Accredited in September 2011
Authors:
Dr Primoz NOVAK, MD., MSc
Head of Unit
Department for Rehabilitation of patients after trauma, peripheral nerve disorders and rheumatic diseases
University Rehabilitation Institute
Linhartova 51
SI-1000 Ljubljana
SLOVENIA
primoz.novak@ir-rs.si
SUMMARY
The described programme of in-patient rehabilitation of persons with acquired peripheral nerve disorders in Slovenia is conducted only at the department for rehabilitation of patients after trauma, peripheral nerve disorders and rheumatic diseases at the University Rehabilitation Institute, Republic of Slovenia in Ljubljana (URI-Soča). The department provides rehabilitation for patients with peripheral nerve disorders due to various diseases as well as trauma and their consequences such as flaccid tetraparesis or paraparesis.
The goals of rehabilitation are to restore patient’s functional independency, to promote (natural) recovery, to prevent secondary complications in early phase of recovery and finally, to help return to her/his home environment.
Patients with non-traumatic peripheral nerve disorders are treated at the departments for neurology, neurosurgery, orthopaedics, infectious diseases, internal medicine, oncology and other departments in Slovenian hospitals. Patients after trauma receive their primary care at the closest regional hospital and are, if necessary, transferred within 24 hours to one of the three trauma centres in Slovenia, where they are surgically treated and they benefit from rehabilitation. Patients are admitted to the University Rehabilitation Institute Soča two weeks to several months after disease onset or trauma, depending on their general medical condition. The rehabilitation programme length is 1 to 4 months. Patients are treated by a rehabilitation team and out-patient follow-up is carried out after discharge as long as is necessary. There is direct communication between the acute care departments and the rehabilitation department of URI Soča. The physicians agree on patient’s transfer and each patient is entitled to the programme of rehabilitation which has no time limit imposed by the insurance system.
Patients are selected for rehabilitation on the basis of admission criteria. The selection of patients for rehabilitation programmes at the University Rehabilitation Institute is done by PRM specialists on the basis of a written proposal by PRM specialists or other specialists in Slovenian hospitals or after an examination at the Outpatient Clinic for peripheral nerve disorders patients at the University Rehabilitation Institute. The department for rehabilitation of patients after trauma, peripheral nerve disorders and rheumatic diseases has 30 beds for inpatient care. It is a part of University Rehabilitation Institute in Ljubljana and is the only such department in Slovenia. About 75 peripheral nerve disorders patients after trauma or disease come yearly for their first admission. There is a large outpatient clinic responsible for the admission and follow-up of peripheral nerve disorders patients. The unit and the Institute are under the authority of the Ministry of Health, Republic of Slovenia and the rehabilitation programme for the patients is paid completely by National Health Insurance. There are 3 full-time PRM specialists, 5 physiotherapists, 3 occupational therapists, 2 university college graduated nurses, 15 nursing staff, one social worker and one psychologist. The multidisciplinary team meets regularly once weekly. There are FIM, FIC, Berg balance scale, COPM and MMT regularly recorded. A clinical pathway will soon be introduced for planning and evaluation of the rehabilitation programme.