Chari, Satyan

English

ResearchOnline at James Cook University

http://ajot.aotapress.net/content/66/2/127.full/reply#ajot_el_829 (​http:​/​​/​ajot.aotapress.net​/​content​/​66​/​2​/​127.full​/​reply#ajot_el_829​)From the Desk of the Guest Editors: 	Elizabeth W. Peterson, 	Marcia Finlayson, 	Sharon J. Elliott, 	Jane A. Painter, 	and Lindy Clemson Unprecedented Opportunities in Fall Prevention for Occupational Therapy Practitioners Am J Occup Ther March 2012 66:127-130; doi:10.5014/ajot.2012.003814 	Full Text (​http:​/​​/​ajot.aotapress.net​/​content​/​66​/​2​/​127.full​) 	Full Text (PDF) (​http:​/​​/​ajot.aotapress.net​/​content​/​66​/​2​/​127.full.pdf+html​) OPEN ACCESS ARTICLE 1.	 (​http:​/​​/​ajot.aotapress.net​/​content​/​66​/​2​/​127.full​/​reply" \l "content-block#content-block​)The untapped potential of occupational therapy in hospital fall prevention programso	Satyan R Chari (​mailto:srcha5@student.monash.edu.au​), Program coordinator - fall prevention o	Alison Pighills Royal Brisbane and Women's Hospital & Monash UniversityDear Editor: The recent special issue on falls prevention in the American Journal of Occupational Therapy was a timely reminder that the profession is yet to fully engage with the field of fall prevention among seniors. We would like to highlight some challenges and opportunities for occupational therapists in the context of preventing falls among hospital patients. The literature is unequivocally positive about the importance of occupational therapists in multidisciplinary fall More... (​http:​/​​/​ajot.aotapress.net​/​content​/​66​/​2​/​127.full​/​reply​)Dear Editor: The recent special issue on falls prevention in the American Journal of Occupational Therapy was a timely reminder that the profession is yet to fully engage with the field of fall prevention among seniors. We would like to highlight some challenges and opportunities for occupational therapists in the context of preventing falls among hospital patients. The literature is unequivocally positive about the importance of occupational therapists in multidisciplinary fall prevention teams, and many, including the authors, have been actively involved in the development and implementation of fall prevention programs across settings over a number of years. However, the near absence of research pertaining to the effectiveness of occupational therapy interventions targeting falls among hospital patients (Oliver, Healey, & Haines, 2010) is a problem for the profession. Most hospital fall prevention guidelines are largely silent on occupational therapy interventions (Panel on Prevention of Falls in Older Persons AGS/BGS, 2011) outside of highlighting the role of occupational therapists in postdischarge assessment. Nevertheless, the inpatient setting offers many opportunities for occupational therapists in a fall prevention context, some of which we would like to highlight here. Falls in older patients rarely present as singular problems; rather, they present as part of a constellation of geriatric syndromes frequently sharing the risk factors of impaired mobility and functional and cognitive impairment (Inouye, Studenski, Tinetti, & Kuchel, 2007). There is a high degree of overlap in the causes and pathophysiology of various geriatric syndromes including falls, functional decline, pressure ulcers, and delirium; this overlap has ushered in the recent emergence of unified person-centered models aimed at reducing falls and other related conditions among older hospital patients using concurrent strategies (Leipzig et al., 2010). Needless to say, person-centered approaches and a restorative focus on function and cognition are core constructs within the models of practice used by occupational therapists (Radomski & Latham, 2008) and highlight the opportunity for our profession to lead initiatives of this nature. Encouragingly, integrated models are showing positive trends in managing the needs of complex older patients, including the reduction of major risk factors for falls (Inouye, Bogardus, Baker, Leo-Summers, & Cooney, 2000; Mudge, Giebel, & Cutler, 2008). The lack of occupational therapy intervention research on falls among hospital patients is not an insurmountable obstacle in itself, but there is a real