Does the clinical context affect the validity of bathroom recommendations made by home health aides?

Guay, Manon; Desrosiers, Johanne; Dubois, Marie‐France

doi:10.1016/j.ergon.2009.08.007

Cited by 6 publications

(11 citation statements)

References 44 publications

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“…A census conducted with Quebec homecare services in 2009 revealed that at least 52 different in-house “tools” were implemented by clinicians to meet the board requirements [9]. These local initiatives add confusion to how skill mix should be implemented in occupational therapy [9] and limit worker mobility [10]. Moreover, the unknown psychometric properties and evidence base of those in-house “tools” shed doubt on the quality of the services provided to elders [9].…”

Section: Introductionmentioning

confidence: 99%

Deimplementing Untested Practices in Homecare Services: A Preobservational-Postobservational Design

Guay

Ruest

Contandriopoulos

2019

Occupational Therapy International

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Introduction. With community-dwelling elders waiting to adapt their bathroom, Health and Social Services Centers in Quebec (Canada) combined human resources through cross-skilling within interdisciplinary teams. To this end, occupational therapists implemented in-house “tools” to support nonoccupational therapists in selecting bathing equipment. However, unknown psychometric properties of those in-house “tools” cast doubt on the quality of service provided to elders. Little is also known about the best processes to use to support the deimplementation of such nonevidence-based practices. This study presents the effect of a knowledge transfer and exchange intervention designed to deimplement in-house “tools” and replace them with an evidence-based tool (Algo). Methods. Censuses were conducted with the 94 Health and Social Services Centers of Quebec providing homecare services, before and after the knowledge transfer and exchange intervention (2009-2013). In 2013, the deimplementation of in-house “tools” and their replacement by Algo were measured with Knott and Wildavsky’s levels of utilization. Results. Cross-skilling within interdisciplinary teams increased between censuses (87% to 98%), as did use of in-house “tools” (67% to 81%). Algo’s uptake started during the knowledge transfer and exchange process as 25 Health and Social Services Centers achieved the first level of utilization. Nonetheless, no Health and Social Services Center deimplemented the in-house “tools” to use Algo. Conclusion. The knowledge transfer and exchange process led to the development of a scientifically sound clinical tool (Algo) and challenged the status quo in clinical settings regarding the use of nonevidence-based practices. However, the deimplementation of in-use practices has not yet been observed. This study highlights the need to act proactively on the deimplementation and implementation processes.

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Section: Introductionmentioning

confidence: 99%

Deimplementing Untested Practices in Homecare Services: A Preobservational-Postobservational Design

Guay

Ruest

Contandriopoulos

2019

Occupational Therapy International

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“…Initiatives about skill mix have fuelled long debates about the involvement of non-occupational therapists in the provision of occupational therapy services (Carrier et al 2010). Nevertheless, occupational therapy support personnel are now involved in the assessment process (Nancarrow and Mackey 2005, Guay et al 2010a, 2010b and, consequently, an emerging distinction between support personnel and occupational therapist clientele is based on the case type: straightforward versus complex. For example, Nancarrow and Mackey (2005) conducted an exploratory qualitative study with assistant practitioners (n = 5), supervising occupational therapists (n = 5), team managers (n = 4) and clients and caregivers (n = 3) on the introduction and the evaluation of occupational therapist assistant practitioners having an assessment role in the UK.…”

Section: Introductionmentioning

confidence: 99%

Identifying Characteristics of ‘Straightforward Cases’ for which Support Personnel Could Recommend Home Bathing Equipment

Guay

Dubois

Desrosiers

et al. 2012

British Journal of Occupational Therapy

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The general consensus is that an occupational therapist should carry out the assessment for recommending home bathing equipment. Nevertheless, in response to a shortage of human resources, home-care occupational therapists in Quebec, Canada, frequently transfer the clinical task of recommending bathing equipment to support personnel in 'straightforward cases'. However, there is no consensus on what constitutes such cases, and clinicians lack information on how to define a straightforward case. Objective: To characterise 'straightforward cases' when recommending bathing equipment in home-care occupational therapy. Design: The RAND/UCLA Appropriateness Method, combining a literature review with a three-round survey and one focus group meeting of nine occupational therapists. Results: Eight characteristics required for describing straightforward cases for bathing equipment recommendations were identified. They cover the three dimensions of the Canadian Model of Occupational Performance and Engagement: the occupation, the person, and the person's home environment. Conclusion: The literature review and collective opinion of experienced occupational therapists made it possible to agree on a common language to describe straightforward cases for bathing equipment. The characteristics identified will, it is hoped, support the critical thinking of clinicians deciding whether or not to transfer the task of recommending bathing equipment to support personnel.

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“…In the cases where 27 residents and staff were consulted, such as the case of the laundry presented above, the outcomes were much more satisfactory to all. Additionally, good examples can be found in the literature, for example consulting formal carers regarding AT for bathroom adaptations (Guay et al, 2010).…”

Section: Detailed Example 4 Communal Laundrymentioning

confidence: 99%

Is extra care housing in England care-neutral?

Mayagoitia

Boxstael

Wojgani

et al. 2015

Journal of Assistive Technologies

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Purpose. Extra care housing (ECH) is housing for older people that aims to provide flexible care while fostering independence. The aim of this paper is to examine the impact that some of the successes and failures in improving accessibility during remodelling had on care provision, in order to offer advice to social housing providers planning to remodel existing properties into ECH. Design and methods.The data consisted of an inventory of accessibility features and assistive technology (AT) items in flats and common areas. The data was drawn from 10 ECH schemes in different regions of England. Findings. Most of the assistive technology found was low-technology supporting independence, such as grabbers; some was specific to care provision, such as hoists. Even after remodelling, the design and layout of most buildings did not fully comply with accessibility standards, leading to increased provision of care for some tenants: a care-negative situation. Research and practical implications. This multidisciplinary, original research on remodelling into ECH presents successful examples of accessibility, assistive technology and care integration that required active tenant involvement and creative design input from care staff, architects and builders who were assistive technology and accessibility aware. It is argued that for new and remodelled ECH buildings to be care-neutral, designers need to work towards the most inclusive model of ECH.

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Does the clinical context affect the validity of bathroom recommendations made by home health aides?

Cited by 6 publications

References 44 publications

Deimplementing Untested Practices in Homecare Services: A Preobservational-Postobservational Design

Deimplementing Untested Practices in Homecare Services: A Preobservational-Postobservational Design

Identifying Characteristics of ‘Straightforward Cases’ for which Support Personnel Could Recommend Home Bathing Equipment

Is extra care housing in England care-neutral?

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