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.
Research Findings
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.
Publications, presentations and webinars
For more information on why this research matters, click the links below:
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.
Project Team
Principal Investigators:
Susan Baptiste, MSc, OT(C) — McMaster University
Michelle Kho, PhD, PT — McMaster University
Co-Investigator:
Jocelyn Harris, PhD, OT — McMaster University
Project Contact: Susan Baptiste — baptiste@mcmaster.ca
KS 2013-13
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.
Project Contact: Susan Baptiste — baptiste@mcmaster.ca
Key Findings for Policy
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.
- The findings of this study suggest that currently the role of OTs in the ICU is restricted to issues of mobility and physical rehabilitation
- The role of OTs in the ICU could be expanded to take advantage of their full scope of practice to include: self-care activities, cognitive interventions and psychological interventions to reduce depression and anxiety
Why This Study was Needed
- Patients that survive the ICU often have a lengthy rehabilitation course post-discharge, which can impact the patient’s quality of life and the burden on the healthcare system
- Rehabilitation programs initiated in the ICU, incorporating OTs’ full scope of practice, can improve functioning at discharge from ICU and improve care. However, little is known about current practices around the use of OTs in ICUs
Study Summary
This was a scoping review to identify research looking at the role and potential roles for OTs in the care of patient in critical care units. Nine medical databases were searched, as were grey literature sources (conference abstract databases). Of the 32,707 references identified, 389 met inclusion criteria. Of these, 98 reported an active and 291 a potential role for Occupational Therapy. Documents reporting an active OT role included narrative or systematic reviews (58%), original research (20%), editorials/commentaries/appraisals (13%) and other (8%). The top three active roles identified included mobility (86%), activities of daily living (34%) and cognitive assessment and intervention (19%).
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.
Project Contact: Susan Baptiste — baptiste@mcmaster.ca
Key Findings for Researchers
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.
- The findings of this study suggest that currently the role of OTs in the ICU is restricted to issues of mobility and physical rehabilitation
- The role of OTs in the ICU could be expanded to take advantage of their full scope of practice to include: self-care activities, cognitive interventions and psychological interventions to reduce depression and anxiety
Why This Study was Needed
- Patients that survive the ICU often have a lengthy rehabilitation course post-discharge
- Rehabilitation programs intiated in the ICU, incorporating OTs’ full scope of practice, can improve functioning at discharge from ICU. However, little is known about current practices around the use of OTs in ICUs
Study Summary
This was a scoping review of the actual and potential roles for OTs in the care of patient in critical care units. Nine medical databases were searched, as were grey literature sources (conference abstract databases). Of the 32,707 references identified, 389 met inclusion criteria. Of these, 98 reported an active and 291 a potential role. Documents reporting an active OT role included narrative or systematic reviews (58%), original research (20%), editorials/commentaries/appraisals (13%) and other (8%). The top three active OT roles included mobility (86%), activities of daily living (34%) and cognitive assessment and intervention (19%).
Future Research
This study provides a foundation for future research projects to examine an expanded role of OTs in the ICU. Future research should be initiated and led by OTs together with the critical care team.
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.
Principal Investigators
Susan Baptiste, MSc, OT(C) — McMaster University
Michelle Kho, PhD, PT — McMaster University
Presentations
Costigan, F.A., Baptiste, S., Harris, J., Duffet, M., Kho, M. (October 2014). Investigating the occupational therapy role in critical care: Development of a scoping review. Critical Care Canada Forum. Toronto, ON.
Costigan, F.A., Harris, J., Duffett, M., Kho, M., Baptiste, S. (Submitted for October, 2014). Occupational therapy in critical care: An interdisciplinary scoping review development. Annual Canadian Association of Occupational Therapy Conference. Winnipeg, MB.
Harris, J., Costigan, F.A., Kho, M., Baptiste, S. (Submitted October, 2014 for extended session). Exploring the role of occupational therapy in caring for individuals who are critically ill. Annual Canadian Association of Occupational Therapy Conference. Winnipeg, MB.
Costigan, F.A., Baptiste, S., Harris, J., Duffet, M., Kho, M. (September 21-23, 2014). Exploring the role of occupational therapy in critical care: Developing a scoping review. 2nd Annual TVN Conference on Improving Care for the Frail Elderly. Toronto, ON.
Webinars
Role of OT in the ICU — Susan Baptiste and Michelle Kho
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.
Principal Investigators
Susan Baptiste, MSc, OT(C) — McMaster University
Michelle Kho, PhD, PT — McMaster University
Rationale: Patients that survive the ICU often have a long rehabilitation course post-discharge. Rehabilitation programs initiated in the ICU, incorporating OT’s full scope of practice, can improve functioning at discharge from ICU. However, little is known about current practices around the use of OTs in ICUs.
Objectives: (1) Describe the current OT ICU role, outline how that role could be enriched and how best to achieve that goal and (2) identify the role of OTs in ICU in order to maintain and restore function in seriously ill patients.
Research Plan: 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.