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POSITION: Occupational Therapist
DEPARTMENT: Walking Stick Rehabilitation
RESPONSIBLE TO: Director, Rehabilitation Services

Scope of Practice

Reporting to the Director of Clinical Services, the Occupational Therapist is responsible for encouraging growth through the provision of programs and services to residents according to established standards and administrative policies. This will involve promotion of health and optimal occupational performance; prevention of disability; assessing resident’s needs, and planning, implementing, evaluating and documenting a plan of care. Occupational Therapists work as part of a multi-disciplinary team. As an employee of the RK Mac Donald Nursing Home every person has a responsibility to be involved in providing a stimulating environment for the residents. In keeping with the philosophy of RK MacDonald Nursing Home and the established policies and procedures of RK MacDonald Nursing Home, all services provided are in accordance with residents’ personal choice and preferences with the aim of achieving excellence in the care and well-being. In keeping with our Mission, Vision and Core Values and our philosophy of Resident Centered Care, the Occupational Therapist, as a partner in the provision of care and support of our Residents, represents the home in a positive, professional, efficient and confidential manner.

Key Responsibilities

Professional Accountability

1. Carries out assessment, plan implementation, plan evaluation and education in accordance with RK policies and procedures, the Occupational Therapy Code of Ethics, the National Occupational Therapy competency requirements, and the Occupational Therapy Act of Nova Scotia.
2. Conducts self within legal/ethical/professional obligations and requirements.
3. Performs beyond entry level competencies and within medical directives and delegated medical functions as approved for the practice setting as per the the National Occupational Therapy competency requirements, and the Occupational Therapy Act of Nova Scotia.
4. Works as a champion of person-centered care.
5. Respects the individuality, autonomy and confidentiality of the resident and ensures the resident is treated respectfully and uses a resident-centered approach involving shared decision making and responsibility with the resident and Substitute Decision Maker.
6. Demonstrates professional integrity and a commitment to the well-being of all residents.
7. Engages in professional development and lifelong learning activities.
8. Orientation of new employees and mentoring / preceptors new and existing employees as appropriate.
9. Acts as a mentor / preceptor for student clinical internships.

Communication and Collaboration

1. Establishes and maintains effective communication with residents, relevant others and professional colleagues.
2. Maintains an accurate account of care given through clear, concise, written and verbal communication and evaluates, communicates and documents resident response to care in a timely manner.
3. Develops and maintains information systems to ensure appropriate access to accurate, objective, relevant information about the resident and general occupational therapy services.
4. Collaborates, partners, and communicates with the individual, family, and external service providers when there is a difference between the care plan and the wants, needs and abilities of the resident.
5. Demonstrates effective collaboration and inter-professional teamwork by consulting and sharing information with other health professionals, family and community organizations in a timely manner, provided resident consent is obtained where required, to ensure comprehensive, safe service delivery.
6. Facilitate admission planning and transitions across the health care continuum, ensuring the resident’s needs are met in appropriate setting.
7. Participation in staff meetings or working group meetings.
8. Participation in and /or leadership of program planning, research, continuous quality improvement initiatives, committees, staff education, safety initiatives, and accreditation as requested.
9. Demonstrates effective verbal and non-verbal communication abilities to prevent adverse events.
10. Communicates effectively in special high-risk situations to ensure the safety of residents.

Assessment / Treatment / Education

1. Participates in screening and prioritizing referrals to Occupational Therapy to determine the individual’s need for Occupational Therapy Services as required. Identifies the resident, based on each unique situation, and identifies the resident’s support system (e.g., family, significant others, caregivers, community, etc.).
2. Consults with the resident on options for service; explains and obtains resident consent. Services at the RK include:

• • Seating prescription – assessment and maintenance
  • Assessment and provision of Individual Specialized Equipment
  • Administration of the Red Cross Specialized Equipment
  • Dysphagia Assessment
  • Pressure Management – Wound care
  • Activities of Daily Living Assessment
  • Administration of wheelchair safety audits and maintenance
  • Administration of specialized mattress program
  • Assessment and provision of slings for ceiling / hoyer lifts
  • Transfer Code and Mobility Assessments
  • Mental Health and Behavioural Assessments
  • Provide clinical education to occupational therapy student interns
  • Provides annual Safe Lifting and Transferring In-services for staff

3. Selects an appropriate theoretical approach to address the resident’s occupational performance issues.
4. Advocates with resident to establish positive first contact, consults on options for service; educates and collaborates to establish/remind resident of previous signing and document consent.
5. Engages with resident to build rapport and the relationship, clarify values, organize a schedule and places to meet for assessment.
6. Collaborates with resident to identify priorities for assessment and possible expected outcomes.
7. Collaborates with members of the healthcare team and resident to collect, validate and expand assessment data i.e. Falls Committee
8. Documents and communicates pertinent information in a timely and concise manner.
9. Monitors, through assessment data, the ongoing status of the resident.
10. Recognizes changes in occupational performance and engagement, functional abilities, and health care needs and adjusts the care plan accordingly.

