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Welcome to the Occupational Therapy International Online Network (OTION).

Our goal is to provide an online resource for the international occupational therapy community through this on-line forum.

You will have the opportunity to participate in discussion topics related to your practice area and interact with your international colleagues. A moderator, who will be a resource to the group, monitors each topic.

We look forward to your participation and contribution to international occupational therapy practice.

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#1 Monday 1st of May 2017 18:22

sandra
Moderator

OT in ICU and Critical Care

This is a topic of interest to occupational therapists working in Canada. I look forward to the discussions about this.

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#2 Friday 5th of May 2017 14:49

jharris
Member

Re: OT in ICU and Critical Care

sandra wrote:

This is a topic of interest to occupational therapists working in Canada. I look forward to the discussions about this.

Hello everyone!

I am so glad, together with Jocelyn, to be able to open up this discussion space for all of us who are committed to working in meaningful ways with clients and families coping with intensive and critical care experiences. I had never focused on this area during my own career until relatively recently.  I was presented with personal situations that demanded my engagement in and understanding of what it means to be in an ICU. At the same time, a good physiotherapy colleague and I found ourselves discussing often about what are the missing opportunities for patients and families to benefit from occupational therapy services that never seem to be offered in the critical care context.  Yes, we work with physiotherapists and other colleagues in delivering more traditional and recognizable rehabilitative services, but some of our less familiar or visible skills we possess as occupational therapists rarely have the chance to share in that environment.

A scoping review about OT in the ICU was completed; presentations have been given about the findings and a publication is poised on the brink of being submitted. From these exciting actions, Jocelyn and I decided to contact every occupational therapist that had contacted us over the past two years and then explore the idea of joining OTION with a discussion board and space for Working in Critical Care.  Our vision of where this can take us includes collaborations in publications and research, as well as investing in the evolution of a clear and powerful role for our profession in supporting people faced with the mysteries and fears of critical care environments.

Sue Baptiste

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#3 Friday 26th of May 2017 04:04

ClareJ1
Member

Re: OT in ICU and Critical Care

Dear Colleagues,
Greeting from New Zealand. I have worked in ICU since 2010 and decided to focus on occupation for the long stay ICU patients. I am looking forward to learning about all the contributions our profession can make in this emerging area of practice as at times I have felt like my work in ICU varies greatly from what I read about in the literature.
Regards
Clare Jamieson(NZROT)

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#4 Friday 26th of May 2017 17:20

jharris
Member

Re: OT in ICU and Critical Care

Hi Clare,
I recently spoke to an OT who covers ICU and she commented on her divided focus of those in critical care who have long stay due to bed blockage elsewhere in the hospital.  This is usually due to ongoing need of ventilation - here in Canada we are often restricted in how many places can provide appropriate care level for these individuals. 

It might be an interesting project/study to look specifically at the OT role with those long stay individuals.

Jocelyn

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#5 Thursday 1st of June 2017 07:20

SSHAR4
Member

Re: OT in ICU and Critical Care

Hello Fellow OTs,

I am very excited to see our global OT professional organization to be focussing on this highly critical practice are in acute care setting! Many many congratulations to Sue and Jocelyn!
My practice in ICUs started as a relatively new OT grad in 2011-2012 and it was an amazing learning curve to be switching gears from cardiovascular and pulmonary ICUs to Medical ICUs. I recall craving to gather information and guidance to provide appropriate care for my patients. I found that mentorship and ICU specialization certifications may be great pathways to provide enriching experiences for those clinicians involved and interested in this area.
With a few years of getting my feet wet in the setting and continuing to explore available research, I found plethora of information in medical research that primarily included physical therapy measures and treatments and a very few indicated the mention of OT contribution. That networking also let me to reaching out to Sue and Michelle Kho (PT) in Canada. Even though due to life circumstances, I just started working at a Skilled Nursing Facility setting, my heart is still in acute care (ICUs).
I am zealous to be a part of this forum and look forward to great discussions and exchange of knowledge base and experiences.

