OTalk

#OTalk 23rd March 2021 – The Role of Occupational Therapy in ICU

This week Aisling Durkin @ais_d will be hosting #OTalk.

In the past year the role of Occupational Therapists (OTs) in the critical care setting has been brought to the fore.  A number of OTs found themselves redeployed to ICU during the pandemic, working in both established teams as well as in units that previously had no occupational therapy presence.  Roles varied with OTs providing early assessment and rehabilitation (Borgstein, 2020), recruiting, training and organising proning teams as well as working in nursing support roles (Royal College of Occupational Therapists, 2020).  As business begins to return to normal in health services, many occupational therapy and critical care teams are looking at ways to establish and develop occupational therapy service provision in this setting.   

The importance of occupational therapy in the Critical Care setting has long been recognised by the Faculty of Intensive Care Medicine (2015, 2019) and early rehabilitation in this setting is clearly linked to better outcomes for patients (Tipping et al, 2017).  A recent article in the OT News (Borgstein, 2020) also explored the cost effectiveness of an occupational therapy service on ICU, identifying that the cost savings of 20 bed days on ICU would fund a single band 6 occupational therapist for the year.  Despite this, the evidence has not historically translated to funding for occupational therapy services (Firschman, 2019).  In order to explore strategies to establish these services we would like to put forward the following questions for discussion;

1.      What do you think the role of occupational therapy is in critical care? 

2.      What training have you had or do you think we need to work in Critical Care? 

3.      How can we raise the profile of occupational therapy in Critical Care Services? 

4.      How do we keep occupation at the centre of what we do in critical care? 

5.      What can we do to strengthen the evidence base for occupational therapy on ICU? 

Borgstein, C (2020) Occupational therapy in critical care – a case for change. OT News, July 2020. P- 44-46. London: Royal College of Occupational Therapists.

Firshman, P (2019). The occupational therapy role in critical care. OT News, April 2019. P16-18. London: Royal College of Occupational Therapists.

Intensive Care Society (2015) Guidelines for the provision of intensive care services. London: Faculty of Intensive Care Medicine.

Intensive Care Society (2019) Guidelines for the provision of intensive care services. 2nd Ed. London: Faculty of Intensive Care Medicine.

National Institute for Health and Care Excellence (2017) Rehabilitation after critical illness in adults. Quality standard [QS158]. London: NICE. Available at: Overview | Rehabilitation after critical illness in adults | Quality standards | NICE

Royal College of Occupational Therapists (2020) New Occupational Therapy Team leads crucial critical care training, OT News, July 2020. P-9. London: Royal College of Occupational Therapists.

Tipping, C.J., Harrold, M., Holland, A., Romero, L., Nisbet, T. and Hodgson, C.L., (2017). The effects of active mobilisation and rehabilitation in ICU on mortality and function: a systematic review. Intensive care medicine, 43(2), pp.171-183.

Ward, G. and Casterton, K. (2020).  The impact of the COVID-19 pandemic on occupational therapy in the United Kingdom.  Education and Research. London: Royal College of Occupational Therapists.

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