Exploring newly qualified occupational therapist's experiences of implementing person-centred, non standardised functional assessments in acute hospital settings with older adults who have fallen

Abstract

Background: Adults aged 65 and older have an increased risk of falling with 37.3 million falls requiring hospitalisation annually (WHO 2021). Newly qualified occupational therapists are frequently employed in these acute hospital settings, where discharge planning, specifically the delivery of client-centred, non-standardised functional assessments of older adults is a key part of this role (Cusick et al. 2004; Liu 2018). Furthermore, the current policy outlines that a multifactorial assessment is best practice for older adults who have fallen, which is echoed by the American Occupational Therapy Association AOTA (2021) (NICE 2013). In spite of this, acute settings are renowned for their fast pace and quick patient turnovers, which present challenges occupational therapy practice. This raises queries about their ability to deliver client-centred assessments with older adults who have fallen and whether this delivery aligns with current policy.

Literature Review Findings: Emerging from the literature review were three interrelated themes of the challenges of the acute setting, challenges of reduced clinical reasoning, and challenges for professional identity. These themes were all underpinned by client centredness and produced subthemes. The review findings propose that contextual factors within the acute setting challenge newly qualified occupational therapist's delivery of client centred assessments for older adults who have fallen. At this stage to incorporate a more contemporary approach to the research proposal the researcher transitioned from client centredness to person-centredness.

Research Proposal: An interpretive phenomenological study was proposed to explore the contextual factors impacting newly qualified occupational therapist’s experiences of person centred, non-standardised assessments in acute hospital settings with older adults who have fallen. The research aims to ascertain the lived experiences of three newly qualified occupational therapists through semi-structured interviews (Creswell 2014). The data will be recorded using an electronic recording device and subsequently transcribed several times. The assignment of patterns or assigning meaning to the research will be aided by the use of NVivo software. Participants will then engage in a follow-up interview to ensure the data 10 has been accurately interpreted to reflect the true meaning participants assigned to the data.

Conclusion: The current findings indicate that these contextual factors can have a significant impact on newly qualified occupational therapist’s ability to provide person-centred, functional assessments with older adults who have fallen, and do not articulate whether this practice aligns with NICE (2013) or the Scottish Government (2019) policy on falls and falls prevention.