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Compression Garment Selection, Fitting and Monitoring Project for Malignancy Related Lymphoedema – Project Completion Report - 44 -

Appendices


Appendix A: Guideline for Compression Garments






Appendix B: TOR Steering Committee

TERMS OF REFERENCE Compression garment selection, fitting and monitoring

implementation

Steering Committee

PURPOSE

The purpose of the Statewide Compression garment selection, fitting and monitoring

implementation Steering Committee (the “Committee”) is to provide oversight, strategic

advice and support for the development, direction and implementation of the redesign

trial and implementation for the Guideline for Compression Garments for Adults with

Malignancy Related Lymphoedema: Eligibility, Supply and Costing

MEMBERSHIP

Sponsor (or representative), Chief Allied Health

Officer, Allied Health Professions Office of

Queensland (AHPOQ), Department of Health,

Queensland

Julie Hulcombe

Allied Health Professional Leader/Project Officer,

AHPOQ

Fiona Hall

Directors of Allied Health Professional Advisory

Group

Kerrie-Anne Frakes

Director of Physiotherapy Mark Cruickshank

Director of Occupational Therapy Vilma Girardi

Rural and Remote Workforce Committee

Representative

Ilsa Nielsen

Cancer Care Workforce Development

Representative

Suzanne McCorkell

Academic Representation : James Cook

University

Susan Gordon

Chair: Sponsor

Coordinator: Coordination and secretariat functions are provided by the Project Officer

OBJECTIVES

The Committee will:


Provide strategic advice and support regarding the implementation for the Guideline

for Compression Garments for Adults with Malignancy Related Lymphoedema:

Eligibility, Supply and Costing

Provide oversight, guidance and feedback to the project officer and sponsor on all

facets of the compression garment selection, fitting and monitoring redesign project.

– Contribute to the development and review of project documentation including

project plan, resources developed, education package and completion report.

Support information provision and consultation processes with stakeholders in

respective areas.

PRINCIPLES OF OPERATION

The Committee will meet monthly for the development phase of the project (February

2014 - June 2014) and then bimonthly for the remainder of the project (July 2014-June

2015) or at a frequency otherwise agreed by member consensus.

Extraordinary meetings may be called by the Chair if indicated.

Papers may be electronically circulated out-of-session by the Chair for noting or

decision.

A quorum will consist of 50% of Committee members plus the Chair.

Members may provide a suitably briefed proxy if they are unable to attend a meeting.

The Member must notify the Chair of their nominated proxy prior to the meeting.

Agenda and any briefing documents will be distributed 5 working days before the

meeting.

Minutes will be distributed within 5 working days of the meeting.

REPORTING RELATIONSHIPS

The Committee is sponsored by the Chief Allied Health Officer, Allied health

Professions Office Queensland

Recommendations from this Committee may contribute to information provided to the

Project officer for decision / action.

RESPECT AND CONFIDENTIALITY

Committee discussions will be professional, respectful and value the contribution of all

members.

Notwithstanding the information sharing and communication functions of the

Committee, any information that a Committee member identifies as sensitive or not for

dissemination shall be treated as confidential by members.

DISTRIBUTION OF MINUTES

The minutes will be provided to the Committee members, and may be provided to the

Directors of Allied Health Professions Advisory Committee if requested.

ENDORSEMENT:


Appendix C: TOR Reference Group

TERMS OF REFERENCE Compression garment selection, fitting and monitoring

Implementation

Reference Group

PURPOSE

The purpose of Statewide compression garment selection, fitting and monitoring

Implementation Reference Group (the “Reference Group”) is to:

support the implementation of the Guideline for Compression Garments for Adults with

Malignancy Related Lymphoedema: Eligibility, Supply and Costing

Provide guidance for and support the implementation of the initiative

Promotion of available education opportunities for Lymphoedema Therapists

MEMBERSHIP

Chair: Statewide Lymphoedema Working Group Chair Suzanne McCorkell

Project Officer : Allied Health Professions Office Fiona Hall

Statewide lymphoedema working group members:

Cairns Hospital

Princess Alexandra Hospital

Royal Brisbane and Womens Hospital

Townsville Hospital

Lauren Frame

Amanda Purcell

Hildegard Reul-Hirche

Nicola Cosgriff

Central Area, Cancer Care Work Force Development

Officer

Juanine Passfield

Coordination: Chair: Statewide lymphoedema Working Group Chair

Coordination and secretariat functions will be provided by the Project Officer

OBJECTIVES

The Reference Group will:

Provide guidance and develop resources for the trial

Help facilitate the implementation of the initiative

Provide leadership and support the implementation of the Guideline for Compression

Garments for Adults with malignancy Related Lymphoedema: eligibility, Supply and

Costing.


The Reference Group will meet approximately monthly for the term of the development

of the resources and then bimonthly until the completion of the redesign trial and

implementation of the Guideline (February 2013– June 2015) or at a frequency

otherwise agreed by member consensus.



decision.


As the Reference Group is not a decision making group, a quorum is not required,

however in the event of low attendance, attendees will determine if the meeting is to

proceed.


meeting.

A record of actions and resolutions will be distributed within 5 working days of the

meeting for members’ review.

ACCOUNTABILITY AND REPORTING RELATIONSHIPS

The Reference Group is sponsored by and reports through the Chief Allied Health

Office, Allied Health Professions Office Queensland.

Recommendations from this Reference Group may be provided to the Steering

Committee for decision / action.

Final decision making rests with the sponsor


Reference Group discussions will be professional, respectful and value the contribution

of all members.

