Only a small proportion of recommendations arising from RCAs in Victoria are 'strong'. This suggests that insights from the majority of RCAs are not likely to inform practice or process improvements. Suggested improvements include more human factors expertise and independence in investigations, more extensive application of existing tools that assist teams to prioritize recommendations that are likely to be effective, and greater use of observational and simulation techniques to understand the underlying systems factors. Time spent in repeatedly investigating similar incidents may be better spent aggregating and thematically analysing existing sources of information about patient safety.
Participants from both settings described their experience in positive terms, reflecting satisfaction with their management by an expanded scope of practice musculoskeletal physiotherapist.
As the prevalence of musculoskeletal conditions increases, a new workforce of advanced musculoskeletal physiotherapists is emerging. A clinical education framework has been developed to address the specific needs of the population, organisations and experienced musculoskeletal physiotherapists recruited to these roles. A competent workforce has direct benefits for the community, healthcare organisations and the physiotherapy profession.
Background Water displacement is considered to be the gold standard for measuring foot volume; however, it is time-consuming and infrequently used in clinical practice. The objectives of this study were to determine whether a home-made water displacement device is a reliable and time-efficient method for determining foot volume. Methods Thirty participants with no foot pathologies were enrolled and had their foot volume measured in two home-made water volumetry devices (Preski and PreskiLite). The participants' foot volumes were measured on two occasions on each of two different days. Results All measurements were achieved in less than 90 seconds. Within-day reliability was high (intraclass correlation [ICC]=0.997–0.999) with the minimal detectable change (MDC) at the 90% confidence level (MDC90) of less than 25 ml for both devices. Mean differences in volume displaced between days were small (range 0.6– -5.4 mls). For between-day measures on the same leg, the mean coefficient of variation ranged from 0.65–1 with associated ICCs of 0.989–0.997. The MDC90 for between-day measures was 46 ml for the PreskiLite and 23 ml for the Preski. The difference in volume displaced between right and left legs was less than the MDC90 for both devices. Conclusions A novel, home-made water volumetry device provides reliable measures of foot volume both within and between days. Measurements taken on the contralateral leg provide an adequate control. These portable devices provide rapid measurements and only one measurement is needed per day.
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