Assessment and management of visual deficits within the hospital setting
Fischer-Camara, Bonnie Lynn
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The proposed vision program, the Assessment and Management of Visual Deficits within the Hospital Setting, will establish an evidence-based evaluation, treatment, and referral process for individuals with visual impairment (VI) (either neurological or due to low vision) within the acute care, hospital setting. It is reported that 80% of all VI can be prevented or cured (Pan American Health Organization/World Health Organization, 2014) and research supports a need for intervention for VI within the hospital setting, as it is often an overlooked area. Despite this high prevalence of poor vision among inpatients, vision is reportedly not routinely tested nor documented (Press et al., 2015; Roche, Vogtle, Warren, & O'Connor, 2014). The occupational therapy practitioner (OTP) is recommended to incorporate vision screening and intervention to maximize clients’ occupational performance and successful participation in daily activities. Support exists that VI and falls are prevalent in older adults (Roche et al., 2014) and addressing this gap in care shows value by reducing LOS, cost, and improving patient satisfaction (Morse, Seiple, Talwar, Lee, & Stein, 2019; Wong, Brooks, & Mansfield, 2016). This occupational therapy (OT) program will describe a vision screen for use within a hospital setting that assesses key areas of visual acuity, contrast sensitivity, visual field, convergence, and eye range of motion. This program could be implemented across settings including inpatient and outpatient rehabilitation, thus following the continuum of care, and across diagnostic categories (Balcer, Miller, Reingold, & Cohen, 2015; Cate & Richards, 2000; Roberts et al., 2016). Incorporating this vision screen into daily practice may occur as one component of a comprehensive OT evaluation or a subsequent treatment session. The screen could be administered by OTPs once clinical competence has been established through hands-on training utilizing the OT Vision Assessment/Management Manual and mentoring by senior staff and the Vision Program Coordinator. Community-based resources are reviewed to aid in the acquisition of services and proper eyewear. This program is designed to establish an educational pathway to support those patients identified with a VI within a hospital setting.