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This test could be used in acute care. This assessment offers a hospital version (MET_HV) that would be appropriate in the VA setting. This test was developed for use with a wider range of participants than the original version; it has more concrete rules, simplification of task demands and space provided on the instruction sheet for the patient to record the information they were to collect. There are 12 separate subtasks within four sets of simple tasks. These four task sets are as follows: 1. The patient must complete six specific errands (purchase 3 items, use the phone, collect and envelope from reception and send a letter to an external address), 2. The patient must obtain and write down four items of designated information (e.g. the opening time of a shop on Saturday), 3. The patient must meet the assessor outside of the hospital reception in 20 minutes after the test had begun and state the time, 4. The client must inform the assessor when he/she finishes the test. The test cannot be administered to patients confined to bed due to the nature of the questions. The test would be difficult to complete on patients instructed to only get up with help as they would have to have a nurse available at the time they need to meet some of the task requirements. Both validity and reliability have been established for this test for various populations (see citation for specifics).

This AJOT article is titled Intervention Planning Facets-Four Facets of Occupational Therapy Intervention Planning: Economics, Ethics, Professional Judgment, and Evidence-Based Practice. The article discusses four basic principles of occupational therapy and offers the perspectives of occupational therapists in applying these principles to everyday practice.

This article discussed how professional judgement, ethics, EBP, and economic constraints are interrelated in OT practice. Each need to be considered during intervention planning, however, some therapists may find this difficulty. A literature review found that overall there is a lack of evidence supporting OT practice and that it can be difficult to integrate research findings into treatment. One question mentioned was should clients be quantified and reduced to variables as each person is unique?. Practitioners need to remember that research provides guidance for interventions, rather than step by step how-tos. It is up to the OT to use their judgment and experience to incorporate it.

Atwal, A., & Caldwell, K. (2003). Ethics, occupational therapy and discharge planning: Four broken principles. Australian Occupational Therapy Journal, 50(4), 244-251. This article examines ethical dilemmas occupational therapists may face during discharge planning. Data was collected from ten occupational therapists to determine how well therapists are able to follow the ethical principles of autonomy, beneficence, non-maleficence, and justice. Researchers found that the therapists in this study unintentionally breached these four principles. The authors speculate that a push for speedy discharges leaves many therapists facing ethical dilemmas. The authors offer solutions for eliminating breaches of each of the four ethical principles listed above. They suggest that utilizing a multidisciplinary approach may offer a means of discussing ethical concerns so that practitioners are better able to provide ethical care.

This article explores four of our Ethicall principles, autonomy, beneficence, non-maleficence and justice. When included in the discharge process this article identified that OT practitioners are unintentionally breaching these principles in our code of ethics. The article goes on to clear up that OT's are having to scarifice their ethics to cooperate with a faster discharge date.

Ethics

This document provides a definition for supervision: viewed as a cooperative process in which two or more people participate in a joint effort to establish, maintain and or elevate the level of competence and performance. The authors add that supervision is based on a mutual understanding between the supervisor and supervisee about each other's competence, experience, education and credentials. For me, it was interesting that the authors indicated that supervision is supposed to promote growth, encourage creativity and innovation. Thus, if your relationship with your supervisor does not reflect this then you may want to meet and discuss this document.

This article discusses the general supervision guidelines for OTs and OTAs. It is broken down into four sections which cover general supervision, supervision of OTs and OTAs, roles and responsibilities, and supervision of OT aides. Supervision is defined at a joint effort to establish, maintain, or elevate competence and performance. The article urges OTs to seek mentorship as supervision to maintain competency and increase knowledge. Delegation of tasks to OTAs by OTs should be done with regard to the complexity of the client's needs/the intervention technique, the practice setting, and state/agency requirements.

OT's play a significant role in the discharge process and are often exposed to ethically challenging decision-making. This paper examines the moral basis of discharge planning, relating it to the four fundamental bio-ethical principles of respect for autonomy, beneficence, non-maleficence and justice. Using a case study design, data was collected from 10 occupational therapists and two elder care patients using the critical incident approach, as part of a wider study to determine their perceptions of discharge planning and multidisciplinary teamwork. Direct observation of interaction within multidisciplinary teams was also undertaken. This study suggests that occupational therapists are unintentionally breaching a set of principles laid out in the Code of Ethics and Professional Conduct. It is suggested that occupational therapists should further utilize multidisciplinary teams as a place where they can speak about their ethical concerns so that they are able to be effective client centered practitioners.

