Interventions Within the Scope of Occupational Therapy to Address Preventable Adverse Events in Inpatient and Home Health Postacute Care Settings: A Systematic Review.
Interventions Within the Scope of Occupational Therapy to Address Preventable Adverse Events in Inpatient and Home Health Postacute Care Settings: A Systematic Review.
复制标题
职业治疗范围内的干预措施，以解决住院和家庭健康急性期护理环境中可预防的不良事件：系统评价。
DOI：
10.5014/ajot.2022.047589
复制
发表时间：
2022
影响因子：
2.9
通讯作者：
Elizabeth K. Rhodus
中科院分区：
文献类型：
--
作者：
Elizabeth G Hunter;Elizabeth K. Rhodus
重要性
从业者需要熟悉并参与管理急性后期护理中与质量相关的不良事件。
客观的
确定职业治疗范围内的干预措施，以解决成人急性后住院患者和家庭健康环境中可预防的不良事件。
数据来源
通过搜索 MEDLINE、PsycINFO、CINAHL、OTseeker 和 Cochrane 数据库识别出 1995 年 1 月至 2019 年发表的文章。研究选择和数据收集：文章由两名独立评审员收集、评估和分析。对它们进行评估和综合，目的是为临床实践提供信息。
发现
评论中纳入了二十四篇文章。在 10 个医疗保险和医疗补助服务中心的可预防不良事件中，有 6 个得到解决：糖尿病管理 (n = 2)、吞咽困难 (n = 5)、感染控制 (n = 1)、压疮 (n = 6)、跌倒 (n = 5) 和出院管理 (n = 5)。有强有力的证据表明，在适当的情况下，应在住院和家庭健康环境中实施锻炼计划，以降低跌倒的风险。有中等强度的证据表明，从业者可以考虑实施一项全机构范围内的基于证据的压疮计划；针对吞咽困难提供多学科康复和吞咽强化练习；实施多学科、多组成部分的跌倒计划；并在家庭健康中使用手动抑郁症干预措施来减少再入院率。
结论和相关性
该审查强调了可预防的不良事件以及职业治疗从业者承认和管理这些事件以改善健康结果和控制医疗保健成本的重要性。本文补充内容：通常由职业治疗从业者执行的许多干预措施可解决可预防的不良事件。该审查强调了从业者意识到此类损伤或伤害的重要性。
IMPORTANCE
Practitioners need to be familiar with, and involved in, managing quality-related adverse events in postacute care.
OBJECTIVE
To determine interventions within the scope of occupational therapy that address preventable adverse events in adult postacute inpatient and home health settings.
DATA SOURCES
Articles published from January 1995 through 2019 identified through searches of MEDLINE, PsycINFO, CINAHL, OTseeker, and Cochrane databases. Study Selection and Data Collection: Articles were collected, evaluated, and analyzed by two independent reviewers. They were assessed and synthesized with a goal of informing clinical practice.
FINDINGS
Twenty-four articles were included in the review. Of the 10 Centers for Medicare & Medicaid Services preventable adverse events, 6 were addressed: diabetes management (n = 2), dysphagia (n = 5), infection control (n = 1), pressure ulcers (n = 6), falls (n = 5), and discharge management (n = 5). There was strong strength of evidence that exercise programs should, when appropriate, be implemented in both inpatient and home health settings to decrease the risk of falls. There was moderate strength of evidence that practitioners could consider implementing a facility wide evidence-based pressure ulcer program; providing multidisciplinary rehabilitation and swallow strengthening exercises for dysphagia; implementing a multidisciplinary, multicomponent falls program; and using a manualized depression intervention in home health to decrease hospital readmission.
CONCLUSIONS AND RELEVANCE
The review highlights the importance of preventable adverse events and of occupational therapy practitioners acknowledging and managing these events to enhance health outcomes and to control health care costs. What This Article Adds: Many interventions typically performed by occupational therapy practitioners address preventable adverse events. The review highlights the importance of practitioners being aware of this category of impairment or injury.