Exploring the impact of occupational therapy provision in the intensive care unit: A UK single-centre service evaluation

Abstract

Background: Occupational Therapy (OT) in the Intensive Care Unit (ICU) supports recovery in physical, cognitive, emotional domains, and activities of daily living (ADL), yet. Provision across the UK remains inconsistent, with variable staffing and role integration and no data illustrating the potential impact from such roles. Method: A retrospective service evaluation was undertaken in a UK NHS adult ICU to examine the association of increased OT staffing with changes in rehabilitation activity and functional status. Patients with ICU stays over 7 days were included in line with NICE CG83 high rehabilitation risk criteria. Three 1-month timepoints were compared. Data included delivery of OT interventions, functional outcomes (Modified Barthel Index), and discharge destination. Results: Ninety-nine patients were included. Increased OT staffing was associated with a greater proportion of patients receiving OT assessments, upper limb rehabilitation, personal activities of daily living retraining, cognitive screening, delirium management, and therapy handover. Modified Barthel index scores at hospital discharge increased across timepoints 1, 2 and 3 (55, 71.5 and 82, respectively (p = 0.02)). Discharge destination patterns varied and could not be attributed solely to staffing changes. Discussion: Increased OT staffing was associated with greater delivery of rehabilitation interventions and potential improvements in functional outcomes. However, differences in patient clinical complexity across timepoints may also have influenced these results. Further evaluation is required to establish causal relationships.