I get asked all the time about how to perform a quick and easy occupational therapy screening to help decide if a referral is necessary for skilled occupational therapy services, specifically in skilled nursing facilities.
Don’t you worry – I gotcha!
Because this is such a popular topic, I wanted to share one of the Micro Learning Videos from the OT Flourish Membership titled “How to Perform an Occupational Therapy Screening,” as this is one of the questions that members had and all treatment ideas, resources, handouts, etc are created directly from member requests!
What is an Occupational Therapy Screening?
An OT “screen” is a “hands-off” look to identify a patient’s needs and possible rehab potential with the determination to see if they would benefit from skilled OT services.
You may be requested to do a screen because it is a “quarterly” screen (in a nursing home setting) or referral for screen from staff/other disciplines/MD to see if a prescription would be appropriate.
They can take a lot of time while you are learning, but trying to be efficient is key. Mine typically take no more than 15 minutes. You are not evaluating them, but seeing if they would benefit from SKILLED OT service.
Occupational Therapy Screenings Include a Short Chart Review and Specifically Look at:
- level of function at admission
- current pain scales
- functional level charting (and if it has changed recently)
- talking to the staff and/or referral source (CNAs have SO much knowledge about the patients/residents functional ability and difficulties)
- ask the patient directly what they are having trouble with and if they have noticed any changes in:
- function
- more staff assistance
- pain
- skin integrity
- mobility
Most common things to pick a patient up for skilled OT service through a screen include:
- pain
- falls
- w/c positioning
- splinting/ROM changes
- w/c management
- do they need a power mobility?
- are they able to perform functional mobility independently?
- ADL
- weight loss: feeding/eating difficulty
- cognitive changes affecting occupational performance
- wounds/skin
- it’s impact on transfers, use of equipment, positioning, etc
- do they need a restorative nursing program established (in nursing home setting) or does the program need to be modified to pt’s current needs?
In the Nursing Home Setting:
- If you think it is appropriate to “pick them up,” you must make sure that there is nursing/CNA documentation that they have had a decline in the area that you are seeing
- Many facilities require “3 days” of documentation, with your screen to actually pick them up and do an evaluation, even though the CMS regulations on this is not clear.
I have developed an OT Screen Form that is a printable in the OT Flourish Membership to make the entire process a little easier!
What do you include in your occupational therapy screening checklist?
