The Association of Occupational Therapists of Ireland Occupational Therapy Standards of Practice Statements 2008 Submitted to the AOTI Council by: Aine Clyne, AOTI Project Manager, Therapy Project Office Date: February 2008
Table of Contents Table of Contents...2 Acknowledgements...3 Introduction...4 Purpose...4 Outline of Statement Headings...5 1. Professional Responsibility...6 2. Consent...6 3. Referral...7 4. Assessment & Planning...7 5. Intervention and Evaluation...8 6. Discharge...8 7. Documentation...9 8. Service Quality...9 9. Continuing Professional Development...10 10. Research...10 11. Practice Education...10 References...11 Glossary of Terms...13 Appendix 1...14 The AOTI Definition of Occupational Therapy...14 Appendix 2...15 Irish Requirements for a Professional Qualification in Occupational Therapy...15 2
Acknowledgements Thanks are due to the time and effort of the members of the standards of practice working group: Aine O Reilly, Anine Willemse, Carol Hills, Cassie Hammond, Christine Linscott, Deirdre McKenna and Mary Coveney. The project was managed by Aine Clyne, AOTI Project Manager, Therapy Project Office. We wish to acknowledge the support received from the College of Occupational Therapists (UK) in giving the working group permission to adapt the format of the College of Occupational Therapists document: Professional Standards for Occupational Therapy Practice 2007 in the development of the AOTI Standards of Practice Statements. We also wish to thank Vanessa Hamilton, Project Manager for Irish Society of Chartered Physiotherapists for her practice assistance and Carmel D Arcy, Quality Assurance Manager for Eve Limited for her advice during the process. 3
Introduction The Association of Occupational Therapists of Ireland (AOTI) is the recognised professional body for Occupational Therapists (OTs) in Ireland. These Standards of Practice Statements have been developed in conjunction with the AOTI Code of Ethics and Professional Conduct for Occupational Therapists (2007). Together, these documents aim to inform Occupational Therapists, people who use Occupational Therapy services and employers as to what can be expected of an Occupational Therapist working in Ireland. The standards are generic and are applicable to a broad range of work areas, age groups and service settings. They will be reviewed and developed further in the future as part of the AOTI s commitment to ensuring that the highest possible standards are promoted by and for the profession. A definition of Occupational Therapy is included in Appendix 1. An outline of the professional qualification requirements for Occupational Therapists working in Ireland is included in Appendix 2. Purpose The purpose of the Standards of Practice Statements document is to: outline a minimum standard of practice for occupational therapists in Ireland; guide members of AOTI in the development and practice of their profession; promote consistency in the delivery of Occupational Therapy services. 4
Outline of Statement Headings The Occupational Therapy Standards of Practice Statements are presented under the following headings: Professional Responsibility Consent Referral Assessment & Planning Intervention & Evaluation Discharge Documentation Service Quality Continuing Professional Development Research Practice Education 5
1. Professional Responsibility 1.1. follow the Code of Ethics and Professional Conduct of the Association of Occupational Therapists in Ireland (AOTI); 1.2. deliver services which reflect the principles, theory and client centred approach of the occupational therapy profession; 1.3. apply and deliver Occupational Therapy services in accordance with national and local workplace standards/guidelines, policies and procedures; 1.4. keep up to date with legislation, health and social policy that affect the service user and the practice of Occupational Therapy; 1.5. demonstrate an awareness and sensitivity to social, cultural and diversity issues that affect the service user and the practice of Occupational Therapy; 1.6. have a duty of care to adhere to all local health and safety policies and procedures; 1.7. have clear and transparent complaint procedures for service users, in keeping with local policies. 1.8. take appropriate action if their physical and/or mental health is impairing or limiting safe and effective practice. 2. Consent 2.1. obtain consent from the service user or person(s) advocating on his/her behalf, in keeping with local policies before initiating the Occupational Therapy process; 2.2. ensure that the service user or advocate receives all relevant information to inform his/her consent; 2.3. accept the service user s decision to refuse or withdraw consent at any time. 6
3. Referral 3.1. have a clearly documented system for referral to Occupational Therapy services in keeping with local policy; 3.2. provide accessible information to others on how to access occupational therapy services; 3.3. prioritise referrals in accordance with local policies and procedures; 3.4. refer or recommend referral of service user to other appropriate services based on identified need. 4. Assessment & Planning 4.1. carry out a comprehensive assessment of need (following referral) in collaboration with the service user and/or with an advocate acting on his/her behalf; 4.2. assess the person s skills and abilities to perform occupations within his/her environmental context; 4.3. use standardised or non standardised assessment tools based on clinical reasoning and in keeping with the service user s identified needs; 4.4. ensure that they are adequately trained to select, administer and interpret the results of the appropriate assessment(s); 4.5. analyse and interpret the outcomes of assessment(s) in order to identify the service user s needs and to inform the intervention plan; 4.6. prioritise therapeutic goals in collaboration with the service user based on his/her identified needs and preferences; 4.7. document and communicate assessment outcomes and intervention plan to all relevant persons. 7
