Occupation

Abstracts Thursday 30th June 2016
References
Costello, J. (2012) ‘Background to bereavement and
bereavement care’, in Wimpenny, P. and Costello, J. (eds.) Grief,
loss and bereavement: Evidence and practice for health and
social care practitioners. Oxon: Routledge, pp. 5–16.
Hoppes, S. and Segal, R. (2010) ‘Reconstructing Meaning
Through Occupation After the Death of a Family Member:
Accommodation, Assimilation, and Continuing Bonds’, American
Journal of Occupational Therapy, 64(1), pp. 133–141.
Neimeyer, R. A. and Sands, D. C. (2011) ‘Meaning reconstruction
in bereavement: from principles to practice’, in Neimeyer, R. A.,
Harris, D. L., Winokuer, H. R. and Thornton, G. F. (eds.) Grief and
Bereavement in Contemporary Society: Bridging Research and
Practice. London: Routledge, pp. 9–22.
Keywords
Occupational therapists, Research, Occupational science
Contact E-mail Addresses
jcarruthers6@hotmail.co.uk
Author Biographies
After ten years working in the media, Joanne Carruthers
decided on a career U-turn and returned to university to study
occupational therapy. This is her pre-reg Masters’ research
project and was inspired by some of the amazing people she
met in her former job,
Session 56b.1
The impact of functional status on UK acute
readmissions
Sterling J, Atwal A, Roden P, Brunel University
Introduction: Discharge planning is essential to ensure safe
and efficient use of resources. Occupational therapists have an
integral role in determining fitness for discharge by conducting
functional assessments. However, premature discharges of
older adults have been linked to higher readmission rates and
increased costs (Deschodt et al, 2015). In addition, little is known
about the effectiveness of occupational therapy functional
assessments on the discharge process. The aim of this study
was to ascertain whether older adults are achieving functional
recovery before being discharged from acute settings, and the
impact of functional status on readmission rates within one
month.
Methods: Cross sectional study using the modified Barthel Index
in an acute elderly care ward. Data was collected by therapists
prior to admission and discharge over a 9 month period. In total
84 complete scores were obtained. Data was analysed using
T-tests, Mann-Whitney tests and logistic regression.
Results: Patients readmitted within 28 days had significantly
lower changes in function (mean=0.94 points median=0.00
points) when compared to those who were not (mean=9.30
points median=0.00 points), on both the T-test (t=2.78) and the
Mann-Whitney test (U=385.50). Functional change and length
of stay may be predictors of 28-day readmission in older adults
(chi-square=21.84, R2=0.403). The readmitted group contained
a high prevalence of patients with multiple comorbidities,
including heart disease, falls and Type 2 Diabetes.
Implications for Occupational Therapy: In contrast to current
policy that recommends early supported discharge from acute
settings, this study suggests that functional recovery should
be achieved prior to discharging older adults from acute
settings in order to reduce 1-month readmissions and improve
health outcomes. Functional improvement may be particularly
important in patients with multiple comorbidities.
References
Deschodt M, Devriendt E, Sabbe M, Knockaert D, Deboutte
P, Boonen S, Milisen K (2015) Characteristics of older adults
admitted to the emergency department (ED) and their risk
factors for ED readmission based on comprehensive geriatric
assessment: a prospective cohort study, Journal of BMC
Geriatrics, 15(1), 54–60.
Keywords
Older people, Research, Pathways or models of service delivery,
NHS
Contact E-mail Addresses
juliaclairesterling@gmail.com
Author Biographies
Julia has recently completed her MSc in occupational therapy at
Brunel University. She currently works at Addenbrookes hospital.
Session 56b.2
Improving patient outcomes through occupational
therapy partnership working on a care of the elderly
ward
Hanson J 1 , Hird V 2 , Durham R 1 , Tees, Esk and Wear Valleys
NHS Foundation Trust 1 , County Durham and Darlington
NHS Foundation Trust 2
The NHS Five Year Forward View sets out a triple integration
agenda, including greater integration between physical and
mental health care. Services will be organised around the needs
of patients rather than professional boundaries (NHS England,
2014).
60% of older people who occupy acute hospital beds will either
have or develop a mental health problem during their stay.
This psychiatric co-morbidity has the potential for detrimental
outcomes for this population including increased length of stay,
increased rates of re-admission and increased rates of discharge
to institutional care, rather than the patient’s own home,
reflecting higher levels of morbidity, dependence and functional
impairment (Royal College of Psychiatrists 2005).
The role of the occupational therapist is to assess and
understand the impact of the older person’s mental health
condition upon their occupational performance skills, and
to maintain, restore or create a match between the abilities
of the person, the demands of daily occupations and their
environment. Interventions should focus upon the client
achieving their optimal level of function (Creek 2003).
This poster discussion will utilise service evaluation data and a
case study to demonstrate the impact of the development of
partnership working between the care of the elderly and liaison
psychiatry occupational therapy teams upon patient outcomes
and service delivery in this clinical area.
References
Creek, J. (2003). Occupational therapy defined as a complex
intervention. College of Occupational Therapists: London.
NHS England (2014) Five Year Forward View.
Royal College of Psychiatry (2005). Who Cares Wins. Royal
College of Psychiatrists: London
Keywords
Older people, Service improvement or transformation, Innovative
practice, NHS
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