A Pilot Study to Investigate the Feasibility of an Occupational Therapy Early Referral Tool for Nurses in Acute Care

Abstract

Background/aim: Acute care priorities are focused on stabilisation of a patient’s condition on admission. Patients with multi-morbidities affecting functional performance may not have their needs adequately met. Occupational therapy is well placed to address factors affecting functional decline thus early and accurate identification of patients requiring referral is imperative. This study investigated the feasibility of an occupational therapy early referral tool for acute care nurses. Methods: A mixed methods cross-sectional approach was used including: i) Completion of the Modified Blaylock Referral Tool (MBRT) on 305 patients by six acute care nurses in 3 wards. The tool results were analysed using descriptive and non-parametric statistics. ii) Semi-structured interviews with nurses on completion of the trial to understand their perspectives of occupational therapy and using the MBRT. Results: Of the assessed patients, 45% were recommended for occupational therapy referral. The main criteria associated with functional decline risk were mobility, memory and recent hospital admissions. Nurses indicated barriers to referral included resource limitations, lack of visibility and understanding of occupational therapy and lack of holistic assessment of patients. The MBRT identified patients consistent with nurses’ own recommendations and was easy to administer during admission to the ward. Conclusion: This study demonstrates the clinical utility of the MBRT for nurses to identify acute care patients at risk of functional decline. Recommended further research includes trials with larger nurse and ward samples and longitudinal studies to examine the effect of the MBRT on outcomes such as length of stay and post-discharge functional performance.