title: Rehabilitation in skilled nursing centres for elderly people with lower limb amputations: a mixed-methods, descriptive study.
abstract: OBJECTIVE
  To describe the current set-up, barriers and potential for providing rehabilitation to people with lower limb amputation in skilled nursing centres.
  
  
  METHODS
  Survey and interviews.
  
  
  METHODS
  Elderly care physicians, physiotherapists.
  
  
  METHODS
  In 2011, clinicians from 34 skilled nursing centres participated in a semi-structured interview covering rehabilitation and daily care, personal skills and training, team work and communication, and discharge processes.
  
  
  RESULTS
  Each centre sees only a small proportion of people with amputation (a maximum of 3.6% of all admissions). This limited number of patients appears to be the main barrier in providing care, as it is difficult for clinicians to maintain knowledge, and resources are spread widely. Two main areas of improvement were suggested by participants: (i) use of guidelines in care; and (ii) collaboration with specialized team members.
  
  
  CONCLUSIONS
  The spread of patients across many centres makes it difficult for professionals working in skilled nursing centres to obtain the necessary skills and knowledge for care of people with amputation. A designated skilled nursing centre for amputation rehabilitation is presented as a solution, but smaller clinical changes are also suggested, including improvements in communication and training.
authors.affiliation: Department of Rehabilitation Medicine, University Medical Center Groningen, PO Box 30.001, NL-9700 RB Groningen, The Netherlands. l.v.fortington@umcg.nl, lauren.fortington@gmail.com.
authors.forename: Lauren V
authors.initials: LV
authors.lastname: Fortington
authors.forename: Gerardus M
authors.initials: GM
authors.lastname: Rommers
authors.forename: Anne
authors.initials: A
authors.lastname: Wind-Kral
authors.forename: Pieter U
authors.initials: PU
authors.lastname: Dijkstra
authors.forename: Jan H B
authors.initials: JH
authors.lastname: Geertzen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000534:rehabilitation*; D006801:Humans; D035002:Lower Extremity / Q000601:surgery*; D008875:Middle Aged; D009426:Netherlands; D012866:Skilled Nursing Facilities