Tan Emma Su Zan, Mackenzie Lynette, Travasssaros Katrina, Yeo Megan
a Discipline of Occupational Therapy , University of Sydney , Lidcombe , New South Wales , Australia ;
b Discipline of Occupational Therapy , Royal North Shore Hospital , St. Leonards , New South Wales , Australia.
Disabil Rehabil. 2016 Aug;38(16):1610-9. doi: 10.3109/09638288.2015.1107632. Epub 2015 Dec 18.
Acute hospitals are facing more complex admissions with older people at increased risk of functional decline. This study aimed to create and trial the feasibility of a new screening tool designed to identify patients at risk of functional decline who need an occupational therapy referral within acute care.
Ten screening tools were reviewed and the Modified Blaylock Tool for Occupational Therapy Referral (MBTOTR) was developed. The MBTOTR was applied in a retrospective chart review of 50 patients over the age of 65 years who were admitted to five acute wards. Data on patients identified at risk of functional decline were compared to patients who were referred to occupational therapy.
Occupational therapy referrals were made by ward staff for 14 out of the 50 patients reviewed (32.5%). Only 14% (n = 7) of patients did not require a referral. The MBTOTR identified no irrelevant occupational therapy referrals. However, 66.5% of patients identified as needing an occupational therapy referral did not get one.
The MBTOTR identified high risk acute patients requiring an occupational therapy referral who were not referred to occupational therapy. Use of the MBTOTR would facilitate early occupational therapy referrals for complex patients, and potentially better discharge outcomes. Implications for rehabilitation The MBTOTR can be used in acute care settings to facilitate relevant occupational therapy referrals. Without a screening tool, many older people who should have an occupational therapy assessment may not receive a referral for occupational therapy. Nursing and medical staff need to use this tool to identify older people in their care who may benefit from occupational therapy assessment and intervention. If occupational therapy referrals can be made early, this may contribute to reducing delays to discharge plans for complex patients.
急症医院面临着更为复杂的入院情况，老年人功能衰退风险增加。本研究旨在创建并试验一种新的筛查工具，该工具旨在识别在急症护理中需要职业治疗转诊的功能衰退风险患者。
对十种筛查工具进行了审查，并开发了改良的职业治疗转诊布莱洛克工具（MBTOTR）。MBTOTR应用于对入住五个急症病房的50名65岁以上患者的回顾性病历审查。将确定有功能衰退风险的患者数据与转诊至职业治疗的患者数据进行比较。
在所审查的50名患者中，有14名（32.5%）由病房工作人员转诊至职业治疗。只有14%（n = 7）的患者不需要转诊。MBTOTR未识别出无关的职业治疗转诊。然而，被确定需要职业治疗转诊的患者中有66.5%未得到转诊。
MBTOTR识别出了需要职业治疗转诊但未被转诊至职业治疗的高危急症患者。使用MBTOTR将有助于为复杂患者尽早进行职业治疗转诊，并可能带来更好的出院结果。对康复的启示MBTOTR可用于急症护理环境，以促进相关的职业治疗转诊。如果没有筛查工具，许多本应接受职业治疗评估的老年人可能无法获得职业治疗转诊。护理和医务人员需要使用此工具来识别其护理中可能从职业治疗评估和干预中受益的老年人。如果能尽早进行职业治疗转诊，这可能有助于减少复杂患者出院计划的延误。
