Predicting Community Discharge for Occupational Therapy Recipients in the Neurological Critical Care Unit

2021 ◽  
Vol 76 (1) ◽  
Author(s):  
Matt P. Malcolm ◽  
Adam R. Kinney ◽  
James E. Graham
Keyword(s):  
Critical Care ◽  
Occupational Therapy ◽  
Critical Care Unit ◽  
Inpatient Rehabilitation ◽  
Cross Sectional ◽  
Term Care ◽  
Discharge Disposition ◽  
Comorbidity Burden ◽  
Therapy Services ◽  
Neurological Critical Care

Importance: Occupational therapy in the neurological critical care unit (NCCU) may enable safe community discharge by restoring functional ability. However, the influence of patient characteristics and NCCU occupational therapy on discharge disposition is largely unknown. Objective: To examine how patient factors and receipt of occupational therapy predict discharge disposition for NCCU patients. Design: Retrospective cross-sectional cohort study of electronic health records data from adults admitted to the NCCU between May 2013 and September 30, 2015. Setting: NCCU in a large urban academic hospital. Participants: Adults age 18 yr or older (N = 1,134) admitted to the NCCU. Outcomes and Measures: Using logistic regression with discharge disposition as the dependent variable, we entered sex, age, length of stay (LOS), baseline Glasgow Coma Scale score, Elixhauser Comorbidity Index, and receipt of occupational therapy services as predictor variables. Results: Of NCCU patients, 39% received occupational therapy. Younger age, shorter LOS, lower comorbidity burden, and not receiving occupational therapy services increased the likelihood of discharge to the community. Men who received occupational therapy were less likely to be discharged to the community than men who did not receive occupational therapy. As age increased, differences in the probability of community discharge decreased between recipients and nonrecipients of occupational therapy services. Conclusions and Relevance: Our results suggest that patients receiving occupational therapy services in the NCCU may have a lower likelihood of community discharge. However, these findings may result from therapist's consideration of the safest discharge location to ensure the greatest balance between independence and support. What This Article Adds: This study's findings suggest that receipt of occupational therapy in the NCCU is associated with higher likelihood for noncommunity discharge (i.e., to inpatient rehabilitation, skilled nursing, or long-term care). However, activity limitations and comorbidity burden may be greater for recipients of occupational therapy, and these NCCU patients are presumably less prepared for community discharge.

scholarly journals Patient functional independence and occupational therapist time-use in inpatient services: Patient demographic and clinical correlates

2021 ◽  
pp. 156918612110187
Author(s):  
Bianca E Summers ◽  
Kate E Laver ◽  
Rebecca J Nicks ◽  
Nadine E Andrew ◽  
Christopher J Barr ◽  
...  
Keyword(s):  
Occupational Therapy ◽  
Time Use ◽  
Health Care Expenditure ◽  
Functional Independence ◽  
Occupational Therapist ◽  
Sociodemographic Characteristics ◽  
Cross Sectional ◽  
Patient Demographics ◽  
Therapy Services ◽  
Multivariable Modelling

Introduction Health care expenditure has rapidly increased in Australia. Effective management of occupational therapy services is required to meet clinical demand. Improving our understanding of factors which influence occupational therapy service delivery is a vital step to manage workload distribution and optimise service efficiency. This study aims to examine the influence of patient sociodemographic characteristics, diagnosis and functional independence on the utilisation of occupational therapy resources in hospital inpatients over 18 years old. Methods Prospective, cross-sectional, observational cohort study of 4549 inpatients from three hospital sites in Melbourne, Australia. Data extracted from organisational databases and included in this study were: patient demographics, diagnosis, functional level assessed using the SMAF (Functional Autonomy Measurement System) and occupational therapy time-use. Data were analysed using univariable and multivariable modelling. Results Occupational therapy time-use was significantly associated with all variables included in analysis ( p < 0.05). For each variable the amount and direction of effect differed between hospital sites. The SMAF was the only variable consistently associated with occupational therapy time-use. Higher occupational therapy time-use was associated with lower functional independence (leading to a 3.5 min increase in median occupational therapy time for every unit decrease in SMAF score). Conclusions Management of resources within busy hospitals require knowledge of factors associated with occupational therapist time-use. This study identified that time-use could in part be predicted by functional independence, diagnosis and sociodemographic characteristics. Occupational therapy managers can use this information to support decision making while acknowledging other patient and therapist level factors also influence time-use.

