Parameters of OT assessment

We assess ADLs as OTs and after treatment or intervention, we compare progress to the initial information we obtain during initial assessment. We are very attuned to assessing independence level of the clients and we set goals generally based on this. Sometimes, an OT will come to a point where he/she cannot obtain outcome based on independence of the client.  So what other parameters should we be looking for and what other aspects do we need to assess apart from level of independence of the clients?  We tend to miss these other parameters and if you keep them in mind, your assessment will be more holistic and you will be able to Identify problems better which can aid in your goal setting.  The parameters of assessment has an acronym of VISA.

1. Value - Level of value or importance the task is to your client
2. Independence - this is self explanatory
3. Safety - How safe is the client while he/she engages in the desired occupation?
4 Adequacy or Quality - you probably have improved the quality of performance the client engages in

more detail can be read in Willard and Spackman

PROMOTING OCCUPATIONAL THERAPY:USE UNIFORM TERMINOLOGY

There is a problem promoting Occupational therapy.  This is because we are dealing with human occupation that is very difficult to label and quantify. 

Imagine this situation, if you are an OT and you are asked by a TV advertiser to promote or endorse a product, what product would it be? Though eh?  If you have a suggestion, pass it around to colleagues and it will surely stir up conversation.

A basic way of promoting OT is if we OTs talk the same talk. If we use the same words and termonologies in our daily documentation. ( Dont get me started on writing SOAP. We'll get to SOAP eventually.)  Today I am just focusing and highlighting OT Uniform Terminologies. Basic. Simple.

Think of these:

Do we use uniform terminologies in our day to day documentation?
Do we use it when discussing cases with MDT?
Which Countries have a set and well defined OT uniform termonology?
Are we mandated to use it or to come up with a list?
Do you think life will be easier if all OTs use the same terminology?
Would it not be easier to talk to other professions about OT if we have the same Lingo? If we all speak as one? If we speak in uniform?

Let's look at ADLs of self maintenance tasks.  What does it mean?What does it encompass?

Here's a list of Activities of Daily Living or self maintenance tasks. Hope it helps.

Grooming, Oral Hygiene, Bathing/showering, Toilet hygiene, Personal Device Care, Dressing, Feeding and eating,Medication Routine, Health Maintenence, Sicialisation, Functional Communication, Functional Mobility, Community Mobility, Emergency Response, and sexual expression.

........just a food for thought....just a food for thought.

REQUIREMENT FOR DISCHARING A PERSON HOME

the basic occupational requirement that a person needed to go home are:

1. he/she should be able to transfer safely from bed to toilet/commode to chair- home can be set up where the chair is close to the bed and commode so walking is not really essential for discharge from hospital.  This can be improved by follow up services such as reablement team, intermediate care team or community physios etc.
2. client should have access to toiletting facility - e.g. commode if unable to walk to the toilet safely
3. client should be independent with toilet hygiene - this usually the make or break if a person is going to be independently safe at home. Unless client was incontinent prior to admission. On which case, client only needed to have regualr and frequent checks daily
4. client should have means of nourishment - either carers assist in setting up breakfast or client should have meals on wheels
5. client should'nt have any behaviour that will cause them or anybody at home any harm - this refers to cognition of the client, behaviour of wandering of psychosocial behaviours that could harm themselves or other peple in the house
6. client should have access to a sleeping facility - bed should be brought downstairs if client cannot manage stairs

these are basic requirement and could be made successfull with appropriate support either from family, carers, reablement services, intermediate care, meals on wheels

OT ROLE IN HOSPITAL SETTING

You have a simple role if you are working in a hospital setting in the UK. You have to get the person out of the hospital as soon and as safe as possible.  Your options are simple and few and you must decide as to which option is fastest and safest in getting the person out of the hospital. 

Here are your options: You have to aim either discharge home, rehab facility, step down bed, residential or nursing home, home with support, home with intermediate care, home with reablement services, home with care package, home with family support.

In terms of Clinical reasoning, the facet that will dictate your judgement and options is the pragmatic aspects of the situation and hospital/NHS's general rule of getting people out ASAP tends to pull a lot of weight in your decision making.

Clinical reasoning

I have encountered many people talking about clinical reasoning. It is a well used term but not a lot of people know how to break down their clinical reasoning.  Here in the UK, I have commonly come across with people or colleagues who are quick to question a clinical reasoning of another colleague when the Colleague was only asking bout the procedure how to order equipment - that is not a problem with clinical reasoning.  It is a problem with procedural know how. What does Clinical reasoning actually mean?  Check the books people. It's there.

facets of CLinical reasoning are these:
1. clinical aspects of the case
2. narrative(personal aspects of the case)
3. ethical aspects of the case
4. pragmatic aspects of the case

( you can find details about this in willard and spackman ---- 8th edition)
try using these four areas if you want to make a decision about your cases.  I will be blogging about this in detail as we go along

What is OT in a nutshell

Occupational Therapy (OT) is a profession that is concerned with "human occupation" - anything that a person does or thinks. Anything that prepoccupies the person.  An Occupational therapist (OT) would, after medical condition of illness/accident, will try to get a person back to their occupations by either resolving the physical problems brought about by the condition or by adapting the environment to allow the person to be as independent as possible

What this blog is for

Im very new in blogging.  I actually just learned about the definition of it from travelling colleagues so I'm giving this a go.

This Blog is intended as an outlet of my thoughts and views that are not a representation of the whole OT community.
 I will try to be as responsible as I can be but if I get very passionate about some topics, I beg apologies.

This is intended for students and other colleagues