Notwithstanding the information sharing and communication functions of the Working

Group, any information that a Working Group member identifies as sensitive or not for



The minutes will be provided to the Sponsor for noting.

The minutes may be provided to Steering Committee in relation to specific issues /

matters, at the discretion of the Chair.


Appendix D: TOR Working Group

TERMS OF REFERENCE Working Group

PURPOSE

The purpose of Statewide compression garment selection, fitting and monitoring

redesign trial, Working Group is to support the implementation of the redesign trial

MEMBERSHIP

Project Officer : Allied Health Professions Office Fiona Hall(Chair)

Lymphoedema Therapists

A/Advanced Oncology Occupational Therapist

Cairns Base Hospital

Lauren Frame

Cancer Care Occupational Therapist, Gladstone

Hospital

Robyn McMillan

Senior Physiotherapist, Cancer Care Support Team

Bundaberg Hospital

Natasha Moore

Occupational Therapist, Nambour General Hospital Michelle Basford

Occupational Therapist, Princess Alexandra Hospital Megan Trevethan

Senior Occupational Therapist The Townsville

Hospital

Nicola Cosgriff

Occupational Therapy Dept, Mackay Base Hospital.

Bridge Road, Mackay, Qld 4740

Nicole Little

Kirsty Bell

Generalist Therapists

Physiotherapist, Cooktown Multipurpose Health

Service

Debra Horsfield

Occupational Therapist, Atherton Hospital Cathryn Taylor

Occupational Therapist, Emerald Hospital Asmita Sarang

Senior Occupational Therapist, North Wide Bay

Gayndah Community & Rural Allied Health, Gayndah

Elizabeth Keith


Occupational Therapist, North Wide Bay, Gayndah

Community & Rural Allied Health, Gayndah

Kirsty Bailey

Occupational Therapist, Caloundra Sunelle Hargreaves

Occupational Therapist, South West, Charleville,

QLD,

Melinda Brassington

Occupational Therapist, Roma Hospital Yvette Ladner

Occupational Therapist Proserpine Stephanie Fanias

Chair: Project Officer, AHPOQ

Coordination and secretariat functions will be provided by the Project Officer,

OBJECTIVES

The Working Group will:

provide a forum for regular informal reporting of progress on the implementation of

project activities and achievement of project milestones at local Hospital and Health

Service Sites (HHS)

provide opportunity for sharing of barriers, strategies and learning’s between HHS’s

provide peer support and guidance for the Project Site Coordinators (PSCs)

provide updates from the project officer and collection and review of evaluation data


The working group will meet approximately bi-monthly for the term of the

implementation of the Redesign Trial (October 2014– October 2015) or at a frequency

otherwise agreed by member consensus.



decision.

As the Working Group is not a decision making group, a quorum is not required,

however in the event of low attendance, attendees will determine if the meeting is to

proceed.


meeting.

A record of actions and resolutions will be distributed within 5 working days of the

meeting for members’ review.

ACCOUNTABILITY AND REPORTING RELATIONSHIPS

The Working Group is sponsored by and reports through the Chief Allied Health Office,

Allied Health Professions Office Queensland.


The Working Group does not possess decision-making accountability in relation to the

project. Recommendations from this Working Group may be provided to the CGPFAM

Steering Committee for decision / action.


Special Interest Group discussions will be professional, respectful and value the

contribution of all members.

Notwithstanding the information sharing and communication functions of the Working

Group, any information that a Working Group member identifies as sensitive or not for



The minutes will be provided to the Sponsor for noting.

The minutes may be provided to Steering Committee in relation to specific issues /

matters, at the discretion of the Chair.


Appendix E: Capabilities of the compression garment selection, fitting and monitoring education program

Module 1: Overview of lymphatic system and lymphoedema

Knowledge

(knowing what)

Skills

(knowing how)

Therapeutic approach

Anatomy, physiology,

pathophysiology of the lymphatic

system

Risk factors for malignancy related

lymphoedema

Functional and psychosocial impact

of having lymphoedema

Identify signs of lymphoedema

Apply lymphoedema grading

system

Provide clear

explanations to patient

to assist their

understanding of

lymphoedema.

Module 2. Assessment of lymphoedema

Causes of and contributors to

malignancy-related lymphoedema

Knowledge of differential diagnosis

including metastasis

Contraindications for compression

Accurately conduct

circumferential measurements

and pitting test

Complete a thorough and

accurate lymphoedema

assessment

Evaluate history to determine

suitability for compression

Identify suitable referral

pathway to tertiary services

Provide thorough

assessment of status of

patient with stable

lymphoedema

Identify when patient

requires intervention

from lymphoedema

therapist

Module 3. Management of lymphoedema

Overview of the full scope of

management of malignancy related

lymphoedema

Role of generalist therapists in

management of malignancy related

lymphoedema

Contraindications and precautions to

compression therapy

Determine the appropriateness

of compression therapy for an

individual patient

Provide individualised

information related to use of

compression garments, risk

reduction strategies, skin care

and exercise advice

Partner with patients in

the development &

monitoring of

individualised self-

management plans


Module 4. Compression therapy and garments.

Principles of compression therapy.

Range and characteristics of

compression garments including:

correct fitting principles and

consequences of poor fit; donning/

doffing strategies; garment care and

wearing precautions

Determine appropriate

compression garment

prescription based on

assessment outcomes

Fit and evaluate the

compression garment

prescribed

Provide a regime for wearing,

care instructions and

precautions for compression

garments

Apply professional reasoning

to emergent problems with

compression garment wear

and identify appropriate

resolution.

Using a patient centred

approach the therapist

will support the

individual patient in the

long term self-

management of stable

lymphoedema

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