Occupational therapy outcomes in skilled nursing facilities

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.

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 in a more detailed analysis of when occupational therapy might be helpful for a patient in a skilled nursing facility and when it is likely to result in little improvement in quality of life. This research will tie together the research that has preceded it in this area.

Benefits

This research will result in improved patient outcomes, which will benefit the patients, skilled nursing facilities, occupational therapists and other stakeholders.

Goals

This project will focus on ways to determine when occupational therapy would be helpful for patients and when it would not likely be of benefit.

SMART Process Objectives

This research will result in a deliverable that will present the results of the data obtained during the research study. This document will present the literature review, data and analysis from the research study. This research will provide a data breakdown as to the conditions and initial assessment categories of the patients. It will evaluate the effectiveness of occupational therapy for each of these patient categories.

Deliverables

The key deliverable for this project will be the final report detailing the conduct, data, and results of the study.

Success Criteria

The project will be a success if differences are found that are predictive of the outcome of occupational therapy in skilled nursing facility patients.

Strategic Plan

Description

Completion Date

Design Study and find all study instruments

March 1, 2011

Conduct Literature Review

July 1, 2011

Contact Skilled Nursing Facilities, Obtain Permissions and Make Arrangements

August 1, 2011

Conduct Baselines

September 1, 2011

Conduct Second Set of Measurements

December 1, 2011

Conduct Third Set of Measurements

March 1, 2011

Conduct Fourth Set of Measurements

August 1, 2011

Data Analysis

October 1, 2011

Final Report Writing and Editing

December 31, 2011

Presentation of Final Report

January 1, 2012

Risk Management/Support Strategies

The key risk in this study is the inability to assess certain patients due to their physical condition. For instance, they might not be able to talk, or to physically respond to the assessment questionnaire. In these cases, the nurses will be enlisted to help complete the assessment. Another risk is that the sample population might change between the beginning and the end of the study. The final study will be assessed according to the number of patients who actually complete the study.