Occupational Therapy Commons^™

Virtual Reality As A Training Tool To Treat Physical Inactivity In Children, Adam W. Kiefer, David Pincus, Michael J. Richardson, Gregory D. Myer

Psychology Faculty Articles and Research

Lack of adequate physical activity in children is an epidemic that can result in obesity and other poor health outcomes across the lifespan. Physical activity interventions focused on motor skill competence continue to be developed, but some interventions, such as neuromuscular training (NMT), may be limited in how early they can be implemented due to dependence on the child’s level of cognitive and perceptual-motor development. Early implementation of motor-rich activities that support motor skill development in children is critical for the development of healthy levels of physical activity that carry through into adulthood. Virtual reality (VR) training may be beneficial …

The Pathway To The Use Of A Structured And Supported Approach To Debriefing, Anne H. Zachry, S. B. Lancaster

Faculty Presentations

Debriefing plays a critical role in the transfer of knowledge in simulation education. Various methods are used in the debriefing process based on a variety of factors; this presentation sheds light on the pathway to the use of a structured and supported approach as traversed in the Department of Occupational Therapy at the University of Tennessee Healthcare Center as well as reflections and lessons learned along the way. Engagement in this session will allow learners to further develop their debriefing skills through exposure to information about strategies to use in the debriefing process that can be used as part of …

The Contribution Of Technology To The Development And Sustainability Of An Occupational Therapy Community Of Learners In Doctoral Education, Susan Toth-Cohen, Phd, Otr/L, Mary Gozza-Cohen, Phd, Sandra Schefkind, Otd, Otr/L, Faota

Department of Occupational Therapy Posters and Presentations

This case study describes the pivotal role of technology in developing a community of practice (COP) designed for post professional occupational therapists that enabled doctoral students, alumni and faculty to share information and insights about topics, initiatives and research critical to the Occupational Therapy field. The COP evolved through ongoing development of the post-professional occupational therapy doctorate (PPOTD) program at Jefferson University in Philadelphia.

The conceptual foundation for the COP moved beyond an initial focus on course delivery to an emphasis on development, implementation, and sustainability of a vibrant learning community. Transformation of the COP was greatly facilitated through the …

Minimal Clinical Important Difference Of The Quick Disabilities Of The Arm, Shoulder, And Hand (Quickdash) For Post-Surgical Finger Phalanx Fractures, E. Smith-Forbes, Dana Howell, J. Willoughby, G. Pitts, T. Uhl

EKU Faculty and Staff Scholarship

Purpose: STUDY DESIGN: Retrospective, multiple-group observational design.

Objective: To determine the minimal clinically important difference (MCID) for the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) outcome measure, for post-surgical phalanx fracture diagnosis, using a triangulation of distribution-and-anchor-based approaches.

Background: The MCID for the QuickDASH has been established using a pool of multiple conditions, and specifically for the shoulder, and other diagnoses in the elbow and wrist, but not for post-surgical finger fracture. Understanding specific threshold change values for post-surgical finger fracture can enhance the clinical decision-making process.

Development Of A Concussion Pathway In Acute Care., Katharine Bell Ms, Otr/L, Cbis, Alisha Unternahrer Ms, Otr/L

Department of Medicine

No abstract provided.

Perceived Stress Levels May Impact Upper Extremity Function Among Women Treated For Breast Cancer, Mary Insana Fisher, Anne Fleischer, Kimbery Parent, Renee Roberts, Megan Mcclure, Lynn Hendricks

EKU Faculty and Staff Scholarship

Women treated for breast cancer report ongoing disability in their involved upper extremity, however, often objective measures do not appear to explain the level of perceived dysfunction. The purpose of this study was to investigate the relationship between perceived stress level, fear of physical activity and self-reported upper extremity function among women treated for breast cancer.

Opening A Student-Run Pro Bono Occupational Therapy Pediatric Clinic, Anne H. Zachry

Faculty Presentations

This presentation described the opening of a student-run pro bono pediatric therapy clinic that provides services to children/families who are economically disadvantaged. The benefits of participation for students and clients were reviewed, and fund-raising and the development of a mission statement were discussed.