5. Intervention and Evaluation 5.1. focus therapeutic interventions on enabling the restoration, maintenance and promotion of meaningful occupation; 5.2. implement the intervention plan using activities or therapeutic methods that are meaningful to the service user and which aim to achieve the highest possible functional level of independence; 5.3. provide written information and instruction to enable intervention to be implemented safely and effectively when delegating interventions based on the Occupational Therapy assessment to other Occupational Therapy staff or persons in a care role; 5.4. Collaborate as appropriate with other professional services in the implementation of the intervention plan; 5.5. adapt and grade interventions to enable optimal occupational performance; 5.6. evaluate interventions within agreed timeframes in collaboration with the service user and either discontinue intervention or set new goals to best meet the service user s needs; 6. Discharge 6.1. cease intervention when the service user has achieved optimum benefits from occupational therapy; 6.2. prepare the service user for discharge or transfer to alternate services taking their skills and abilities into consideration within the context of their current or future environment; 6.3. discharge a service user from Occupational therapy if they withdraw their consent to intervention; 6.4. provide written communications of discharge to the service user and/or advocate acting on his/her behalf. 8
7. Documentation 7.1. maintain comprehensive, contemporaneous and accurate records of all professional activities in relation to practice, in keeping with recognised policy; 7.2. keep records of practice in such a manner that it is possible to audit and evaluate the service they provide; 7.3. ensure that all records are dated, signed and maintained; 7.4. countersign documents where Occupational Therapy intervention is carried out by an unqualified person who is being supervised by an Occupational Therapist; 7.5. follow the legal requirements in relation to confidentiality, storage, disposal of records and the service user s right to freedom of information. 8. Service Quality 8.1. provide services that are safe, cost effective and of the highest quality based on available resources; 8.2. evaluate the efficiency and effectiveness of the occupational therapy service and seek opportunities to improve the quality of existing services for service users; 8.3. make decisions based on knowledge, clinical reasoning and available research evidence; 8.4. be responsible for the service user safety while engaging in Occupational Therapy; 8.5. take measures to ensure that the risks of working alone are minimised and comply with all of their employer s requirements. 9
9. Continuing Professional Development 9.1. Develop and maintain clinical competence, professional skills and knowledge through formal and informal continuing education; 9.2. engage in and provide supervision for staff to support their practice and professional development; 9.3. develop a professional development plan and review on a regular basis. 9.4. maintain a record of their professional development; 10. Research 10.1. facilitate and/or participate in research as it applies to the practice of Occupational Therapy; 10.2. follow local, national, and professional policies and ethical guidelines when engaging in research; 10.3. seek opportunities to gain knowledge of new research advances and introduce them to practice as appropriate. 11. Practice Education 11.1. demonstrate a commitment to the provision and facilitation of practice education for students; 11.2. collaborate with the educational bodies to ensure that they have adequate knowledge, skills and support to facilitate students to achieve learning outcomes that prepares them for competent practice; 11.3. collaborate with the Educational Bodies to evaluate and promote quality practice education for students. 10
References American Occupational Therapy Association (AOTA) (2005), Standards of Practice. Association of Occupational Therapists of Ireland (AOTI) (2007), Code of Ethics and Professional Conduct for Occupational Therapists. AOTI, Dublin. Association of Occupational Therapists of Ireland (AOTI). Standards of Practice and Code of Ethics (publication date unknown). AOTI, Dublin. Australian Association of Occupational Therapy (1994), Australian Competency Statements for EntryLlevel Occupational Therapists. OT Australia, Victoria, Au. Blesedell Crepeau E, Cohn E.S, Boyt Schell B.A, (2003) Willard & Spackman s Occupational Therapy, 10 th Edition. Lippincott Williams & Wilkins, USA. British Dietetic Association (BDA) (1993), Setting and Monitoring Standards in the Workplace. Briefing Paper Number 7. Professional Development Committee, BDA. UK. College of Occupational Therapists, UK (2007), Professional Standards for Occupational Therapy Practice, Standard Statements. College of Occupational Therapists Ltd. London. Canadian Association of Occupational Therapists, (2002) Enabling Occupation: an Occupational Therapy Perspective. CAOT Publications, ACE. Ottowa, Ontario. Creek, Jennifer (2003). Occupational Therapy Defined as a Complex Intervention. College of Occupational Therapy Ltd. London. Department of Occupational Therapy (2006) Practice Educators Handbook. National University of Ireland, Galway. 11