Kind regards and Cheers to all
Shubhangi Sharma (USA)

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#6 Tuesday 13th of June 2017 18:12

NickMorrison
Member

Re: OT in ICU and Critical Care

Hello everyone,

My name is Nick Morrison from Hamilton (Canada) and I have been working in physical rehabilitation since 2013 in an ICU setting as well as most recently in augmentative and alternative communication this year. Very excited to be a part of this forum and thanks to Sue and Jocelyn for organizing this opportunity!

In regards to your comment Jocelyn, I definitely see some strong research potential for these patients. I have had one patient with bulbar ALS that has been living on my unit for two years come September and is still on the wait list for ventilator dependent placement. It really is a unique experience where the patient's residence has become the hospital and what that means for the individual.

Nick

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#7 Tuesday 6th of March 2018 21:19

holdinav
Member

Re: OT in ICU and Critical Care

Hi everyone,

I'm an OT working at St. Joseph's ICU in Hamilton, Ontario. My manager is trying to collect some information and I am posting on her behalf. If this is applicable to you, we appreciate your responses!

"Hi Everyone,

Please consider responding to this benchmarking question. We are looking for the below information from the Juravinski, Hamilton General (med/surg ICU), LHSC, Ottawa (non neurotrama), and St. Michaels.

What is the number of beds on your unit?

We are looking for the staffing compliment (# of FTE)

Do you have backfill for sick time/vacation etc

What is the role -- ADL practice

                                 Functional mobility

                                 wheelchair seating,

                                 splinting and positioning

                                 cognitive stimulation   

                                 discharge planning

                                 other

What gaps might remain in your practice?"

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#8 Thursday 3rd of May 2018 00:41

Margarita
Moderator

Re: OT in ICU and Critical Care

Occupational Therapy at the ICU of the National University Hospital
Bogotá- Colombia.
Mg Sylvia Cristina Duarte Torres1
The Intensive Care Unit, which opened in April 2016, has a capacity of 30 beds and comprises an interdisciplinary team of specialist doctors, nurses an occupational therapist, audiologist and physiotherapists. A psychologist and social worker attend interdisciplinary meetings along with the medical specialists.
The primary aim of the unit is to offer a service of high quality in a caring way, with a humanistic focus. This service is delivered to users through early intervention from the first day of entry in order to avoid conditions of physical incapacity and delirium. Communication with family members is encouraged through daily visiting between the hours of 10 am to 6 pm, with occasional short stays of a couple of days to help maintain the person in as an alert, active and well oriented condition as possible.
Every person coming into the unit has an occupational therapy evaluation (through relatives) to establish their previous occupational areas of weakness, along with risk factors (age, background, lifestyle etc.) The persons entering the unit are classified in 3 groups:
1.    Those with neurological conditions
2.    Those with respiratory conditions
3.    Those with coronary conditions
Treatment is classified in phases:
A.    Patients with catheters or mechanical ventilation
B.    Those withdrawing from sedation with possible delirium
C.    Recuperation through participation through activities

It has been demonstrated that occupation or engagement in meaningful activity is a means of re-establishing routines and patterns of self-care and stimulating cognitive and perceptual skills. Support is given both to recuperation of the individual and in aiding the family members helping in the process. Occupational Therapy has a key role in this, as intermediary between the human being who is a critical state with tubes, catheters, cables by explaining to them and their family what is happening and why. Activity is seen as key by the professionals in the interdisciplinary team who monitor patients closely to see how they respond to unimodal and multi-model multisensory stimuli and to gauge if they are able to engage in the activities we propose for them.
Occasionally we join forces with an audiologist or dietician and the physiotherapist works with us, for example to evaluate an individual’s visual range for working when sitting on the edge of a bed or in a chair.
Amongst the evaluation instruments applied are:
Glasgow Awareness Scale
RASS Sedation Scale
FIN Independent Functioning Scale
MOCA Cognitive Test
I have taken the opportunity to be part of this team and additionally to prepare final year occupational therapy students at a practical/theoretical level to develop decision-making skills. This is in an environment with a high level of pressure, stress and tension, due to persons being at high risk, as well as feelings and reflections of the team members, the arduous sessions and the worries of the patients’ families.

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