Elizabeth G. Hunter, PhD, OTR/L, is Assistant Professor, Graduate Center for Gerontology, College of Public Health, University of Kentucky, Lexington;
Elizabeth Rhodus, PhD, OTR, is Postdoctoral Fellow, Sanders-Brown Center on Aging, College of Medicine, University of Kentucky, Lexington.
Am J Occup Ther. 2022 Jan 1;76(1). doi: 10.5014/ajot.2022.047589.
Practitioners need to be familiar with, and involved in, managing quality-related adverse events in postacute care.
To determine interventions within the scope of occupational therapy that address preventable adverse events in adult postacute inpatient and home health settings.
Articles published from January 1995 through 2019 identified through searches of MEDLINE, PsycINFO, CINAHL, OTseeker, and Cochrane databases. Study Selection and Data Collection: Articles were collected, evaluated, and analyzed by two independent reviewers. They were assessed and synthesized with a goal of informing clinical practice.
Twenty-four articles were included in the review. Of the 10 Centers for Medicare & Medicaid Services preventable adverse events, 6 were addressed: diabetes management (n = 2), dysphagia (n = 5), infection control (n = 1), pressure ulcers (n = 6), falls (n = 5), and discharge management (n = 5). There was strong strength of evidence that exercise programs should, when appropriate, be implemented in both inpatient and home health settings to decrease the risk of falls. There was moderate strength of evidence that practitioners could consider implementing a facility wide evidence-based pressure ulcer program; providing multidisciplinary rehabilitation and swallow strengthening exercises for dysphagia; implementing a multidisciplinary, multicomponent falls program; and using a manualized depression intervention in home health to decrease hospital readmission.
The review highlights the importance of preventable adverse events and of occupational therapy practitioners acknowledging and managing these events to enhance health outcomes and to control health care costs. What This Article Adds: Many interventions typically performed by occupational therapy practitioners address preventable adverse events. The review highlights the importance of practitioners being aware of this category of impairment or injury.
从业者需要熟悉并参与管理后急性护理中的质量相关不良事件。
确定职业治疗范围内的干预措施，以解决成人后急性住院和家庭健康环境中的可预防不良事件。
通过 MEDLINE、PsycINFO、CINAHL、OTseeker 和 Cochrane 数据库的搜索，从 1995 年 1 月至 2019 年发表的文章。
两位独立评审员收集、评估和分析了文章。他们对这些文章进行了评估和综合，旨在为临床实践提供信息。
共有 24 篇文章纳入了综述。在 10 项医疗保险和医疗补助服务中心的可预防不良事件中，有 6 项得到了处理：糖尿病管理（n=2）、吞咽困难（n=5）、感染控制（n=1）、压疮（n=6）、跌倒（n=5）和出院管理（n=5）。有强有力的证据表明，运动计划应酌情在住院和家庭健康环境中实施，以降低跌倒的风险。有中等强度的证据表明，从业者可以考虑实施全机构基于证据的压疮计划；为吞咽困难提供多学科康复和吞咽强化锻炼；实施多学科、多成分的跌倒计划；并在家中使用基于手册的抑郁干预措施来降低医院再入院率。
该综述强调了预防不良事件的重要性，以及职业治疗从业者承认和管理这些事件以改善健康结果和控制医疗保健成本的重要性。这篇综述的重要性在于，许多职业治疗从业者通常进行的干预措施都可以解决可预防的不良事件。这突出了从业者意识到这一类损伤或伤害的重要性。