Planning

1. Engages the resident in the goal setting process to identify the resident’s priorities.
2. Engages in critical thinking, analyzes and interprets assessment data for the resident, his/her support system and the health care team to identify the resident’s occupational performance issues, strengths and weaknesses.
3. Re-evaluates and adjusts theoretical approach (es) as necessary to fit with the resident’s Occupational Performance Issues (OPIs).
4. Through collaboration with the resident, develops the plan of care based on the analysis of assessment findings, chosen theoretical approaches, clinical best practices, and the resident’s vision for his/her life opportunities.
5. Initiates planning and establishes short- and long-term goals, expected outcomes, a plan of care, and a discharge plan.
6. Applies knowledge of pertinent Occupational Therapy and related healthcare research and evidence to care planning; uses current knowledge to justify plan of care.
7. Integrates interdisciplinary and multiagency factors into the care plan.
8. Negotiates and communicates with the resident, his/her support system, the health care team, and service providers when there is a difference between the care plan and the wants, needs and strengths of the resident.

Implementation

1. Engages the resident in treatment (either individual or group) by providing interventions with an aim to maximize occupational functioning and minimize barriers that impede occupational engagement. Implementation of the plan involves promotion of safety, choice, and risk engagement.
2. Interventions may occur in resident’s usual environment and may include one or more of the following: remediation, adaptation, compensation, prevention, health promotion, or education. Interventions typically target the person, occupation, and environment collectively as these elements are inter-related.
3. Teach and coach residents and families in a flexible and creative manner using accurate and consistent information, which may include the development of educational materials.
4. Plans for timely completion of occupational therapy intervention and follow-up, as required, to meet resident’s needs.
5. Delegates appropriate tasks / activities to a Rehabilitation Assistant, rehabilitation aide, or other members of the health care team.
6. Co-supervises Rehabilitation Assistants, and Rehabilitation Aides.

Evaluation

1. Evaluates, communicates, and documents expected and unexpected responses to care, to the resident, his/her support system, and the health care team. Evaluates and monitors broad outcomes including healthy living, and reducing hospitalization.
2. In collaboration with the resident, his/her support system and the health care team monitors resident’s response to interventions and modifies/grades treatments and care plans, as indicated.
3. Discusses observations with and makes recommendations to interdisciplinary team and leaders to influence program development/evaluation.
4. Maintains an accurate account of care given through clear, concise, written and verbal communication and evaluates, communicates and documents resident response to care.
5. Continuously engages in critical thinking, and evaluates plan of care and makes revisions to plan as necessary in consultation and collaboration with other members of the health care team, resident, his/her support system.
6. Consults, collaborates, advocates, educates and engages the resident to optimize services.
7. Protects resident and family confidentiality, privacy and creates an overall environment that is safe and secure.
8. Terminates Occupational Therapy Services in agreement with clinical best practices, and/or when maximal therapeutic outcomes / functional gains are achieved.

Other Related Duties

Other duties as assigned by the Director of Clinical Services.
Safe Work Practices / Responsibilities

The R.K MacDonald Occupational Health and Safety Home Policy establishes employee expectations for working safely. To achieve these expectations employees at all levels of the organization must adhere to Core Values of Safety and Safety Responsibilities listed below:

• Commit to working safely.
• Adhere to Safety Rules.
• Conduct Inspections.
• Conduct JTA`S & Develop SWPs.
• Adhere to SOPs & SWPs.
• Report Incidents / Hazards.
• Wear PPE.
• Apply their training.

Inter-Professional Competencies

1. Describes one’s roles and responsibilities and scope of practice clearly to other professionals / residents / family members.
2. Describes overlapping aspects of own professional knowledge and skills with other health professionals and paraprofessionals.
3. Recognizes and respects the role, responsibilities and competence of other professions / paraprofessionals in relation to one’s own.
4. Demonstrates respect and trust to ensure that collaborative relationships are fostered.
5. Practices within own scope of practice, code of ethics, standards and/or clinical guidelines while working within a collaborative person-centered relationship.
6. Works with others to assess, plan, provide and review care to maximize health outcomes for individual residents.
7. Gathers assessment data from all health professionals/paraprofessionals / residents / family involved in care.
8. Demonstrates effective sharing of information and exchanging of ideas.
9. Integrates information from each health professional / paraprofessional / resident / family to develop common resident-centered goals.
10. Participates effectively and appropriately in an inter-professional health care team to optimize resident safety.

POSITION SPECIFICATIONS

Minimum Formal Education

Education preparation accepted by the College of Occupational Therapists of Nova Scotia for Registration with the Nova Scotia College of Occupational Therapists.

