Chest Physio and severe physical disability

[HollyG]

A colleague and myself have started an education programme at a local residential home for children and adults with profound learning and physical disability.
We do an introduction into how physical disability impacts upon lung function, susceptibility to chest infections etc and how postural management, exercise and specific chest physiotherapy can prevent and treat.

Although we are pleased with the results of the lectures (this winter we have noticed a reduction in hospital admissions of the residents for chest infections - audit currently being undertaken) we have some concerns over some of the care homes work practices. Some of the residents who do not have specific chest pathology are given 15-20 mins of manual chest physio with (+/- postural drainage) up to 6 times a day. To me this seems more than over zealous. The problem is, it's historical and they are proud of their results.

Clinically I find it highly unlikely that a resident would require so much manual chest physio and feel inclined to recommend position changes, postural management equipment, hydro, exercise etc as a first choice. I am not saying that it doesn't have its place .... but an hour and a half a day seems excessive to me, But you may have other ideas.

We are going to be having a problem-solving workshop with the duty managers at the beginning of May. I would highly appreciate any advice, articles, experience that will help me out!
Thanks in anticipation
Holly




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[violablue]

? Query, how do they know what postural drainage positions to put the people in if the people have no chest issues? My perception was the positions happen because of problems with a certain area of the lung. And the area of lung problem determines position used.