OTA 1170 Phys Dysfunction Fieldwork

Community Engaged Learning (CEL) Project and Reflection

         For my CEL project I made a PVC pipe exercise tree which cost about 30 dollars. I spent at least 15 hours on this project. I had some ideas for the project in my head but when my supervisor expressed an interest in the PVC tree I decided to go from there.

All of the ones she looked at online were 70 dollars minimum. After studying a picture of it online I felt like I had a good understanding of what was needed. I located all of the pieces at Lowe’s. The tools required for this project were: PVC pipes, fittings and pieces, PVC cutter, wooden round, super glue, ruler, pencil, hole punch, drill, string, laminated pictures with step-by-step instructions and a carrying tote. I had to drill, glue, cut and construct the object. Once that was complete, I needed to put a step-by-step booklet together.

The instructional booklet took a fair amount of time as well. I had to lay out each piece in sequence and snap a picture. I later edited each picture and inserted a short, concise instruction with a page number. After printing each picture, I took them to the copy shop and had each laminated. I then gave each a hole punch and threaded a string through to tie it all together. My husband had a tool bag that was brand new which he was never going to use so I swiped that to store all of the parts and pieces in.

This PVC pipe exercise tree works by following the instructions in the guide booklet to organize PVC pieces together to create a rectangle shape on a stand. This CEL project will help clients improve fine motor manipulation, cognition, ocular motor and visual perception skills.

This project was set up in a way that it can be added onto by future students or OT practitioners. The tote is big enough to hold extra pieces for future shapes and booklets and allows for easy storage.

Lindsy Kaminska

Fieldwork I CEL Project

November 8, 2023

Fieldwork I CEL Project Reflection

         During this project I learned how to make a PVC pipe exercise tree. I studied the pictures online, constructed it, and put an instructional booklet together to guide the user. Each part of this project took a fair amount of time. I located all of the pieces at Lowe’s to construct the PVC tree. The tools required for this project were: PVC pipes, fittings and pieces, PVC cutter, wooden round, super glue, ruler, pencil, hole punch, drill, string, laminated pictures with step-by-step instructions and a carrying tote. For the instructional booklet I had to lay out each pvc in sequence and snap a picture. I later had to edit each picture and insert a short, concise instruction with a page number. After printing each picture, I took them to the copy shop and had each laminated. I then gave each a hole punch and threaded a string through to tie it all together. My husband had a tool bag that was brand new which he was never going to use so I swiped that to store all of the parts and pieces in. I also learned that this CEL project will help clients improve fine motor manipulation, cognition, ocular motor and visual perception skills.

I thoroughly enjoyed putting this project together. When it was all finished my kids and husband enjoyed following the instructions and putting the PVC tree together. I think it’s going to be a helpful tool for the residents there. I feel like this is a useful tool for the OT practitioners and clients that should last for years to come.

I wouldn’t say this project was especially meaningful to me. However, I was excited to present this to my supervisor because I had worked so hard on putting it together and knew it was something she had wanted for a while. She did a wonderful thing for me that day and let me introduce, set up and explain the PVC pipe exercise tree to a resident there. This resident had lost her care giver/husband several years ago.  As she touched the PVC she said, “this reminds me of the time my husband and I worked together to put our sprinkling system in.” I like to think it was a happy memory for her and I was glad that this project did that for her. I don’t have any pictures of her using it as per her request.  She had previously been napping and didn’t feel presentable.

Client Data Collection 1

·      Client Diagnosis: unspecified dementia, mood disturbance and anxiety, congestive heart failure, generalized muscle                      weakness

·      Client Functional Deficits: cognition, poor balance, poor standing tolerance, ROM, gross motor skills

·      Occupational Areas which are or should be addressed with this client: getting her involved in meaningful occupations, such          as leisure. Pt needs work on community integration in the facility. Pt needs work on functional transfers

·      Client Measurable Goals: to participate c other patients/residents, implement toilet transfers and increase overall strength

·      Client Treatment Activities: therapeutic exercise, neuromuscular reeducation, manual therapy, group therapeutic procedures,        occupational therapy evaluation, moderate complexity, therapeutic activities, self-care management training

·      Client Response to Activities enjoys coloring, responds well, focused, inconsistent on transfers for fear of falling.

Client Data Collection 2

·      Client Diagnosis: Stroke affecting L side, dementia, limited mobility in R shoulder, arthritis, ROM in L shoulder limited.

·      Client Functional Deficits: upper body mobility causing difficulty c ADL’s, losing independence, safety awareness               deficits due to dementia

·      Occupational Areas which are or should be addressed with this client: ADL’s upper body mobility, sleep in proper              positions, leisure

·      Client Measurable Goals: lower body dressing goals c S, upper body dressing c set-up assist, sequencing tasks c S         for safety, increase ROM, from 0-105 degrees in R shoulder flexion.

