The occupational therapy intensive care unit guide: a practical guide for implementing occupational therapy services with people who are critically ill
Woodard, Mallory Maray
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Patients who are critically ill in the intensive care unit (ICU) or critical care unit are at risk for cognitive, psychosocial, and physical impairments as a result of their admitting diagnosis or secondary diagnoses acquired during their hospital stay. Occupational therapy is a profession that facilitates patients’ recovery through holistic evaluation and treatment. Occupational therapy in the ICU improves patients’ strength, cognition, functional independence in activities of daily living and walking, decreases the duration and incidence of delirium, decreases time spent on mechanical ventilation, decreases the length of time patients spend in the hospital, and saves the hospital money (Alvarez et al., 2017; Lord et al., 2013; Schweickert et al., 2009; Weinreich, Herman, Dickason & Mayo, 2017). However, the problem is that a small number of patients are receiving occupational therapy when they are in the ICU. Due to the complexity of the medical environment, severity of patients’ illness, limited education on ICU care in entry- level occupational therapy and occupational therapy assistant programs, and limited research on the efficacy of occupational therapy evaluations and treatments, many occupational therapy practitioners do not have the knowledge and confidence to work in the critical care setting (Accreditation Council for Occupational Therapy Education (ACOTE) 2018; Foreman, 2005). In addition, many critical care team members are not aware of the benefits of early intervention occupational therapy in the ICU, impacting the number of referrals placed for patients while they are in the ICU setting (Zanni et al., 2010). The Occupational Therapy Intensive Care Unit Guide (OT ICU Guide) was created to improve the knowledge, confidence, and competency of occupational therapy practitioners working in the ICU in order to increase the presence of occupational therapy practitioners in the ICU. Increasing the presence of occupational therapy practitioners in the ICU will lead to an increase in the number of patients receiving occupational therapy during their stay in the ICU. The OT ICU Guide is a “one-stop shop” to guide occupational therapy practitioners on providing safe and evidence-based evaluations and treatments to patients in the ICU. The OT ICU Guide includes handouts, resources, guides, and brochures highlighting the role and benefits of occupational therapy in the ICU, safety and medical information for working with medically complex patients, and examples of occupational therapy assessments and treatment interventions for patients in the ICU. The OT ICU Guide is a steppingstone for increasing the presence and frequency of occupational therapy services in the ICU.