risk of progressive "genericization" of our professional role in hospital fall prevention programs if this gap continues to go unaddressed. As the understanding of geriatric syndromes in hospital patients improves, it is likely that the role of occupational therapy will be seen as increasingly important in addressing the needs of this group. However, the extent to which the discipline flourishes in this area will be determined by how effectively we engage with these emerging models and by our ability to reinforce how the professional underpinnings of occupational therapy naturally complement moves towards the holistic care of older patients in hospital. Leland, Elliott, O'Malley, and Murphy (2012) and Peterson, Finlayson, Elliott, Painter, and Clemson (2012) provided an excellent overview of the fall prevention literature as it pertains to occupational therapy and identify important priorities for research and practice. Hospital environments are a known precipitator of falls (Tzeng & Yin, 2008), so occupational therapy interventions targeting environmental risk factors for falls may be worth considering in the hospital setting. On the basis of the points raised here, however, we suggest that occupational therapy researchers also consider extending lines of inquiry into the holistic care needs of older hospital patients. Doing so would offer an opportunity to develop and evaluate interventions that further build upon areas of traditional strength for occupational therapists and position the profession more centrally in this critical area. ReferencesInouye, S. K., Bogardus, S. T., Jr., Baker, D. I., Leo-Summers, L., & Cooney, L. M., Jr. (2000). The Hospital Elder Life Program: A model of care to prevent cognitive and functional decline in older hospitalized patients. Journal of the American Geriatrics Society, 48, 1697. Inouye, S. K., Studenski, S., Tinetti, M. E., & Kuchel, G. A. (2007). Geriatric syndromes: Clinical, research, and policy implications of a core geriatric concept. Journal of the American Geriatrics Society, 55, 780-791. http://dx.doi.org/10.1111/j.1532-5415.2007.01156.x Leipzig, R. M., Whitlock, E. P., Wolff, T. A., Barton, M. B., Michael, Y. L., Harris, R., et al. (2010). Reconsidering the approach to prevention recommendations for older adults. Annals of Internal Medicine, 153, 809-814. Leland, N. E., Elliott S. J., O'Malley, L., & Murphy, S. L. (2012). Occupational therapy in fall prevention: Current evidence and future directions. American Journal of Occupational Therapy, 66, 149-160. http://dx.doi.org/10.5014/ajot.2012.002733 Mudge, A. M., Giebel, A. J., & Cutler, A. J. (2008). Exercising body and mind: An integrated approach to functional independence in hospitalized older people. Journal of the American Geriatrics Society, 56, 630-5. http://dx.doi.org/10.1111/j.1532-5415.2007.01607.x Oliver, D., Healey, F., & Haines, T. P. (2010). Preventing falls and fall-related injuries in hospitals. Clinics in Geriatric Medicine, 26, 645-692. http://dx.doi.org/10.1016/j.cger.2010.06.005 Panel on Prevention of Falls in Older Persons AGS/BGS. (2011). Summary of the updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. Journal of the American Geriatrics Society, 59,148-157. http://dx.doi.org/10.1111/j.1532-5415.2010.03234.x Peterson, E. W., Finlayson, M., Elliott, S. J., Painter, J. A., & Clemson, L. (2012). Unprecedented opportunities in fall prevention for occupational therapy practitioners. American Journal of Occupational Therapy, 66, 127-130. http://dx.doi.org/10.5014/ajot.2012.003814 Radomski, M. V., & Latham, C. A. T. (Eds.). (2008). Occupational therapy for physical dysfunction. Baltimore: Lippincott Williams & Wilkins. Tzeng, H.-M., & Yin, C.-Y. (2008). The extrinsic risk factors for inpatient falls in hospital patient rooms. Journal of Nursing Care Quality, 23, 233-241. Conflict of Interest:None declared 

The untapped potential of Occupational Therapy in hospital fall prevention programs. Letter to the editor

https://researchonline.jcu.edu.au/60347/1/2012%20PUBLISHED%20-%20EAM%20letter%20AJOT%2005.06.12.doc

The untapped potential of Occupational Therapy in hospital fall prevention programs. Letter to the editor

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