·      Client Treatment Activities: increase upper body strength, ROM, safety awareness training, ADL training education

·      Client Response to Activities: actively participating, ROM in R shoulder is slow, and safety awareness c cueing

Client Data Collection 3

·      Client Diagnosis: Stroke affecting L side, arthritis in hands

·      Client Functional Deficits: L arm has hypertonicity affecting ROM, ADL of self-feeding requires max A, upper body dressing c       max A, groom hair c min A, use of w/c for mobility

·      Occupational Areas which are or should be addressed: ADL’s of feeding and grooming

·      Client Measurable Goals: ADL of self-feeding, working on stretching trunk, using the hand splint to extend L ring finger.

·      Client Treatment Activities: increase time in L hand splint, improve flexibility in neck and L shoulder

·      Client Response to Activities: today Pt tired quickly and cut treatment short, participated in contracture management of L               hand 

Client Data Collection 4

·      Client Diagnosis: Fell causing ORIF

·      Client Functional Deficits: ADLs in toilet transfer and toileting, dressing lower body and self-care while receiving mid A, insite        affected and decreased awareness

·      Occupational Areas which are or should be addressed with this client: ADLs of dressing self, lower body mobility

·      Client Measurable Goals: lower body dressing, supine to EOB, activity tolerance, transfer sit to stand, static standing

·      Client Treatment Activities: ROM strength in activity tolerance of PRE in order. To complete task of dressing

·      Client Response to Activities: Pt engaged in therapy, OT says she’s improving, poor ability to maintain TTWB, requires less          v/c for sequence of lower body dressing

Client Data Collection 5

·      Client Diagnosis: paraplegic, perineal care, super pubic catheter, colostomy bag, vaginal discharge, wants assisted living

·      Client Functional Deficits: no use of LE, fine motor skills are impaired

·      Occupational Areas which are or should be addressed with this client: ADLs, vaginal care, hygiene care

·      Client Measurable Goals: to empty catheter independently, work on fine motor skills, slide board transfer, and use of therabar     15 x per session

·      Client Treatment Activities:  therapeutic activity, purposeful activities include; getting nails done, slide board transfers and              transfer to assisted living. Do games c grandkids

·      Client Response to Activities: she follows directions, engages and she responds well when given options

Lindsy Kaminska 

OTA-1170 Fieldwork 

Round Table Written Report 

For my level 1 Fieldwork I was placed at Draper Rehab and Care Center. This is a skilled nursing and rehab facility with 64 beds, 14 are designated as skilled rehab beds. There are 46 long term care patients and 10 skilled rehab patients. The ages of the residents there varied from 35 to 96 years old, however 80 to 90 was the average age. The majority of residents lack mobility and have impaired cognition. Some of the diagnoses were paraplegia, hemiplegia, hemiparesis, stroke, arthritis, dementia, muscle weakness and injury from a fall.  

During my time there I shadowed Jamie Thaxton, a COTA with 14 years of experience. There was another COTA whose name was Katelyn Kunlzer and two OT/R’s named Alex Howard and Patrice Zhao. Each day spent at the center was a busy one. Jamie typically had a list of 8 residents to see. We would go to the residents’ room, and I would observe as Jamie would interact and begin treatment. She knew her residents well and I could tell she cared about them. She mostly used a MOHO adaptation in her treatment sessions. I never witnessed an OT practitioner do group therapy; it was always an individual session. Jamie was a helpful supervisor who was ready to answer any questions and educate me along the way.  

While I was there, I observed therapeutic use of occupations and activities with some preparatory interventions. Depending on the residents goals, and if they needed to work on preparatory tasks, Jamie would have them use the exercise bike, the therabar, fine motor boards or use weights. For purposeful tasks she used static standing, to help with balance and walking. For occupation-based interventions I observed ADL’s and play. I would say I saw a pretty even mix of occupations and activities and preparatory methods and tasks.  

One of the highlights of this experience came on the last day. I brought my completed CEL project in to present to Jamie, excited to see her use this with a resident. She said she knew just the person she was going to use it with. When we got to the residents room she said, “I want you to present this to her. Explain it, set it up and tell her how it works.” I was nervous yet excited for the opportunity. She completed the activity and judging from her comments I think she really enjoyed it. It sparked a good memory for her and that made me feel good about the work I was doing.  

One of the things I noticed while I was there was that every resident used a wheelchair and in their rooms were tools like reachers, dressing hooks, sock aids, shoehorns, and a variety of walkers. We had just learned about these adaptive aids. We learned about types of muscle conditions, synergies, medical terminology and acronyms, types of grading and tools used for measurements. We learned about FOR’s, cognitive deficits and record keeping.  It was great to see all of these things being used in the work setting.  

I 100 percent loved this experience as an educational tool. Time will tell if this is the right setting for me professionally but that is why we are here. I’m learning about me through fieldwork. One thing I know for sure is I will continue to care about the people I spent four days with and hope the best for them.