Capstone Project on "Tertiary Prevention Occupational Therapy and Wellness in the Skilled Nursing Facility"

Capstone Project 6 pages (2078 words) Sources: 6

[EXCERPT] . . . .

Occupational Therapy

Tertiary Prevention: Occupational Therapy and Wellness in the Skilled Nursing Facility

Learning Contract

Capstone Project Overview/Aims:

This purpose of this Capstone Project will be to explore the long-term outcomes of occupational therapy for patients in a skilled nursing facility. It will examine a group of patients who are participating in their assigned occupational therapy program and will compare them to a group of patients who are not participating in their assigned occupational therapy program. It will follow these two groups of patients for a period of one year. It will measure their clinical, mental health, and functional outcomes.

A baseline will be taken of these three functional areas at the beginning of the project. A re-assessment of these three areas will be performed every three months. The outcomes in these three functional areas for these two groups of patients will be compared after a period of one year. This study will help to determine if occupational therapy results in an improvement or at least a reduction in the worsening of their conditioning and functioning.

The primary aim of this study will be to determine the role that occupational therapy plays in the improvement or slowing of the condition for which the patient was admitted into the skilled nursing facility. This research will examine a wide variety of patients who were admitted for a variety of conditions. The baseline will be the determining element that will determine whether occupational therapy has a positive effect on patient outcomes.

2. Learning Objectives* for OTD Capstone Project:

At the conclusion of this research study, I will be able to do the following:

1. Understand the role that occupational therapy plays in long-term patient outcomes.

2. Analyze the outcomes of patient interventions and their role in tertiary prevention in patients in skilled nursing facilities.

3. Synthesize the information obtained in coursework so that it will become a tool in my daily work as an occupational therapist.

4. Evaluate the body of information that already exists in light of the information gathered in this research study.

3. Assessment of Objectives:

1. Understand the role that occupational therapy plays in long-term patient outcomes.

Activity: Evaluate the outcomes of improvements, lack of worsening, or lack of improvement in the two patient groups used in this study over the course of the study period.

2. Analyze the outcomes of patient interventions and their role in tertiary prevention in patients in skilled nursing facilities.

Activity: The researcher will critically appraise the results of the study and the conclusions that can be drawn from them. Discuss various factors that might have influenced the outcomes of the study and assess their importance in the ability to draw conclusions from the results obtained in this study.

3. Synthesize the information obtained in coursework so that it will become a tool in my daily work as an occupational therapist.

Activity: Explore ways in which the information gained in this study can be applied to my work. The information will be discussed in terms of how to take actions based on the information gained during this study in order to improve patient outcomes in skilled nursing facilities. A set of goals will be developed that represent best practices in the field in terms of planning for and promoting participation in occupational therapy among patients in skilled nursing facilities.

4. Evaluate the body of information that already exists in light of the information gathered in this research study.

Activity: During the course of this research study, a thorough examination of literature on the topic of patient outcomes and its relationship to occupational therapy will be conducted. The outcome of this literature review will be presented in the final presentation. The information obtained in this research study will be discussed in terms of how it compares to the information found during the literature review. The results of this research study will be examined in terms of what they add to the current body of existing literature on the topic.

Project Initiation Documentation

Purpose: To explore the role of occupational therapy in the ability to prevent a worsening of the disease or disability in a skilled nursing facility.

Instructions: Please complete the following information.

Capstone Project Title: Tertiary Prevention: Occupational Therapy and Wellness in the Skilled Nursing Facility

Primary Project Aim

The proposed Capstone Project will demonstrate leadership through the exploration of a topic that is of concern to the Occupational Therapy profession. It will utilize evidence-based practice in its findings. It will explore the relationship between occupational therapy and long-term outcomes for patients in a skilled nursing facility.

Secondary Project Aim

My professional goal as an occupational therapist is to find ways to maximize patient outcomes. This research will give me an opportunity to engage in evidence-based practices that will accomplish this task. This research will serve patients, the facilities, and other occupational therapists by improving patient outcomes.

Background

Tertiary prevention of disease and disability refers to interventions that are designed to stop the progression of a condition and to prevent further disability from occurring. It is also designed to promote social opportunities for the individual. Occupational therapy and wellness programs in a skilled nursing facility are designed to accomplished these goals of tertiary prevention. Occupations are daily activities that are meaningful and that fill a person's time with purpose. They include self-care, work, play, or leisure activities. Occupational therapy helps to provide the patient with choice, meaning, and balance through a number of activities through the day. Occupational therapy emphasizes occupation as the basis for promoting strategies that help the patient avoid further disease or disability and that help to give their life meaning. Occupational therapy plays a key role in improving the lives or patients in skilled nursing facilities.

The role of occupational therapy in tertiary prevention of disease states and disability has received considerable academic attention in the past several years. This literature has focused on the patient outcomes based on a particular occupational modality. The following highlights some of the more important studies that have been conducted regarding this topic.

A retrospective exploratory study examined the clinical and economic outcomes of cardiopulmonary patients referred to skilled nursing care after an acute care stay. This research found that patients who participate in physical and occupational therapies improved in their functional living skills (Vincent & Vincent, 2008). The authors noted that advanced age, dementia and the type of illness had an affect on the ability of patients to be released to homebound care.

A similar study found that patients who had mobility issues did not improve after a three-month physical/occupational therapy combined program (Sackley, van den Berg, & Lett et al., 2009). The author felt that the limitations of the patients played a role in the outcome of this study and suggests that further studies are needed to determine if physical or occupational therapy should be recommended for similar patients. However, in another study using a sample of stroke patients, occupational therapy was found to reduce deterioration and improve their daily living skills (Sackley, Wade & Mant et al., 2006). Chin, Duncan, & Johnstone et al. (2005) found that occupational therapy was an important part or treatment for children with cerebral palsy who underwent surgery.

Fall prevention in the elderly is a key concern for both those living at home and in skilled nursing facilities. Johnston, Barras, & Grimmer-Somers, (2010) found that conducting a pre-discharge occupational therapy home assessment was an important strategy for preventing falls in non-neurological patients. The study found that neurological problems were predictive of a higher fall risk than non-neurological conditions. Therapy extender personnel can improve the quality of therapy and result in improved patient outcomes. Therapy extenders allow the primary therapist to perform higher-level functions in the therapy program (Hsieh, Putnam, & Nichols et al., 2010). These studies indicate that results differ in terms of patient outcomes regarding the success of occupational therapy. The results of this literature review suggest that additional research is needed in the area of tertiary prevention and occupational therapy.

Conceptual Foundation

The theoretical foundation for this project is based on the disparities in research results concerning patient outcomes in long-term nursing care. It was found that in some cases, patients greatly improved their functional skills and abilities in daily living skills (Sackley, van den Berg, & Lett et al., 2009). In others occupational therapy was found to play a key role in their ability to function, resulting in improved quality of life for the patients (Johnston, Barras, & Grimmer-Somers, 2010; Vincent & Vincent, 2008).

Implications for Occupational Therapy

Thus far, the literature seems to suggest that occupational therapy has a greater outcome for patients with non-neurological problems or those who not physically limited in their ability to participate in the therapy. The physical limitations of the patient will be included in the patient profile and assessment to be used in this study. This study will attempt to identify the conditions that lead to or compromise patient response to occupational therapy. It will result… READ MORE

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