The Role of Rehabilitation Specialists in Canadian NICUs: A 21st Century Perspective

Abstract

Rehabilitation specialists are an integral part of the team in the neonatal intensive care unit (NICU). New approaches to rehabilitation practice in the NICU have evolved over the past decade that aim to promote child health and development. Aims: The aim of this study was to describe the current roles of the occupational therapist (OT), physical therapist (PT) and speech-language pathologist (SLP) in Canadian NICUs as compared to the roles documented in an earlier national survey conducted 15 years ago. Methods: A telephone survey was conducted across Canadian NICUs and each telephone interview was recorded by a research assistant. In total, 42 questionnaires were completed across 25 health care institutions. Results: Eighty percent of the PT, 93.7% of OT and 50% of SLP provided direct services to neonates in the NICU. The results demonstrated that the therapists were involved with case discussion (85.7%), decision-making (97.6%), referrals to other services (97.6%) and discharge planning (97.6%). Splinting (87.5%) and feeding (100%) were most often carried out by OT, whereas chest physiotherapy (65%) and range of motion (100%) were predominantly provided by PT. Changes in the role of rehabilitation specialists over the last decade predominantly included enhanced collaboration with the NICU team, more frequent use of standardized outcome measures and use of interventions supported by evidence. Conclusion: In comparison with results of the previous survey of rehabilitation practices in Canadian NICUs, rehabilitation specialists now have more dedicated time in the NICU and more frequently use standardized measures and apply interventions that are supported by recent scientific studies.

Keywords:

• Neonatal intensive care unit
• occupational therapy
• physical therapy
• speech-language pathology
• rehabilitation services

Acknowledgements

We would like to thank all the health professionals and institutions that participated in the survey.

Disclosure statement

There is no conflict of interest to report.

Additional information

Funding

We also wish to thank Coordenação de Aperfeiçoamento de Pessoal e Nível Superior for funding this study under process number 99999.010624/2013-09.

Notes on contributors

Pamela Borges Nery

Pamela Nery PT, PhD was a doctoral exchange student from Department of Pediatrics, Ribeirao Preto Medical School University of Sao Paulo, Sao Paulo, Brazil; Centro Universitario Estacio de Ribeirao Preto, Ribeirao Preto, Brazil.

Laurie Snider

Laurie Snider is Director & Associate Dean, School of Physical & Occupational Therapy, McGill University.

José Simon Camelo

Jose Simon Camelo Junior is appointed to the Department of Pediatrics, Ribeirao Preto Medical School University of Sao Paulo, Sao Paulo, Brazil and the Centro Universitario Estacio de Ribeirao Preto, Ribeirão Preto, Brazil.

Zachary Boychuck

Zachary Boychuck is a PhD student in Rehabilitation Science, School of Physcial & Occupational Therapy, McGill University.

Fatima Khodary

Jessica Goldschleger and Fatima Khodary were graduate students in Rehabilitation Science, School of Physical & Occupational Therapy, McGill University at the time of this study.

Jessica Goldschleger

Jessica Goldschleger and Fatima Khodary were graduate students in Rehabilitation Science, School of Physical & Occupational Therapy, McGill University at the time of this study.

Annette Majnemer

Dr Annette Majnemer is Professor and Vice-Dean, Education, Faculty of Medicine, McGill University and Senior Investigator, Research Institute, McGill University Health Centre, Montreal, CANADA.