A Scoping Review Determining the Current and Future Role of Occupational Therapy in the ICU
This project systematically collected information to help describe what occupational therapists (OTs) are currently doing in intensive care units (ICUs) and also other ways they could help critically ill patients.
Findings: Our search yielded 3,126 abstracts for review; of these we retrieved 1,119 full-text reports with 389 meeting our inclusion criteria. Reports on OT in critical care reveal that (1) it is studied on a worldwide scale, (2) reviews accounted for 44% of the reports and (3) active role for OT accounted for 26% of reports compared to 74% of potential role. The top three active roles identified from 96 reports were mobility (87.5%), range of motion/strengthening (85.4%) and activities of daily living (30.2%); potential roles include cognitive, psychosocial and environmental interventions.
Impact of findings: The results of this study indicate that the use of OTs full scope of practice is not being leveraged to improve the quality of care patients surviving the ICU receive. Further research into the effectiveness of the current and potential OT roles in critical care emphasizing cognitive, psychosocial and environmental interventions is essential. Our findings suggest a natural inter-professional relationship in caring for patients who are critically ill and one which may facilitate collaboration. Given the short- and long- term consequences of critical illness and the expertise of occupational therapists, we believe increased involvement in the care of those who are critically ill will enhance recovery, clinical outcomes, and ultimately quality of life.
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About the Project
OTs could play an important part in caring for people who are critically ill in ICUs, but little is known about how they currently help ICU patients.
Therefore, a comprehensive database search was completed by an information scientist from inception to November 2013 for all documents reporting clinical roles in critical care that are currently occurring or could be fulfilled by OTs. Interdisciplinary teams (including OTs, physiotherapists, critical care experts and methodological experts) examined citations to select relevant reports, abstract data and resolve discrepancies by consensus.
It was found that in ICUs, occupational therapists help people mostly to move in and out of bed as well as walk. Furthermore, it was discovered that occupational therapists could contribute more in the ICU, to help people build the skills needed to improve independence in daily, social and work activities.
For more details on the project rationale, objectives and research plan, click here.
Susan Baptiste, MSc, OT(C) -- McMaster University
Michelle Kho, PhD, PT -- McMaster University
Jocelyn Harris, PhD, OT -- McMaster University
Project Contact: Susan Baptiste -- firstname.lastname@example.org