Background: Best practice supports early, high intensity upper limb (UL) therapy for patients following a stroke or neurological event. To date, the use and effectiveness of these groups has not been explored in acute settings. The acute stroke and neurology ward at The Royal Melbourne Hospital (RMH) has a dedicated allied health therapy area. Group UL therapy has been implemented into usual practice, however success of implementation and the clinical outcomes had not been evaluated.
Aims: This study aims to evaluate the feasibility of implementing a group-based UL intervention group in an acute model of care.
Methods: A mixed methods implementation research design was used to evaluate a once weekly group-based UL therapy led by occupational therapy on a stroke/neurology ward at a major hospital. During a seven-month intervention period, patient and staff feedback was gathered via paper and electronic surveys and thematically analysed. Purposively sampling occurred and data saturation reached. A retrospective audit was completed of electronic medical records to collect clinical and service data and quantitatively analysed.
Results: Patients who participated in the UL group (n=26), allied health (n=10) and nursing (n=14) staff on the ward were recruited to the study. On average, 79% of patients referred attended the group. Patients received an additional 89 minutes UL therapy time with average group attendance over an inpatient stay of 1.48 times. Survey data revealed that both staff and patient viewed the upper limb group as satisfactory and suitable within an acute model of care.
Conclusion: Group upper limb therapy is feasible within an acute setting, allowing for greater therapy provision and efficient use of resources. Further evaluation is needed of impact on patients UL outcomes to determine the optimal intervention dosage.