Interprofessional Grand Rounds: Student Hotspotting Team 2016-2017, Caroline Komanecky, Peter Sacci, Danielle Mcfadden, Nuriya Neumann, Michaela Scotten, Melissa Murphy

Department of Occupational Therapy Posters and Presentations

No abstract provided.

Health Promotion And Wellness Strategies And Self-Regulation Interventions For Occupational Therapy Assistant Program Graduates Preparing For The Nbcot Exam, Marcia Hamilton

Occupational Therapy Collection

New graduates of Occupational Therapy Assistant (OTA) Programs are challenged with the preparation and successful completion of the National Board for Certification in Occupational Therapy (NBCOT) Certified Occupational Therapy Assistant (COTA) examination. The threat of not passing this exam is intensified due to the cost of the exam and lack of provisional licensing. Anecdotal experience of faculty in an OTA Program supports concern for new graduates as they report feelings of distress and anxiety, as they enter the one- to two-month period prior to the exam. An occupational role shift must occur during this transitional period, as the new graduates …

Identification Strategies For The Very High Fall Risk Patient In An Acute Inpatient Psychiatric Unit, P6 Inpatient Geri-Med Psychiatry, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

Patients falling as a result of geriatric and psychiatric impairments are at a much higher risk than the average patient population. An acute care inpatient psychiatric team used baseline metrics to demonstrate increasing fall rates per month that surpassed the unit’s target number. As a result, a quality improvement project around falls was felt to be warranted.

The overall goal of this study was to improve patient safety by reducing falls for their very high risk fall population. A root cause analysis determined that this population was not being properly identified and several tools were developed and employed to better …

Delirium Reduction Strategies For The Critically Ill, June Chaves, Sam Canonico, Will Cheney, Tammy Corey, Gil Fraser, Alex Kowalewski, Jen Low, Cardiac Intensive Care Unit, Haley Pelletier, Cathy Palleschi, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

MaineHealth Maine Medical Center

Delirium, an acute and fluctuating disturbance of consciousness and cognition, is a common manifestation of acute brain dysfunction in critically ill patients. Patients with delirium have longer hospital stays and a lower 6-month survival rate than do patients without delirium. Preliminary research suggests that delirium may be associated with cognitive impairment that persists months to years after discharge.

In a large acute care hospital, the cardiac intensive care staff became interested in mitigating their unit’s high delirium rate of ventilated patients. At baseline, many members of the healthcare team did not believe that delirium could be prevented and the predominant …

Strategies To Improve Interdisciplinary Communication In An Acute Care Inpatient Pediatric Unit, Sarah Thompson, Haley Pelletier, Barbara Bush Children's Hospital-Inpatient, Maine Medical Center, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

MaineHealth Maine Medical Center

Interdisciplinary patient rounding has been shown to improve patient and family satisfaction as well as reduce patient length of stay and readmission rates. In an acute care inpatient pediatric unit, baseline metrics demonstrated that 100% of the time, nursing was not included in these rounds thus resulting in sub optimal communication.

The goal of this performance improvement project was to attain increased nursing participation. Data collection demonstrated several reasons for lack of participation and corrective actions were instituted. After undertaking this KPI goal and utilizing operational excellence, 95% of the time, nurses were called to morning rounds with the medical …

Patient Fall Prevention, R9 West Cardiovascular, Cathy Palleschi, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

MaineHealth Maine Medical Center

PATIENT FALL PREVENTION STRATEGIES IN AN ACUTE HOSPITAL

Every year in the United States, hundreds of thousands of patients fall resulting in injury. Injured patients often require prolonged hospital stays and a resultant increase in medical costs.

The purpose of this study was to identify the current state of fall prevention strategies on a hospital inpatient acute care cardiac unit. Through a root cause analysis, some deficiencies were identified and a process improvement plan was implemented.

