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OT initial assessment Flashcards

1
Q

OT initial assessment in hospital setting

Effectiveness of OT in Acute Care

A

Patients who received OT as part of their rehabilitation program were more likely to be discharged to home environments compared to patients who did not

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2
Q

OT initial assessment

Issues for OT Initial Interviews in Acute Settings
- LOS

A

Length of Stay (LOS)

  • short time and emphasis on discharge ASAP
  • referrals may come late in the admission when patient stabilises and can then be discharged
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3
Q

OT initial assessment

Issues for OT Initial Interviews in Acute Settings
- Setting

A

Setting

  • Impact on patient
  • Assessment and intervention typically in hospital room or facilities patient may be in bed
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4
Q

OT initial assessment

Issues for OT Initial Interviews in Acute Settings
- Acute nature of the patients illness

A

The initial interview will depend upon the severity of the patients illness

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5
Q

OT initial assessment

Screening and Safety - BEFORE you assess the client check their current status in regards to their

A
  • transfers and mobility
  • cognition and affect
  • infection risk
  • precautions or protocols
  • understand equipment (e.g. tubing, adjusting bed)
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6
Q

OT initial assessment

Screening and Safety - BEFORE you assess the client how do you check their status?

A

Check status through

Case notes

  • initial intake assessment and latest entires
  • staff (nurse, allied health)
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7
Q

OT initial assessment

Screening and Safety - BEFORE you ask the person to transfer and mobilise

A

Work out the situation and risks

  • don’t completey rely on mobility ratings by others
  • check if patient is feeling okay and can do it

Reinforce any relevant transfer cues

Ensure required equipment is there (walking aid)

Provide standby and monitor transfer and mobilising
- optimal position is on the client’s weaker side if relevant

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8
Q

OT initial assessment

Acute Care: OT Initial Aims

A
  • Establish present and likely issues
  • Identify client concerns and priorities
  • Identify environmental supports and issues
  • Identify needs for further tailored assessment
  • Initiate identification of discharge needs and commence planning
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9
Q

OT initial assessment

Acute Care: Decision making

A
  • Further information gathering may be needed on capacity, client aims, future needs and discharge destination
  • Consult with team
  • Frequent monitoring of recovery and capacity
  • Capacity of individual regarding decision making
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10
Q

OT initial assessment

Differences between settings - acute hospital

A

Focus of assessment on ensuring safe and successful discharge

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11
Q

OT initial assessment

Differences between settings - sub-acute or rehab

A

Focus on developing initial plan of intervention

OT has longer to work with client and strengthen OP before discharge

Subsequent assessment to review progress

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12
Q

OT initial assessment

Differences between settings - outpatient

A

Focus of assessment on planning next stages of intervention and monitoring progress

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13
Q

OT initial assessment

Referral

A

Request for service

Referral may come from various sources

  • Agency/Practice policy
  • Funders
  • Potentially Different Aims & Knowledge
    e. g. health professions cp client cp family
  • Different levels of detail

Blanket Referrals

Key decision is whether suitable for OT

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14
Q

OT initial assessment

Screening

A

Gathering of preliminary info to guide OT evaluation & intervention

  • Does your skills/service match client needs?
  • Snapshot of any info about previous & current occupational performance and future needs
  • Prioritisation (can they actually be seen?)
  • Safety considerations

Tools of screening

  • Case Notes or reports
  • Brief screening tests
  • Brief interview with client or family
  • Referral Source
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15
Q

OT initial assessment

Evaluation methods

A

Interview
Observation
Self-rating Scales
Formal & Standardised Tests

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16
Q

OT initial assessment

Interview

A

Planned conversation with a purpose in mind

Recognition that the client’s perspective is key

Their historical narrative and priorities

Supports client-centeredness

OT has ability to clarify answers

Quick, efficient (typically) but reliability may be variable

  • Particularly in performance questions
  • Interpersonal factors
  • Some disorders/diseases can mean a fluent and plausible history may be confabulation
17
Q

OT initial assessment

Observation

A

Observation of occupational performance is key for OT

Can be used to qualify or validate specific info from an interview

Can point to why problem exists in actibities (e.g. performance skills)

Focused observation

Used even when interviewing

Recording observationsa and checklists

Can show effect of others + environment on performance and abilitiy

18
Q

OT Initial assessment

Comprehensive Occupational Therapy Scale (COTE)

A

Developed for use in acute, short term psychiatric settings

Rates 26 observable behaviours broadly categorises into

  • General Behaviours
  • Interpersonal Behaviours
  • Task Behaviours
19
Q

OT initial assessment

Common Areas for Standardised Tests in OT

A

Developmental

Grip Strength

Upper Limb Function

Work Skills

Perceptual/cognitive

20
Q

OT intial assessment

Evaluation (OTPF)

A

Occupational Profile (history, clients concerns and priorities)

Analysis of occupational performace (using assessment tools + observation)

21
Q

OT initial assessment

Analysing Occupation Performance

A

Using assessment tools and observation to gather info on skills and performance
Focus guided by the Occupational Profile
Examine how contexts and environments may assist or limit or influence performance

22
Q

OT initial assessment

Occupational Profiles

A

Work out through interview and some self-rating tools

OTPF about client

  • who
  • why
  • what areas of occupation are successful/problematic
  • occupational history
  • client goals
23
Q

OT initial assessment

Occupational History

A

Previous patterns of engagement in action and daily life

What pattern reveals about person’s values and interests

24
Q

OT initial assessment

Analysing Occupational Performance

A

Using assessment tools and observation to gather info on skills and performance
Focus guided by the Occupational Profile
Examine how contexts and environments may assist or limit or influence performance

25
Q

OT initial assessment

Importance of OT assessment in hospital settings

A
  • skill of anticipating the potential impact of changed capacity for OP

The OTs ‘prognostic reasoning’ is the basis for helping the client (and others) anticipate and effectively plan for changed OP after discharge

26
Q

OT initial assessment

Time frame

A

Evaluation may be one off or over a longer period

Depends on setting and clients needs

27
Q

OT initial assessment

Evaluation: Key outcome

A

Leads to identification of goals with the client

Guides development of intervention including methods, duration, frequency

28
Q

OT intial assessment

Initial interview structure

A

Preparation

Intro

Warm up/convo

Exploration

Wrap up

29
Q

OT intial assessment

Initial assessment competencies

A
  1. Gathering relevant data
  2. 1 Conducting interview:
    - Introduce self, outline OT role and purpose of initial assessment and obtain consent to conduct assessment.
    - Establish pre-admission occupational performance (self-care, household ADL, work, leisure).
    - Discuss home environment including access, existing equipment etc.
  3. 2 Consultation/ Planning
  4. 3 Goal Setting
  5. Documentation
    - Documentation follows departmental guidelines and includes occupational goals, timeline and plan for further assessment / intervention
30
Q

OT initial assessment

Initial interview content

A

Proforma used for assessment and write up

Interview driven with some observation and direct performance as required

31
Q

OT initial assessment

Documentation

A

Communication between Multi-d team

Provides detail on where client is at re medical issues and discharge

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