Certification / Registration / Designation

1. Eligible for registration with the College of Occupational Therapists of Nova Scotia.
2. Eligible for membership with the Nova Scotia Society of Occupational Therapists and the Canadian Association of Occupational Therapists.

Special Knowledge and Skills

1. Thorough knowledge of Occupational Therapy practice, with an interest in program development and evaluation skills
2. Demonstrated accountability and responsibility.
3. Strong resident focus and ability to build solid resident relationships.
4. Demonstrated collaboration and teamwork skills with the resident at the centre.
5. Commitment to continuous improvement and innovation.
6. Demonstrated leadership abilities.
7. Demonstrated planning, organization, and time management skills.
8. Commitment to promoting a culture that supports safety, ethical practices and organizational health.
9. Demonstrated good attendance in current and past employment.
10. Exemplary work history as demonstrated in current and past employment.
11. Computer skills (e.g., statistics input, word processing, email, etc.).
12. Physical capabilities to perform the duties of the position.
13. Occupational Therapy is a diverse profession and additional courses/education/ or training in many specialized areas of practice may be required, e.g., stroke rehabilitation, seating, splinting, mental health services, etc.
14. Experience with the Red Cross Specialize Equipment Program
15. Experiences managing Responsive Behaviors or willingness to learn

Judgement and Initiative

1. Identifies the need for and coordinates occupational therapy services to maintain and enhance the occupational performance and engagement of the resident.
2. Continuously engages in critical thinking, and evaluates plan of care and makes revisions to plan as necessary in consultation and collaboration with the resident, his/her support system and other members of the health care team.
3. Articulates rationale for decisions that are based on clinical best practice, current theory and research
4. Intervenes when standards of practice are violated or not upheld.
5. Refers to appropriate professionals for issues beyond the profession’s scope of practice and the individual’s personal competence.
6. Seeks direction or assistance from other health care professionals as required.

Type and Level of Supervision Exercised

1. Delegates appropriate tasks/ activities to a Rehabilitation Assistant, rehabilitation aide, or other members of the health care team.
2. Supervision of Occupational therapy assistants, rehabilitation assistants, and occupational therapy aides.
3. Acts as a mentor / preceptor for students.

Key Relationships:

1. Engages with resident to build rapport and the relationship, clarify values, organize a schedule and places to meet for assessment..
2. Collaborates with resident to identify priorities for assessment and possible expected outcomes.
3. Collaborates and communicates effectively with resident, his/her support system, team member(s) and internal/external resources to implement and coordinate plan of care/services.
4. Collaborates and works consultatively with team members, all levels of management, and other departments and agencies both internal and external to the organization.
5. Engages with Professional Associations.
6. Act as a Communicator, to promote of the profession of Occupational Therapy, and the concepts of occupational performance, occupational functioning and occupational engagement.

Physical Demand

Physical capabilities to perform the duties of the position including working in awkward positions; sitting; stretching/reaching; on feet, standing/walking; pulling/pushing; lifting more than 40 lbs.; transferring residents; crouching; and manual dexterity.

Mental and Visual Demand

These include but are not limited to:

• Active listening / counselling / interviewing
• Clinical reasoning and critical thinking
• Observation
• Providing training / instruction to patients / students / families / caregivers
• Report Writing / documentation
• Data entry / computer use
• Health Record review
• Making presentations
• Driving

Working Environment and Unavoidable Hazards

Work is inside in resident’s rooms and Occupational Therapy spaces.

Safety (Resident, Worker, & Workplace)

Demonstrate good stewardship in the identification, reporting & mitigation of unsafe Acts or conditions.

1. Contribute to a culture of resident safety.
2. Work in teams for resident safety.
3. Communicate effectively for resident safety.
4. Manage safety risks.
5. Optimize human and environmental factors.
6. Recognize, respond to and disclose adverse events.

Professional Qualification / Education / Experience

• Minimum of 3 years recent experience in a Long Term Care setting and/or Community with emphasis on adaptive equipment [Red Cross Specialized Equipment Program] and responsive behaviors
• Bachelor of Science Degree in Occupational Therapy or Masters of Science in Occupational Therapy Entry Level, from an accredited University.
• Registered member of the College of Occupational Therapists of Nova Scotia.
• Safety certification such as BCLS, CPR, WHIMIS, CPI
• Ability to work independently with minimal supervision.
• Ability to organize, develop and initiate ideas and programs.
• Commitment to working in an interdisciplinary approach.
• Demonstrate good communication skills, verbally and in writing.
• Demonstrated physical ability to perform the duties of the position.
• Good Attendance and Work Record.
• Alzheimer and Related Dementia course.
• Criminal Records check – including Vulnerable Sector Search.