Title: A Survey of Occupational Therapy Assessment and Treatment Practices in the Intensive Care Unit

 

Authors:
James R. Devanney, DO
Shannon Stillwell, PT
Brian McDonnell, PT
Katelyn Campbell, OT
Casey Hynes, OT
Marissa James, OT
Somnath Bose, MD, MPH
Margaret M. Hayes, MD
Corey R. Fehnel, MD, MPH

JACOT Volume 8, Issue 1

Abstract

Background:
Survivors of critical illness suffer significant disability. Occupational therapists (OTs) have the expertise to address the physical, cognitive, and psychological impairments resulting from critical illness, yet their role in intensive care units remains underexplored.

Methodology:
An electronic survey developed according to best practices was sent to OTs currently practicing in the ICU in the United States through purposive snowball sampling. The survey collected data on both current and perceived best practices among critical care OTs in the United States.

Results:
Among 88 respondents, 51 (58%) had over 5 years of ICU experience, and 57 (70%) worked in academic medical centers. Respondents reported spending the greatest proportion of their ICU time addressing physical functioning, followed by ADL performance and cognition. Respondents used many different assessments for cognition, while only 49 respondents (56%) used standardized ADL assessments. Fifty two respondents (68%) indicated that standardized ADL assessment tools and 37 (51%) treatment protocols would benefit their practice.

Discussion:
There is wide practice variation in how OTs evaluate and treat cognitive, ADL, physical functioning, and psychological impairments in clients with critical illness. The development and standardization of appropriate assessments could help standardize practice, differentiate OT’s unique role in the ICU, and improve early rehabilitation efforts.