1. Infant Onesie for improving teaching of Chest Physiotherapy
Clare Smith, BSc Phys, & Nancy Pullan, BSc Phys, Alberta Children’s Hospital, Calgary, Canada
Background
Newborn screening for CF in Alberta has resulted in age at diagnosis to decrease to approximately 3 weeks. These families, still adjusting to their newborn, are overwhelmed by this new information. These infants are frequently perceived by the families as asymptomatic in contrast to those children diagnosed clinically prior to screening implementation.
Chest Physiotherapy is considered to be a primary component in the management of CF. The treatment routine is time consuming and often regarded as a significant burden of care. Recall of specific treatment techniques is inconsistent at follow-up appointments and implementation of a consistent routine is slow.
Objectives
Provide chest physiotherapy teaching in a consistent but fun and memorable way to attempt to minimize parental fears about the burden of physiotherapy.
Provide a combination of visually based tools to improve recall of techniques and facilitate ongoing treatment.
A secondary objective was to provide a tool that the parents could share with extended family to facilitate sharing of the task.
Description
Infant Onesies were printed with colourful stylized child’s handprints providing landmarks for percussion.
A handout was produced demonstrating modified postural drainage positioning of an infant in the onesie,
Colour photographs were used to ensure consistency between the two teaching tools.
Onesies and handout were provided to each family at initial physiotherapy teaching.
Onesies were also given to families with young children who had received teaching prior to completion of the tools and the handouts were given to all families using postural drainage and percussion.
“As you showed us what to do we thought ‘how hard can it be to do that?’ – it was SO hard. Having the onesie has provided us with a substitute PT at home”
“I felt really comfortable with the teaching we had, and the follow-up … but when we got the onesie and handout I found I was correcting little things I had been doing wrong for months”
Outcomes
The combination of teaching tools has improved consistency of information given to families.
Recall of information and techniques by parents has improved markedly since the combination of tools was implemented.
Families appear more relaxed and willing in follow-up appointments to demonstrate their treatments to therapists.
Families who did not receive the onesie and handout combination at diagnosis felt that it would have facilitated involvement of extended family in physiotherapy treatment, however, the families taught using the combination of tools did not feel that the tools influenced their involvement of extended family.
Acknowledgements: ACH inpatient physios, Catherine, Owen, Lori and Brianna.
The production of the infant onesies was supported by an educational grant from Organon Pharmaceuticals