Advanced Acute Care Rehabilitation: Progress Task Execution, Independence, and Functional Mobility in Medically Complex Patients

Credit

Planning Committee Disclosure - No relevant relationships

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners.  For speaker disclosures, please see the faculty biography.

Speaker

Kirsten Davin, OTD, OTR/L, ATP, SMS Related seminars and products

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Kristen Davin, OTD, OTR/L, ATP, SMS, is a veteran occupational therapist with over 22 years of extensive experience in all aspects of inpatient and acute care practice. She is best known for her live, national speaking tours, as she has conducted thousands of workshops and courses on the topics of splinting, seating/positioning, assistive technology, acute care assessment and intervention, work/life balance and more. She holds four specialty certifications as an Assistive Technology Professional (ATP), a Seating and Mobility Specialist (SMS), a Certified Aging in Place Specialist (CAPS) and a Certified Healthcare Simulation Educator (CHSE). She serves as faculty and the academic fieldwork coordinator for Baylor University’s occupational doctorate (OTD) program in Waco, Texas.

 

Speaker Disclosures:
Financial: Dr. Kirsten Davin maintains private practice and has employment relationships with Baylor University, Lincoln Land Community College, and Memorial Medical Center. She is a consultant for Performance Health. Dr. Davin receives a speaking honorarium and recording royalties from PESI, Inc. All relevant financial relationships with ineligible organizations have been mitigated.
Non-financial: Dr. Kirsten Davin is a member of the American Occupational Therapy Association and the Illinois Occupational Therapy Association.

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Objectives

1. Determine the critical elements of analysis and assessment in mobilizing medically fragile or compromised patients.
2. Construct an appropriate plan of care for patients who present with a critically ill cardiac, neurological, or respiratory diagnosis.
3. Distinguish the characteristics, similarities of, and differences between, patient level of acuity and methods to implement successful therapeutic interventions to restore function, participation in occupation and independence with each.
4. Demonstrate proficiency selecting appropriate outcome tools and measures for assessment of the acute or critically ill patient.
5. Assess several approaches to manage patients with challenging behaviors and design effective techniques to overcome cognitive barriers and encourage meaningful patient participation with therapeutic activities.

Outline

Physiological Changes in Acute Care

• Effects of immobility on organ systems
  • Respiratory | Cardiac | Digestive | Musculoskeletal
  • Early mobilization and intervention
• Reduced risk of delirium via mobilization

Ensure Safe and Successful Transfers and Mobility

• Decision-making algorithm
  • Justification for early mobility
• Weight-bearing restriction mobilization
• Specific mobility restrictions
  • Pulmonary embolism (PE) & Deep vein thrombosis (DVT)
• Mobilization management
  • Chest tubes | Arterial lines | IV management
• Additional considerations
  • Vitals, labs & oxygen titration

ICU/IMC Specific Management

• Fecal management systems
• Various catheter types

Advanced Treatment Interventions For Improved Outcomes

• Orthopedically complex patient
• Cutting-edge interventions
  • Same day discharge
  • Shorter length of stay
• Transfer considerations
  • Alternative techniques for NWB
  • Transfers for all WB restrictions
• Burn injury across the lifespan
  • Burn management and surgical interventions
  • Trends in burn intervention
• Cardiac diagnoses
  • Appropriate therapeutic progression
  • Sternal precautions
  • Implementation of strength training
• Neurological emergencies and trends
  • TNK vs tPA
  • Management of the severe stroke with brief neurological deficits
• Respiratory and cardiopulmonary compromised patient
  • High-flow oxygen management
  • COPD
  • Pulmonary embolism
  • Energy conservation

Interventions For Patients With Cognitive/Psychiatric Diagnoses

• Address the behavioral challenges
  • TBI | Dementia | Aggression
• Major depression and its impact

Outcome Expectations And Goal Considerations

• Short-term vs. long-term goal implementation
• Timing of reassessments
• Predicting the future

Create An Effective And Successful Discharge Plan

• Interdisciplinary approach
• Pros/cons of discharge destinations

Caring For The Caregiver

• Client-centered practice and inclusion of the patient’s support system
• Manage the challenging family/caregiver

Billing And Documentation

• Effective and successful documentation
• Document progression in patients with limited function
• Understand G codes, payment, and billing

Achieve Productivity

• Productivity requirements
• Current trends in productivity expectations

Target Audience

• Occupational Therapists
• Occupational Therapy Assistants
• Physical Therapists
• Physical Therapist Assistants
• Case Managers
• Nurses
• Respiratory Therapists