Graduation Year

2018

Document Type

Capstone

Degree Type

Open Access Capstone

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

Abstract

Background: Occupational therapy (OT) has been identified in existing research as an appropriate profession for addressing cognitive impairments such as delirium common to intensive care unit (ICU) hospitalization. Purpose: This study hypothesized that cultural change must occur within the ICU setting regarding the importance of rehabilitation services for mental functioning and cognitive stimulation in addition to early mobility in the prevention and management of ICU delirium. The intent of this capstone project was to determine the perceptions of ICU nurses regarding the inclusion of and collaboration with OT for the management of ICU delirium. Theoretical Framework: The purpose and objectives for this study were supported by the organizational theory presented in Kirkpatrick’s Evaluation Model, which addresses the process of learning, job performance, and organizational change, as well as examining learners’ reactions to new concepts (Reio, Rocco, Smith, & Chang, 2017). Methods: This pilot study was a mixed-methods approach with survey and qualitative interview design. Participants included nurses working in the ICU. Participants read an education resource titled OT and ICU Delirium Guide and completed an online survey to assess receptiveness to inclusion of OT in delirium management. Qualitative interviews were conducted with a sub-set of participants to obtain a deeper understanding of nursing’s perceptions of OT and its potential role with ICU delirium. Results: Nineteen nurses responded to the survey, with the majority responding they were unaware of OT’s role in cognition prior to reading the OT and ICU Delirium Guide, and were willing to contact OT to have a greater role with ICU delirium. Five nurses were interviewed. Emerging themes were found related to a pause in patient care in the setting of ICU delirium, nurses embodying the role of being the eyes and ears of the medical team, and occupational therapy being perceived as a red-headed step child, with a misunderstood and underutilized role in delirium management. Nurses identified their needs as learners with strategies discussed to make future education and programs meaningful, relevant, and sustainable. Conclusions: Study objectives were met with evidence of nurses perceiving occupational therapy as having a role in ICU delirium management, but increased education was required to promote increased inclusion.

Faculty Mentor

Dana M. Howell

Department Affiliation

Occupational Science and Occupational Therapy

Committee Member

Renee Causey-Upton

Department Affiliation

Occupational Science and Occupational Therapy

IRB Approval Number (if applicable)

1895

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