was also in response to the increase in trauma and brain injuries in Nepal, as the spread of communicable diseases continues to decline, but as the world moves to greater vehicle use and urbanization.
While in Tansen, the team visited the New Life Psychiatric Rehab Centre Facility, just a short drive downhill from UMH. This facility houses people with mental health challenges whose families are unable to support them. Most of the people there live with mental illness such as schizophrenia or bipolar disorders, alongside people with developmental delays who require daily support. A vast acreage has been developed with terraced rice fields and vegetable gardens, and the facility aims to be self-sustaining with power through methane from cow manure.
Green Pastures Hospital and Rehabilitation Centre (GPH)
Teaching and Learning: The focus of this visit wasaround trauma ehabilitation, identified as a primary need. James reviewed the use of outcome measures, and approaches for standardization to support the development of treatment protocols, best practices, and to advocate for funding. The team also offered some bedside teaching, and a repeat workshop on concussion and VOMS.
Dr. Derkatch furthered his discussions on palliative care with Dr. Ruth Powys, who has been championing palliative care both in Tansen and Pokhara. These meetings also lead to preliminary development of a national Nepali palliative strategy.
Finally, Anita & Jill conducted small group sessions on wound measurements with the nursing staff, as well as reviewed basic bowel and bladder routines to support implementation of practice protocols.
As always it was a privilege for the team to visit and provide their support to our clinical partners in Nepal Scroll down for more photos from this visit!