Several positive outcomes were attained as a result of the countermeasures initiated. Patient falls per month and total waste in dollars saw a decline …

Investigating The Enabling Factors Influencing Occupational Therapists’ Adoption Of Assisted Living Technology, Colleen E. Mcgrath

Occupational Therapy Publications

Method

This qualitative study utilized semi-structured interviews and focus groups with 20 occupational therapists in England and Scotland. The goal was to identify those enabling factors necessary for occupational therapists to adopt assisted living technology.

Results

Five themes emerged regarding the enablers needed to support the adoption of assisted living technology by occupational therapists, including: (1) a positive client–therapist relationship; (2) affordability; (3) time; (4) increased awareness, education, and training; and (5) usability features of the assisted living technology.

Conclusion

With an aging population and the increasing role that technology is playing globally in older adults’ lives, it has never …

Taking Steps To Prevent Falls, Kimberly Okechukwu

Doctor of Occupational Therapy Capstone Projects

Fall prevention is imperative in skilled nursing and long-term care facilities. According to the CDC, “about 1,800 older adults living in nursing homes die each year from fall-related injuries and those who survive frequently sustain injuries that result in permanent disability and reduced quality of life”. “Falls can also result in severe pain, high medical costs, fear of falling, less participation in activities, and reduced quality of life “(CDC 2015). Appropriate and effective fall prevention programs need to be established and implemented to reduce falls in nursing homes, which will in turn improve the quality of care.

Optimizing Critical Illness Outcomes Through The Family Experience-A Theoretical Review, Kirby P. Mayer, Samantha A. Mancuso, Dana M. Howell

EKU Faculty and Staff Scholarship

An estimated six to eight million patients are admitted to the intensive care unit (ICU) in the United States every year [1, 2]. It is possible that new and innovative medical therapies have provided patients with treatment options that enhance survival of a critical illness and allow them go home with more medical support than previously available in earlier years. This may explain why there are now millions of ICU survivors are a result of declining mortality rates (8-19%) even though there are increased ICU admissions [3, 4]. This also indicates a change in direction of the attitudes and beliefs …

Ot Department News- Issue #2

Department of Occupational Therapy Newsletter

In this Issue:

• Faculty Spotlight
• OT Roots in Mental Health
• Alumni Highlight
• CREATE
• OT & Design
• Saturday Academic Pipeline
• Post-professional OTD Spotlight

Faculty Led Study Abroad: Influences On Student Intercultural Communication, Interprofessional Attitudes, And Professional Identity, Lynne Andonian, Ruth Rosenblum

Faculty Publications

Interprofessional education is valued within healthcare professional programs as reflected in accreditation standards and program outcomes as well as college-wide initiatives. Little is known about the relationships between interprofessional attitudes among healthcare students (nursing, occupational therapy, social work), their degree of intercultural communication skills, and their professional identity. Thirty three students participating in interprofessional faculty-led study abroad completed pre- and postmeasures of the constructs under study: interprofessional attitudes, intercultural communication, and professional identity. Statistically significant positive relationships were found between interprofessional attitudes and intercultural communication skills which are discussed as well as implications for education and practice. This quantitative, descriptive …

Status Of The Entry-Level Clinical Doctorate In Occupational Therapy Education, Tara N. Ruppert

Doctor of Occupational Therapy Capstone Projects

Occupational therapy education has accepted two degree paths for entry-level practice since 2007 – the Masters in Occupational Therapy (MOT) and the Clinical Doctorate in Occupational Therapy (OTD). A national debate exists about this approach, with strong voices on each side but there is a gap in the research supporting either side. A cohort study was used to gather data from program directors of entry-level occupational therapy programs in the U.S. to determine if there are trends, common perceptions, or predictive factors regarding which degree is supported by a program. Trends were identified, as were some common perceptions regarding the …

Facilitators And Barriers To Neonatal Intensive Care Unit Follow-Up Program Attendance: A Critically Appraised Topic, Ciara Clark, Mariko Rudy, Lauren Maher

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Kari Tanta, PhD, OTR/L, FAOTA is the rehabilitation manager of the neonatal intensive care unit (NICU) and the NICU follow-up (NFU) program at Valley Medical Center (VMC). To address the problem of decreased NFU attendance, the following clinical question was asked: “For families with an infant who has been discharged from a NICU, which factors promote or discourage utilization of follow-up services?” Numerous facilitators and barriers affecting attendance were identified relating to severity of infant illness, parent socioeconomic status and education levels, and pragmatic factors including timing of scheduling.