European Region of World Confederation for Physical Therapy (2002), European Core Standards of Physiotherapy Practice. European Region of WCPT, Brussels. HSE Dublin Mid-Leinster Area Laois/Offaly & Longford/WestMeath Occupational Therapy Department, Standing Operating Procedures (internal document). HSE, Ireland. New Zealand Association of Occupational Therapists (2007), Occupational Therapy Process Standards. NZAOT, Wellington. St Loman s Community Mental Health Services, (2007). Standards of Practice (internal document). HSE, Ireland. Therapy Project Office (2007), Entry Level Competencies for Occupational Therapists. Professional Competencies Framework Project (unpublished). Therapy Project Office, Dublin. Therapy Project Office (2007), Departmental and Individual CPD Planning Tool. (unpublished). Therapy Project Office, Dublin. World Federation of Occupational Therapists (2006). Position Statement on Human Rights. World Federation of Occupational Therapists. Western Australia. 12
Glossary of Terms Client Centred Approach An approach to intervention that demonstrates respect for and partnership with the individual or group receiving the service (Blesedell Crepeau et al, 2003:1027.). Continuing Professional Development Continuing professional development (CPD) is the ongoing process of developing and updating the knowledge and skills necessary to ensure competent professional practice. (Therapy Project Office, 2007:404.) Occupation In occupational therapy, occupations refer to the everyday activities that people do as individuals, in families and with communities to occupy time and bring meaning and purpose to life. Occupations include things people need to do, want to and are expected to do (WFOT 2006) Occupational Performance Occupational performance is the ability to choose, organise and satisfactorily perform meaningful occupations that are culturally defined and age appropriate for looking after oneself, enjoying life and contributing to the social and economic fabric of a community (CAOT, 1997:30 Practice Education Practice education allows students to observe and practice in a variety of settings and to experience the future work environment. During practice education, the student develops, demonstrates and achieves competence to practice and links theory to practice supporting the academic programme (OT Dept. NUIG, 2006:7). Previously, the terms fieldwork or clinical education have been used Service User The service user is the person using the Occupational Therapy service and on who s assessed needs the service is based. Standard of Practice The agreed working definition used to inform this document was: a standard of practice is a statement of minimum practice that is achievable, realistic, measurable and reviewed regularly. 13
Appendix 1 The AOTI Definition of Occupational Therapy Occupational Therapy enables people to engage in the daily activities and occupations which are relevant to their lives. Occupational therapists use their skills to assess and identify an individual s abilities and areas of difficulty in occupational performance which are impacting on independent functioning. Purposeful activities and occupation are used as the treatment media to develop individual skills thus enabling optimal functioning. As occupational engagement can be supported or restricted by the environment, intervention may also involve making adaptations or changes to a person s environment to enhance occupational participation. Occupational therapists work with individuals, families, carers and communities to provide a holistic service that helps people to lead satisfying and meaningful lives. (AOTI 2007) 14
Appendix 2 Irish Requirements for a Professional Qualification in Occupational Therapy In order to qualify as an Occupational Therapist in Ireland, the person must have successfully complete one of the following educational routes: (A) B.Sc (Honours) degree programme in Occupational Therapy obtained from: o National University of Ireland, Galway, o University College Cork o University of Dublin, Trinity College (B) M.Sc (Honours) programme in Occupational Therapy from the University of Limerick. (C) Diploma in Occupational Therapy (Dip. COT) accredited by College of Occupational Therapy (UK). All of the Occupational Therapy courses in the Republic of Ireland are accredited by the AOTI on behalf of the World Federation of Occupational Therapy (WFOT). If the person has gained a professional qualification in Occupational Therapy outside of the Republic of Ireland, they must possess a recognised qualification at lease equivalent to (A), (B) or (C) as outlined above in order to practice as an Occupational Therapist. The qualification must be recognised and accredited by the WFOT. In addition, under EU regulations, qualifications obtained outside the Republic of Ireland must be validated by the Association of Occupational Therapists in Ireland on behalf of the Department of Health and Children. 15