Mrs Helen Titmuss1, Mrs Rebecca Cannell1
1THS-North Occupational Therapy, Launceston, Australia
Neglect is a common perceptual disorder post-stroke, where spatial and/or sensory inattention significantly disrupts independence and occupational performance. Clients experiencing neglect have poorer functional outcomes, increased length of stay, and require more assistance upon discharge to return to community living. A staff survey identified neglect as an area of low confidence and best practice knowledge for Occupational Therapists and Physiotherapists, and wide variations in practice were noted.
A review of best practice measures for assessment and evidence-based interventions for neglect was completed by the Clinical Lead of Occupational Therapy at Launceston General Hospital (LGH) and an interdisciplinary working group in 2015. This enabled increased understanding of the evidence, and knowledge translation gaps within the Occupational and Physiotherapy departments.
An education package was developed, with in-house training for clinicians, with the aim of consistent local terminology and classification, screening, outcome measurement and a selection of interventions for improving practice for this population. Guidelines to support these processes were developed. The primary outcome measure now used across THS-North for neglect, The Catherine Bergego Scale (CBS), has been positively received by therapists, and found to be feasible for use in our setting.
A database was created and maintained for 12 months to collect incidence rates, severity levels and gains made between changes in episodes of care. We will report local incidence and sub-types of neglect in comparison to the literature, and examine impairment and activity restrictions, outcomes, and length of stay data for neglect patients in THS-North. We will also report on our learning’s for knowledge translation activities, including ongoing education for clinicians, to sustain best practice.
Helen Titmuss is a Clinical Lead Occupational Therapist at THS-North, with an interest in best practice for cognitive and perceptual neurological rehabilitation.
Rebecca Cannell is Senior Occupational Therapist on The Launceston General Hospital Stroke Unit, and has extensive experience across rehabilitation services.