Academic journal article Journal of Allied Health

Occupational Therapy Practice in Acute Care Neurology and Orthopaedics

Academic journal article Journal of Allied Health

Occupational Therapy Practice in Acute Care Neurology and Orthopaedics

Article excerpt

The purpose of this research was to develop a consensus description of occupational therapy practice in acute care orthopaedics and neurology by Australian therapists. The Delphi technique was used to develop consensus concerning therapists' aims for their patients, the interventions they used, and the factors affecting their practice in acute care. Therapists' primary aim was to conduct a thorough assessment for referral and further treatment purposes. Therapists in acute hospital neurology focus on developing maximal independence in self-care activities and preventing deformities, followed by preparations for discharge or transfer to rehabilitation. Therapists with an orthopaedic caseload state independence in self-care as their second most important aim, but the ranking of intervention methods indicates preparation for discharge in various ways takes precedence over direct self-care retraining. This difference may indicate a disparity between practice ideals and the realities of the acute care setting. The most important factor affecting practice in acute care is early referral for occupational therapy services. Recommendations are made for managers and educators to ensure the most effective practice in acute care are made. J Allied Health. 2002; 31:35-42.

OCCUPATIONAL THERAPY PRACTICE in acute care hospital settings in Australia is characterized by the use of assessment and intervention strategies that can be conducted in a short time frame to fit in with the short bed stays of clients. Therapists, across a range of caseloads, focus mostly on self-care with an initial interview and specific clinical assessments being the most often used assessments. Individual education and prescribed individual treatment are the two most often used interventions, followed by the prescription of aids and home modifications according to a national survey of occupational therapists working in acute care hospitals.1 The purpose of this study was to gain a more detailed understanding of occupational therapy practice in orthopaedics and neurology, the two most frequently seen caseloads in the national acute care hospitals survey.

Specifically, this study was designed to develop consensus descriptions of occupational therapy practice and factors affecting practice in the areas of acute care orthopaedics and neurology using a national sample of Australian therapists. A more detailed understanding of these practice areas would enable occupational therapy educators to prepare new graduates better for practice. A better understanding also would help to minimize the disparity between what students learn about the provision of occupational therapy services, and the reality of delivering those services and where disparities exist, students would be armed with strategies for dealing with them. Wittman2 suggested that the "profession must decide what to teach students in the academic curricula in order to prepare them most effectively for real-life practice." Information concerning occupational therapy practice in these acute care settings would assist managers and team leaders to provide an environment and resources that would maximize the effectiveness of occupational therapy practice.



Using data supplied by State Health Departments, heads of occupational therapy departments in 20 acute care hospitals were asked to distribute information to therapists working in either acute orthopaedics or acute neurology. Some therapists worked with both caseloads and answered both questionnaires. Therapists working in orthopaedics were sampled from major acute care hospitals in every state (n = 7) and those in neurology from all states except the Australian Capital Territory. Department heads were asked to distribute information packages to their staff, who then made their own decision about participating in the study and corresponded directly with the researcher. Participants included 19 occupational therapists employed in the area of orthopaedics and 26 employed in neurology. …

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