Total hip replacement - College of Occupational Therapists

More documents

Recommendations

Info

2 Objective of the guideline The guideline objective: To describe the most appropriate care or action to be taken by occupational therapists working with adults undergoing total hip replacement. The objective addresses occupational therapy intervention during the service user’s journey along the total hip replacement pathway with reference to: • Pre- operative education and intervention (for elective cases). • The inpatient episode of care and rehabilitation following surgery. • Care in the community following discharge from the inpatient setting (including rehabilitation and reablement). It is intended that occupational therapists use this guideline to inform their work with service users, with a particular focus on empowering the service user to be fully engaged and take responsibility for their recovery from surgery and achieving individual goals. This guideline should be used in conjunction with the current versions of the following professional practice requirements, of which knowledge and adherence is assumed: • Standards of conduct, performance and ethics (Health and Care Professions Council 2012b). • Standards of proficiency – occupational therapists (Health and Care Professions Council 2012c). • Code of Ethics and Professional Conduct (COT 2010). • Professional standards for occupational therapy practice (COT 2011b). It is intended that this guideline be used alongside the therapist’s clinical expertise and, as such, the clinician is ultimately responsible for the interpretation of the evidencebased recommendations in the context of their specific circumstances and the service user’s individual needs. 14 Occupational therapy for adults undergoing total hip replacement
3 Guideline scope 3.1 Clinical question The key question covered by this guideline: What evidence is there to support occupational therapy intervention with adults over the age of 18 undergoing total hip replacement The expert practitioners within the guideline development group identified, from their knowledge of the evidence- base and own clinical expertise, that occupational therapy intervention with adults undergoing a total hip replacement in practice includes a number of clinical, health and social care areas: • Service user engagement (i.e. empowering the service user to be responsible for their rehabilitation through education, setting and prioritisation of rehabilitation goals). • Performance of activities of daily living (personal, domestic and community tasks); for example, discussing adaptation of tasks and practising completion of tasks using new techniques. Tasks may include getting washed and dressed, meal preparation, laundry, shopping or other activities identified by the service user. • Post- operative functional mobility and transfers – practising walking with mobility aids, step and stair negotiation, transfers on/off bed, chair, toilet, in/out of car, etc., in line with any recommended movement precautions. • Pre- and post- operative cognitive and emotional function and impact on occupational performance is taken into account during all stages of assessment and intervention or action, and techniques adapted or strategies employed as required. • Environmental considerations (i.e. ensuring safe home environment for discharge, which may involve discussions with the service user regarding current set- up, access visits, home visits). • Social considerations (i.e. ensuring adequate support in the community, and liaising with the service user, informal carers, and health and social care services as required). • Work and leisure activities (i.e. discussion regarding adapting tasks and environment to suit the service user and maximise functional independence in both the pre- and post- operative phase, including appropriate travel arrangements and return to driving). • Return to previous roles (i.e. discussion regarding adapting activities and environment to empower the service user to resume meaningful roles such as spouse/partner (including sexual relations), family member, caregiver, worker, community member). • Comprehensive falls assessment (where the service user has sustained a hip fracture as a result of a fall), with interventions targeted towards modifiable risk factors (NICE 2004). Individual service user goals are identified at the assessment stage. These are highly influential on intervention following total hip replacement, when they will be College of Occupational Therapists 15
Page 1 and 2: Occupational therapy for adults und
Page 3 and 4: Occupational therapy for adults und
Page 5 and 6: Contents Foreword by Professor Avri
Page 7 and 8: Foreword I am delighted to have bee
Page 9 and 10: Key recommendations for implementat
Page 11 and 12: Key recommendations for implementat
Page 13 and 14: 1 Introduction Total hip replacemen
Page 15 and 16: Introduction Health education of pu
Page 17 and 18: Introduction In terms of best pract
Page 19 and 20: Introduction other members of the m
Page 21: Introduction surgery, the role of t
Page 25 and 26: Guideline scope • There are no re
Page 27 and 28: 4 Guideline development process Det
Page 29 and 30: Guideline development process contr
Page 31 and 32: 5 Guideline methodology 5.1 Guideli
Page 33 and 34: Guideline methodology 5.3 Criteria
Page 35 and 36: Guideline methodology Table 3: Grad
Page 37 and 38: Guideline methodology A recommendat
Page 39 and 40: 6 Background to clinical condition
Page 41 and 42: 7 Guideline recommendations The rec
Page 43 and 44: Guideline recommendations The inter
Page 45 and 46: Guideline recommendations mean leng
Page 47 and 48: Guideline recommendations assessmen
Page 49 and 50: Guideline recommendations suggestio
Page 51 and 52: Guideline recommendations and were
Page 53 and 54: Guideline recommendations 11. It is
Page 55 and 56: Guideline recommendations environme
Page 57 and 58: Guideline recommendations increased
Page 59 and 60: Guideline recommendations contribut
Page 61 and 62: Guideline recommendations an accele
Page 63 and 64: Guideline recommendations In terms
Page 65 and 66: Guideline recommendations spent in
Page 67 and 68: Service user perspectives of the re
Page 69 and 70: 9 Implementation of the guideline T
Page 71 and 72: Implementation of the guideline The
Page 73 and 74:
Recommendations for future research
Page 75 and 76:
Appendix 1: Guideline development g
Page 77 and 78:
Appendix 2: Acknowledgements A2.4 C
Page 79 and 80:
Appendix 3: Service user consultati
Page 81 and 82:
Appendix 3: Service user consultati
Page 83 and 84:
Appendix 4: Literature search strat
Page 85 and 86:
Appendix 4: Literature search strat
Page 87 and 88:
Appendix 5: Evidence- based review
Page 89 and 90:
Page 91 and 92:
Page 93 and 94:
Page 95 and 96:
Page 97 and 98:
Page 99 and 100:
Page 101 and 102:
Page 103 and 104:
Page 105 and 106:
Page 107 and 108:
Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
Appendix 6: Glossary and abbreviati
Page 115 and 116:
References Evidence references Bere
Page 117 and 118:
References Lin JJ, Kaplan RJ (2004)
Page 119 and 120:
References Wang W, Morrison TA, Gel
Page 121 and 122:
References Health and Care Professi
Page 124:
Download for Occupational therapy f
show all

Total hip replacement - College of Occupational Therapists

Create successful ePaper yourself

Delete template?

Save as template?