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

Importance: Occupational therapy use in the neurological critical care unit (NCCU) may relate to patient factors, but data about these relationships remain unpublished. Objective: To examine how patient factors predict NCCU occupational therapy use and intervention types. Design: Retrospective cohor...

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Publicado en:American Journal of Occupational Therapy Vol. 75; no. 5; pp. 1 - 10
Autores principales: Malcolm, Matt, Nordon-Craft, Amy, Sharp, Julia, Moss, Marc, Hoffman, Amanda, Morrow, Meghan, Freeman, Katherine, Graham, James
Formato: pictorial research tables/charts Journal Article
Publicado: American Occupational Therapy Association Sep/Oct2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep/Oct2021
      vid: 75
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      pub: American Occupational Therapy Association
      place: North Bethesda, Maryland
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        10.5014/ajot.2021.041087
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        atl: Occupational Therapist Treatment of Patients in the Neurological Critical Care Unit: Utilization and Patient Characteristics.
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          Malcolm, Matt
          Nordon-Craft, Amy
          Sharp, Julia
          Moss, Marc
          Hoffman, Amanda
          Morrow, Meghan
          Freeman, Katherine
          Graham, James
        affil: Matt Malcolm, PhD, OTR/L, is Associate Professor, Department of Occupational Therapy, Colorado State University, Fort Collins, and Associate Professor, Colorado School of Public Health, Aurora
      sug:
        subj:
          Occupational Therapy Utilization
          Critical Care
          Hospital Units
          Neurology
          Human
          Male
          Female
          Adult
          Middle Age
          Aged
          Academic Medical Centers
          Retrospective Design
          Cross Sectional Studies
          Record Review
          Glasgow Coma Scale
          Scales
          Length of Stay
          Comorbidity
          Self Care
          Therapeutic Exercise
          Occupational Therapists
          Professional Role
          Descriptive Statistics
          Data Analysis Software
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Importance: Occupational therapy use in the neurological critical care unit (NCCU) may relate to patient factors, but data about these relationships remain unpublished. Objective: To examine how patient factors predict NCCU occupational therapy use and intervention types. Design: Retrospective cohort study of electronic health records data from adults admitted to the NCCU between May 2013 and September 2015. Setting: NCCU in a large, urban academic hospital. Participants: Adults (age ≥18 yr; N = 1,134) admitted to the NCCU. Measures: Using length of stay (LOS), number of comorbidities, Glasgow Coma Scale (GCS) score, gender, age, and racial–ethnic minority status as independent variables, separate regression models identified predictors for each dependent variable: receipt of NCCU occupational therapy, occupational therapy onset (days after admission), and receipt of self-care or home management (ADL–Home); functional activities or cognitive training (Func–Cog); and therapeutic exercise (Ther-Ex). Results: Four hundred twenty patients (37.0%) received occupational therapy in the NCCU. Receipt of occupational therapy was positively associated with LOS, number of comorbidities, GCS score, and age. Earlier occupational therapy onset was associated with higher GCS score and shorter LOS. Receipt of ADL–Home or Func–Cog interventions was significantly predicted by number of occupational therapy sessions, but patients with longer LOS were less likely to receive ADL–Home interventions. Receipt of Ther-Ex interventions became less likely as GCS score increased. Conclusions and Relevance: Patients are more likely to receive occupational therapy services if they are older and have a longer NCCU LOS, more comorbidities, and a higher level of consciousness. What This Article Adds: A patient's level of consciousness is clearly associated with occupational therapy utilization and hospital outcomes, but it should not be the only factor considered when prioritizing patients for NCCU occupational therapy services. Compared with patients who were more awake and alert, patients with a lower level of consciousness had a later onset of occupational therapy, which suggests an opportunity for NCCU occupational therapists to collaborate with physicians in the modification of sedation protocols to enable early rehabilitation. Findings indicate that patients with a lower level of consciousness had later onset of occupational therapy, suggesting an opportunity for NCCU occupational therapists to collaborate with physicians in the modification of sedation protocols.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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