The findings of this article showed that those with CHF reported significant reductions in participation in all four domains. The main domain was activity retention (leisure, IADLs and social). Results for depression, cognition, and participation showed that those with CHF have functioning problems and depressive symptoms were present. However, there was no correlation between memory and attention performance. This study was limited to the sample size because it was less than 30. It also stated few participants did not complete the study because of fatigue and scheduling issues, but it never stated how many dropped out. This may affect population validity of the study because it is unknown if there was mortality. Also, the 27 subjects used were all from the same hospital (convenient sample) and this may also pose a threat to population validity. The results of the study suggest that management of CHF should expand in focus from physical functioning and physically demanding activities to consider cognitive and psychological functioning in the context of all life situations. Occupational therapy can play a vital role in helping those with CHF and their psychosocial impairments (decreasing depression), while getting them back into the community and functioning in their everyday tasks, which may also reduce symptoms of depression. I used this article because the facility I'm at now admits a lot of cardiac patients and many have depressive symptoms as they are recovering from their cardiac impairments and returning to their everyday lives in the community.

This is a resource produced by the Association of Occupational Therapists of Ireland. This information gives guidance for supervision of assistants and students. The resource is divided into five chapters with references and appendices also provided. Chapter one provides an introduction and rationale for the need of such as resource discussing supervision in occupational therapy. Chapter two gives definitions for what professional supervision is and is not in occupational therapy, as well as modes, functions and dual approaches in supervision. Chapter three discusses the components of supervision policy in occupational therapy. Chapter four gives an in-depth discussion of intervention strategies to enhance supervision. The final chapter provides a conclusion to the resource. References and Appendices follow with samples and discussion about a project process. This resource gives great information about supervision and allows the readers to gain a perspective of occupational therapy in Europe.

The objective of this study was to identify ethical dilemmas experienced by OTs and PTs working in the UK National Health Service. Little is known about clinical dilemmas OTs and PTS encounter. Without case material which reflects these realities it is difficult for professional organizations to produce ethical codes, for educators to prepare students for practice, and for clinicians to benefit from the experience of others. A four-page questionnaire was designed based on the results of the pilot study and distributed to OTs and PTs in the UK NHS. Emerging themes in OT found included: difficult or dangerous behavior in patients, unprofessional or incompetent staff, lack of respect for vulnerable patients, difficult/risky decisions about patient discharge.

This article looks at autonomy, beneficence, non-maleficence and justice in relation to the moral basis of discharge planning with patients. Researchers utilized a case study research design and direct observation. They concluded that often OT's are breaking these 4 principles and in turn our ethics and code of conduct. It suggests we determine how to fix these problems and implement ethics in the classroom more.

This PDF document highlights Kentucky Law regarding occupational therapists supervisory roles. As mentioned under section two, Kentucky Law states that an occupational therapy supervisor must provide at least four hours per month of general supervision for each occupational therapy assistant whom they supervise. Two of these general supervision hours must include face-to-face, direct contact with the occupational therapy assistant. In addition, the supervising occupational therapist must co-sign all documentation within fourteen calendar days of the notation. All supervision must be documented in a log that includes the date/frequency of supervision, type of supervision provided, observation, dialogue, discussion, and instruction provided, as well as the number of supervisory hours worked. The board can perform random audits examining occupational therapists supervision logs. It is important to note that in Kentucky a supervising occupational therapist may not supervise more than three occupational therapy assistants at one time. For those planning on working in Kentucky, this document is useful in outlining supervisory roles/responsibilities of occupational therapy practitioners in terms of supervision.

I feel that is an important document that all of us should look up, read, and study for our individual home states. In Kentucky, an OTR must provide at least 4 hours of supervision a month for each COTA. Within 14 days, an OTR must co-sign all documents. In addition, in Kentucky an OTR can only supervise 3 COTAs at one time.

This systematic review examined the evidence for interventions designed to modify the activity demands for self care and leisure for those with AD and other types of dementia. The review detailed four major points: treatment should match the person's current level of function, not attempt to make gains; cues, which are short and clear, are important in modifying activity demands; environmental modifications and simple AE should be individualized to meet the person's needs; caregiver training and involvement are vital.

This document contains four sections that direct the delivery of occupational therapy services. These sections are General Supervision, Supervision of Occupational Therapists and Occupational Therapy Assistants, Roles and Responsibilities of Occupational Therapists and Occupational Therapy Assistants during the delivery of Occupational Therapy services and supervision of occupational therapy aides.