Prognosis of Stroke Patients Requiring Mechanical Ventilation in a Neurological Critical Care Unit

Stroke ◽  
1997 ◽  
Vol 28 (4) ◽  
pp. 711-715 ◽  
Author(s):  
Thorsten Steiner ◽  
Gabriel Mendoza ◽  
Michael De Georgia ◽  
Peter Schellinger ◽  
Rolf Holle ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Critical Care ◽  
Critical Care Unit ◽  
Stroke Patients ◽  
Neurological Critical Care

scholarly journals Attitude and coping before death: A current challenge for nurses in times of pandemic [Actitud y afrontamiento ante la muerte: Un desafío actual para los profesionales de enfermería en tiempos de pandemia]

2020 ◽  
Vol 4 (2) ◽  
pp. 13
Author(s):  
Alda Eliana Orihuela Castro ◽  
Mónica Elisa Meneses-La Riva ◽  
Melitta Fidelia Cosme Mendoza ◽  
Silvia Ofelia Soriano Ramos ◽  
María Gioconda Lévano Cárdenas ◽  
...  
Keyword(s):  
Critical Care ◽  
Cancer Patient ◽  
Critical Care Unit ◽  
Emotional Health ◽  
Quality Of Work Life ◽  
Cross Sectional ◽  
Leading Role ◽  
Occupational Risks ◽  
The Face ◽  
And Coping

Currently the pandemic has caused health systems to collapse due to the high demand of patients with VOC 19 with a high risk of mortality bringing with it pain, suffering and death. Objective: To determine the relationship between a nurse's attitude and coping with the death of a cancer patient with COVID-19 in the Critical Care Unit. Methodology: Quantitative, correlational, cross-sectional and non-experimental design approach. The population is made up of a total of 65 nursing professionals who work in the Critical Care Unit. An instrument was applied on attitudes towards death CAM with 3 dimensions: affective, behavioral and cognitive, with 33 items and the Bugen Scale for facing death with 30 items, both Likert scales. The results show that there is a significant correlation 0.039 between both variables and in the case of the nurse's attitude according to the dimensions: cognitive, behavioral, affective and coping, their correlations are: 0.521, 0.719, 0.015 respectively. It is concluded that the attitude and the coping of the nursing professional in the face of the death of the cancer patient with COVID 19, assume a posture of resilience to offer continuous nursing care to ensure, restore and safeguard the life of the person as a priority in their leading role within the health system based on commitment and social responsibility despite the threats of existing occupational risks. It is suggested to offer psychological protection to diminish the potential risks in the emotional health and quality of work life.

scholarly journals Telehealth for the Provision of Occupational Therapy: Reflections on Experiences During the COVID-19 Pandemic

2020 ◽  
Vol 12 (2) ◽  
pp. 77-92
Author(s):  
Sue Dahl-Popolizio ◽  
Heidi Carpenter ◽  
Melissa Coronado ◽  
Nicholas J. Popolizio ◽  
Connor Swanson
Keyword(s):  
Occupational Therapy ◽  
Service Delivery ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Service Delivery Model ◽  
Cross Sectional ◽  
Delivery Model ◽  
Therapy Services ◽  
Effective Service ◽  
Therapy Service

During the COVID-19 pandemic of 2020, healthcare professionals worldwide abruptly shifted from an in-person to a telehealth service delivery model. Many did so without advanced training or preparation. This cross-sectional study explored how occupational therapy practitioners (OTPs) used telehealth during the COVID-19 pandemic, and whether they found it to be an effective service delivery model that should be a permanent option for providing occupational therapy services. An online survey was disseminated; it included Likert scale questions, multiple option questions, and open-ended questions regarding telehealth use during the COVID-19 pandemic. Of the 230 respondents, 176 (77%) support telehealth as a substitute for in-person services; 179 (78%) support telehealth as a permanent option for occupational therapy service delivery. This information lends support to the uninterrupted use of telehealth by OTPs when government emergency orders in response to COVID-19 expire.

Occupational Therapist Treatment of Patients in the Neurological Critical Care Unit: Utilization and Patient Characteristics

2021 ◽  
Vol 75 (5) ◽  
pp. 7505205020p1
Author(s):  
Matt Malcolm ◽  
Amy Nordon-Craft ◽  
Julia Sharp ◽  
Marc Moss ◽  
Amanda Hoffman ◽  
...  
Keyword(s):  
Critical Care ◽  
Critical Care Unit ◽  
Patient Characteristics ◽  
Occupational Therapist ◽  
Neurological Critical Care

scholarly journals Occupational Therapy Services in School-Based Practice: A Pediatric Occupational Therapy Perspective from Ireland

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Carol O’Donoghue ◽  
Jennifer O’Leary ◽  
Helen Lynch
Keyword(s):  
Occupational Therapy ◽  
Service Delivery ◽  
Service Provision ◽  
Online Survey ◽  
Qualitative Content Analysis ◽  
Evidence Based ◽  
Snowball Sampling ◽  
Cross Sectional ◽  
School Based ◽  
Therapy Services