Knowledge translation activities undertaken included collaboration with University of Washington (UW) …

Gender Dysphoria And The Role Of Occupational Therapy, Melanie Murphy, Julie Tinsley Schaefer, Enjoli Washington

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Prompted by Kristin Brubaker, a licensed pediatric occupational therapist who works at the Center for Therapeutic Intervention (CTI) in Gig Harbor, WA, the researchers set out to answer the following question: “What evidence supports the use of occupational therapy (OT) interventions in improving the psychosocial health of children and youth between the ages of 0 to 25 experiencing gender dysphoria (GD)?” After reading and evaluating 29 articles from qualitative and quantitative research, systematic reviews, and additional evidence, the researchers concluded that occupational therapists can assist this population by affirming the experience of GD, encouraging exploration of gender identity, providing a …

Hippotherapy Capstone, Autumn O'Hara

Doctor of Occupational Therapy Capstone Projects

Therapists work with many children with many different diagnoses. One of the most prevalent diagnosis is Autism Spectrum Disorder (ASD). According to recent statistics, available from the Centers for Disease Control and Prevention (CDC), 1 in 68 children are diagnosed with ASD; which is a developmental disability that can cause social and behavioral challenges (CDC, 2016). ASD can also be defined as a complex group of neurodevelopmental disorders characterized by deficits in social interaction and verbal and nonverbal communication, as well as restricted, repetitive interests (APA, 2016). Therapist also work with individuals who have other diagnoses and deficits, including but …

Using Sensation In Pediatric Occupational Therapy, Kaitlin Gaspich, Sydney Anderson, Catherine Terhune, Emiline Gonzalez

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Molly McBroom, OTR/L, of Mary Bridge Children’s Therapy Unit (CTU) requested University of Puget Sound occupational therapy (OT) graduate students research the following question: “What is the effectiveness of using sensory based intervention (SBI) or Ayres’ sensory integration^® (ASI)and neurodevelopmental treatment (NDT) approach with children with sensory processing disorder (SPD), autism spectrum disorder (ASD), and/or attention-deficit/hyperactivity disorder (ADHD) on behavior?” A systematic review of the literature resulted in eight out of 12 studies reporting positive findings. Four of the studies examined ASI and four examined SBI. The other four studies showed inconclusive or negative results. Overall, no clear conclusions …

Interventions For Sleep Problems In Pediatrics, Chelsea Rogers, Marie Trevisan, Maureen Traxler

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Julie Anderson, DrOT, OTR/L, will be conducting screenings and providing treatment for children with sleep problems in the Puyallup School District of Washington. To assist her in this emerging practice area, a systematic search and critical appraisal of research published between 2000 and January, 2017 was completed to address the question, “What is the current evidence regarding sleep intervention effectiveness in school-aged children?” The majority of research has investigated the use of behavioral interventions for improving child sleep. These studies included children with developmental disabilities (DD), attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), oppositional defiant disorder (ODD), sensory …

Cognitive And Occupationally-Based Assessments In Acute Care: For Individuals With Acquired Brain Injury, Jillian Harrison, Stephanie Lenk, Brooke Logan

School of Occupational Therapy Master's Capstone Projects (2016-2021)

The student researchers collaborated with Marcy Boschee, OTR/L, an occupational therapist practicing in the acute care unit at St. Joseph's Medical Center in Tacoma, WA to investigate two clinical questions: [1] “What evidence is there for the effectiveness of the Montreal Cognitive Assessment (MoCA) in predicting functional cognitive impairment of patients 18-years-old and older in acute care who have sustained an ABI?” and [2] “Which occupationally-based cognitive assessments, feasible to use in the acute care setting, are most effective at predicting functional impairment in patients 18-years-old and older with mild to severe ABI?” A systematic review was conducted and 29 …

