Occupational Therapy adding
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Occupational Therapy adding

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Occupational Therapy adding




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Presentation on theme: "Occupational Therapy adding"— Presentation transcript:

Slide1

Occupational Therapy adding value to an Intensive Care Unit A pilot project : Sept 2016 - July 2017

Rebecca Chewter

June 2017

Slide2

AimsExplore the role of Occupational Therapy (OT) in the Intensive Care Unit (ICU)

Identify

drivers for change

Outline our developing

service

Highlight the

need

for OT in ICU

Demonstrate the

impact

and

value

of OT in ICU

Slide3

Why Occupational Therapy?SkillsHolistic

Occupation

Function

Participation

Task analysis

IndependenceRoutineRolesQuality of life

Drivers for changeRehabilitation After Critical Illness in Adults (NICE 2009)Guidelines for Provision of Intensive Care Services (2015)

Slide4

LiteratureOccupational Therapy in ICU:

Improves

function

at

hospital

dischargeShortens episodes of delirium and reduces riskAssociated with reduced ICU and hospital length of stay

, duration of mechanical ventilation and hospital costsSchweickert

et al (2009),

Parker et al (2013

), Alvarez

et al (2016)

Slide5

The Royal Free Service4 streams:

Delirium monitoring

&

management

Disability management

Functional rehabilitation Early discharge planning

Weaning round Multi Disciplinary MeetingsGoal setting

Slide6

Results : so is there a need?

YES!

125 seen by OT

Full caseload

Waiting list

Slide7

What is the impact for patients?75%

achieved rehab goals

100%

maintenance goals

9 home from ICU!

50

%

returned home -

10%

social care

14%

inpatient

rehab

5%

placement

Slide8

What is the impact on teams?

Good

to

humanise

care

Greater

focus on

function

... upper limb &

cognition

helps

us to make more

informed

decisions

more

effective

well-rounded

goal

setting

patients

& families

better emotionally

supported

handover

increased

efficiency

&

continuity of

care

helped

build

rapport

initial

assessment & treatment plan in place… saved time on the ward

Early rehab is beneficial… can reduce length of stay…

more

person-

centred

Slide9

Take home messageOTs in ICU add value to:

Patients

earlier intervention, holistic care, positive outcomes

Families

– practical and emotional support, education, signpostingTeams – decision making, communication, skill sharing, teachingGovernance – length of stay, objectives, guidelines, audit

Profession – role promotion and research

Slide10

ReferencesAlvarez EA, Garrido

MA,

Tobar

EA,

Prieto

SA, Vergara SO, Briceno CD. Occupational Therapy for delirium management in elderly patients without mechanical ventilation in an intensive care unit: A pilot randomised clinical trial. Journal of critical care 2016;37:85-90 National Institute of Clinical Excellence (2009) Rehabilitation after critical illness in adults. Available from: nice.org.uk/guidance/cg83 [Accessed October 2016]

Parker A, Sricharoenchai T, Needham DM. Early Rehabilitation in the Intensive Care Unit: Preventing Physical and Mental Health Impairments Current Physical Medicine and Rehabilitation Reports. 2013;1(4)307-314

Schweickert

W,

Pohlman

MC,

Pohlman

AS,

Nigos

C,

Pawlik

AJ,

Esbrook

CL, Spears L, Miller M,

Franczyk M, Deprizio D, Schmidt GA, Bowman A, Barr R, MacCalliser KE, Hall J, Kress JP. Early Physical and Occupational Therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009; 373, 1874-1882.The Faculty of Intensive Care Medicine & The Intensive Care Society (2015) Guidelines for the Provision of Intensive Care Services Available from: https://www.ficm.ac.uk [Accessed October 2016]

Slide11

Email: rebecca.chewter@nhs.net

Tel: 020 7794 0500 Bleep 2492