Total hip replacement - College of Occupational Therapists

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Guideline scope discussed between the occupational therapist and the service user and prioritised accordingly. The guideline scope included searching for evidence in all the above areas and did not identify specific exclusions in terms of intervention. It is recognised that the occupational therapist works as part of a multidisciplinary team, and that there are some key areas above that overlap with the role of other healthcare professionals working with the group of service users. These include, but are not limited to: • Personal activities of daily living, also addressed by nursing staff. • Functional mobility and transfers, also addressed by physiotherapists. • Social considerations and return to previous roles, also addressed by social workers. Occupational therapy staff must work alongside these professionals in accordance with local service arrangements to ensure the needs of the service user are met. Intervention must be compatible with desired outcomes for the service user, and this person- centred perspective underpins occupational therapy practice. The guideline development group members identified some key outcomes of occupational therapy intervention. These were categorised as service user- centred or service delivery- centred: Service user- centred outcomes: • Reduced anxiety. • Maximised functional independence. • Reintegration into the community. • Resumption of roles. Service delivery- centred outcomes • Reduced demand on support services. • Decreased length of hospital admission. • Low readmission rates. It can be difficult to determine the importance of specific outcomes to individual service users, particularly as in occupational therapy those outcomes are frequently interdependent. A core part of the service user involvement in this guideline development project was to review and judge the importance of these outcomes from the service user perspective (section 4.3). 3.2 Target population This practice guideline relates to adults receiving a total hip replacement. To further define the target population: • Adults are defined as any person aged 18 years and over. 16 Occupational therapy for adults undergoing total hip replacement
Guideline scope • There are no restrictions/limitations on gender, ethnicity or cultural background. • The condition covered by this guideline includes all types of implant/prosthesis and total hip replacement surgical approaches (such as the anterolateral approach, posterolateral approach, minimally invasive approach), and the application of enhanced recovery principles. • There are no exclusions for co- morbidities, however, each service user should be assessed individually (taking into account relevant co- morbidities) when determining appropriate care or action in relation to the guideline recommendations. There are no populations or sub- groups that are not covered by this guideline other than those less than 18 years of age. 3.3 Target audience This practice guideline’s principal audience is occupational therapists working with adults undergoing total hip replacement. It is, therefore, primarily relevant to occupational therapists who come into contact with this group of service users as they progress through the care pathway for total hip replacement; from pre- operative preparation, to inpatient rehabilitation, and on to community care following discharge from hospital. For that reason, this guideline will be applicable in many settings: community/ outpatient clinics, the service user’s home, acute or community hospitals. The publication will be useful to occupational therapists working in health, as well as social services. It can be applied to National Health Service (NHS) settings, as well as the independent sector. In addition to occupational therapy staff, it is suggested that this practice guideline will be relevant: • To members of the multidisciplinary team; for example, physiotherapists, nursing staff, social workers, healthcare assistants and surgeons. This guideline may facilitate a better understanding of the role of the occupational therapist in total hip replacement. This could lead to better working between disciplines, with improved outcomes for service users. • As an educational tool, orientating individuals to the occupational therapy role in total hip replacement (e.g. may be utilised by occupational therapy students, technical instructors, support workers and assistants). • For social care providers who would also benefit from reviewing this document to support interdisciplinary working, facilitating a safe and effective discharge and transition back into the community for the service user. • As evidence for managers and commissioners within healthcare services of the valuable role of occupational therapy with this service user group, and may be used as a reference tool to justify staffing levels, funding, etc. • For private providers/independent sector (i.e. private discharge schemes) to specifically tailor service provision/staffing to suit this group of service users. • To equipment providers/trusted assessors, who would also benefit from reviewing this document to better understand the needs of this specific group of service users. College of Occupational Therapists 17
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 and 22: Introduction surgery, the role of t
Page 23: 3 Guideline scope 3.1 Clinical ques
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
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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
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Appendix 1: Guideline development g
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Appendix 2: Acknowledgements A2.4 C
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Appendix 3: Service user consultati
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Appendix 3: Service user consultati
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Appendix 4: Literature search strat
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Appendix 5: Evidence- based review
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Appendix 6: Glossary and abbreviati
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References Evidence references Bere
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References Lin JJ, Kaplan RJ (2004)
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References Wang W, Morrison TA, Gel
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References Health and Care Professi
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Total hip replacement - College of Occupational Therapists

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