Rate And Duration Of Adaptive Equipment Use Post-Discharge And Factors Affecting Use Post-Discharge, Elizabeth Goodwin, Elizabeth Siska, Jamie Theuer

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Patients in in-patient rehabilitation are often discharged with adaptive equipment in order to be safe and independent in their homes, as is the case for patients at ManorCare, a skilled nursing facility in Tacoma, Washington. However, if adaptive equipment that is functionally necessary is not being used by the patient, it can lead to reduced independence and safety, potentially resulting in incidents that result in injury and re-admittance. Therefore, Rehabilitation Director Joette Jindra, OTR/L requested research to understand the factors that contribute to continued use or non-use after discharge to assist therapists in their clinical decision-making when making equipment provisions …

Impact Of Trauma On Brain Morphology & Maladaptive School Behaviors, Brandon Escobar, Sharlene Lavaris, Teresa Le

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Wendi Trummert, DrOT, OTR/L, the collaborating clinician for this project, works with students in a self-contained program. Wendi wanted to know how childhood trauma affects brain structure and morphology and how it is linked to behaviors seen in children affected by trauma. A synthesis of all articles looking at the brain reveals differences in both structure and function in the brains of individuals exposed to childhood trauma versus those not exposed (e.g. Daniels, Lamke, Gaebler, Walter, & Scheel, 2013; McGowan et al., 2009; Saleh et al., 2017). A synthesis of articles looking at maladaptive behaviors finds that those often seen …

Lymphedema Assessments, Jessica Enyeart, Cullyn Foxlee, Divina Ramolete, Connie Colleen Wyatt

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Heidi Shaffer, a MultiCare occupational therapist specializing in lymphedema (LE) management, proposed the research question of whether bioimpedance spectroscopy (BIS) via the L-Dex (U400 Impedimed) is the most reliable, valid, cost-effective and time-efficient assessment tool on the market for measuring LE in comparison to circumferential measurements (CM). Shaffer currently uses the L-Dex in practice and hoped to substantiate its psychometrics from the literature to promote its clinical usage and potentially obtain consistent insurance coverage. A critical appraisal of the literature revealed a strong correlation between BIS and CM, suggesting that both can be used reliably and validly in clinical practice. …

School-Based Tier Ii And Iii Rti Interventions For Children Affected By Trauma, Sarah Ladderud, Maria Randall, April Crabtree

School of Occupational Therapy Master's Capstone Projects (2016-2021)

We partnered with Wendi Trummert, DrOT, OTR/L, an occupational therapist in a school district in Puyallup, Washington. We collaborated to examine what school-based Tier II & Tier III Response to Intervention (RTI) interventions can be used by occupational therapists, teachers, and paraeducators to improve school participation in children aged 3-13 who have experienced trauma. It was found that various forms of Cognitive Behavioral Therapy (CBT) interventions may reduce post-traumatic stress disorder (PTSD) symptoms, depression, and anxiety in children age birth - 13 who have experienced trauma. CBT was the most effective intervention based on the current literature. Additionally, there is …

Strategies For Effective Collaboration Among Multidisciplinary Teams: Integration Of An Aba Professional, Elizabeth Schroeder, Kalene Lynch, Allison Turgeon

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Our collaborating practitioner (CP), Kari Tanta, PhD, OTR/L, FAOTA, manages Valley Medical Center which is a multidisciplinary pediatric outpatient therapy clinic. Dr. Tanta was seeking research to support incorporating an applied behavior analysis (ABA) professional into VMC’s practice. The focused question became, “What are strategies to promote successful collaboration when integrating a Board Certified Behavior Analyst (BCBA) into an established multidisciplinary pediatric clinic to promote best practice for clients?” From September 2016 - January 2017, 26 articles were analyzed using a critically appraised topic (CAT) table. The literature indicated effective health care team collaboration yields positive patient outcomes, provided strategies …