Purpose. School is a primary setting for pediatric occupational therapy practice, yet little is known about the provision of school-based occupational therapy in many countries internationally. The purpose of this study was to explore current school-based occupational therapy practice for the first time in Ireland to gain insight into current and potential service provision and to identify new directions and potential pathways for development. Methods. This descriptive quantitative study utilized a cross-sectional online survey to gain the perspectives of the population of pediatric occupational therapists working regularly in schools across Ireland. Respondents were recruited through convenience and snowball sampling. Data were analysed through qualitative content analysis and descriptive statistics. Results. The survey elicited 35 responses, yielding a 21.2% estimated response rate. Findings demonstrated that respondents provided therapy services in schools most commonly on a weekly (28.6%) or monthly (34.3%) basis, with only 5.0% working in the same school on a weekly or fortnightly basis. The majority of respondents (54.3%) used a direct therapy approach with a child, rather than coaching or modelling, to primarily address sensory, hand function, or daily living needs. None used a whole class or whole school (universal or tiered) approach. While respondents (54.3%) generally viewed collaborative practice as a strength of school-based practice, they also identified barriers to collaboration in schools. A core barrier is related to how services are constructed across health and education, with differing philosophies of service provision. The majority of respondents (75.0%) reported that they had not received any training to deliver evidence-based practice in therapy provision specific to school-based practice. Implications for Practice. This study indicates that therapists require continual education on evidence-based school practice as it applies in an Irish context. Furthermore, clarification of school therapy roles and service delivery models are required in order to determine how they contrast with traditional clinic roles. This will enable therapists to strengthen the coordination of service delivery between health and educational services to maximize the outcomes of school-based practice.

scholarly journals Awareness and practice of patient’s oral care among critical care nurses in a rural tertiary care hospital

2019 ◽  
Author(s):  
Singla Bhavika ◽  
Akshaya N. N.Shetti ◽  
Rachita Mustilwar ◽  
Singla Anshul
Keyword(s):  
Critical Care ◽  
Critical Care Unit ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Oral Care ◽  
Cross Sectional Study ◽  
Critical Care Nurses ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional

Background and aim: Oral care contributes significantly to the patients’ health outcome in a critical care unit. Nurses play a vital role in maintaining good oral health. However, there remains a dearth of literature regarding oral care practices among nurses workingin an Indian critical care unit. In this descriptive cross sectional study, we assessed the level of awareness and the existing practices of patients’ oral care among our critical care unit (CCU) nurses. Methodology: After obtaining approval from the institutional ethics committee, 64 CCU nurses, having work experience of atleast 6 months in the CCU, were enrolled in this descriptive cross sectional study. A self-structured questionnaire was used to assess the awareness and practice of the nurses. The data collected was analyzed using descriptive statistics and results were expressed as percentages.Result: Of the 64 nurses enrolled in the study, there were no dropouts. It was found that 62 (96.87%) nurses provided oral care to all the CCU patients. 60 (93.7%) nurses claimed that a standard oral care protocol has been provided to them. Documentation of the oral care was carried out by 54 (84.37%) nurses. Although 50% of the nurses had been trained to provide oral care, 54 (84.37%) nurses felt the need of fresh training. 60 (93.7%) nurses preferred using toothbrush in conscious patients. Chlorhexidine was the most commonly used solution. Bleeding, extubation and biting were among the few complications that they faced during routine oral care.Conclusion: Despite working in a rural set up with limited resources available, oral care was provided by most of the nurses. Following a standard protocol and documentation of the same, has helped maintain consistency in oral care of all critical care patients.Citation: Bhavika S, Shetti AN, Mustilwar R, Anshul S. Awareness and practice of patient’s oral care among critical care nurses in a rural tertiary care hospital. Anaesth pain & intensive care 2019;23(3):295-300

scholarly journals Occupational Therapy Goal Achievement for People with Stroke: A Retrospective Study

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Hashem Abu Tariah ◽  
Amal Saud Aljehani ◽  
Dana Yasser Alenazi ◽  
Dona Abdularhman Alturaif ◽  
Malak Nabit Alsarhani
Keyword(s):  
Retrospective Study ◽  
Occupational Therapy ◽  
Goal Attainment ◽  
Study Data ◽  
Occupational Performance ◽  
Cross Sectional ◽  
Therapy Goals ◽  
Medical City ◽  
Therapy Services ◽  
Retrospective Study Design

Background/Aims. The process of occupational therapy services starts with assessing the occupational performance problems, setting goals, and implementing various intervention strategies to achieve the goals. The aim of this study was to assess the extent of achieving occupational therapy goals for people with stroke and categorize the goals according to the aspects of the domain of occupational therapy. Methods. A cross-sectional retrospective study design was used. People with stroke receiving rehabilitation services at King Abdulaziz Medical City (KAMC) were the target of this study. Data about the extent of achieving occupational therapy goals were collected using the Goal Attainment Scaling (GAS). Results. Of the 100 medical records of people with stroke included in this study, only 30% of the goals were functional. Only 54% of the goals were achieved. No association was found between the number of achieved goals and variables such as age, gender, type of stroke, and stroke hemisphere/side. Conclusion. People with stroke included in this study have not shown significant progress toward achieving their therapy goals. As for clinical practice, this study could guide therapists in the future to improve the process of achieving their patients’ goals.

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