KENYATTA NATIONAL HOSPITAL

OCCUPATIONAL THERAPY GUIDELINES DURING COVID-19

PRESENTED BY:

EUNICE WANJIRU – OCCUPATIONAL THERAPIST KNH

SILAS WAKULWA – OCCUPATIONAL THERAPIST KNH

EVANS OKONG’O – OCCUPATIONAL THERAPIST KNH (MODERATER)

6TH MAY 2020

Introduction• Covid-19 pandemic is having a profound

impact on the lives, health and wellbeing of

individuals, families and communities

worldwide.

• These include, but are not limited to;

accessing resources, activities of daily

living, communication, mobility, social

isolation, displacement, mental health and

wellbeing.

DAILY OCCUPATIONS

HAVE BEEN

INTERRUPTED!!!

Purpose

• The purpose of these guidelines is to

enable us to work in a safe environment

considering COVID-19 is a highly

infectious disease

Sensitizing staff and

clients

Stage 1:- sensitization of staff and

clients

•All Occupational Therapists must undergo

sensitization on COVID-19

• All staff to stay updated on the latest about

COVID-19

•Have appropriate written infection prevention

protocols

Cont..• Have signage about hand and respiratory

hygiene

• Client should be given up to date

information on COVID-19

• Always follow the infection control

protocol

preparation

Stage2:- PREPARATION

• Routinely clean and disinfect all frequently

touched surfaces and equipment with the

appropriate cleaning agents

• Ensure social distancing

• Ensure availability of clearly labelled waste

bins

Cont.. preparation

• Stay calm and have an objective view

• Ensure availability of running water and

soap or an alcohol based sanitizer

Risk assessment

Stage 3: Risk Assessment

• Multi-disciplinary sharing of information

• Access clients information from file

• Triage

Reception area

• Ensure social distancing

• Triaging of all clients

• Ensure there is recommended alcohol

based sanitizer

• Clean and disinfect reception area

Intervention

Oral motor stimulation

Stage 4: Intervention

1) Oral motor facilitation

- This aims at facilitating oral motor skills for instance feeding and communication

• Clean and disinfect therapy area and equipments before and after each session.

• Avail all the equipment needed at hand reach

• Emphasize on hand wash and hand sanitization

.

• Be in correct PPE i.e. disposable gown, a

mask, gloves, goggles

• Ensure the care giver has a mask

• Minimize body contact

• In case of contact with saliva, immediately

wash thoroughly with running water and

soap and disinfect.

• Give directions to the caregiver all through

therapy.

Milestone training

2) Milestone training

-It aims at facilitating development milestone

that either delayed or regressed.

• Minimize exposure in our setting

• Practice social distance

• Reschedule non urgent care

• Consider closure if no PPE is available

• One client at a time with accompany of

only one care giver

- Ensure the area is disinfected before and

after every therapy session

- Clean and disinfect equipment.

- Train home programme to reduce

frequency of hospital appointment

Assistive devices

3) Assistive devices

-This are equipments and devices issued to

clients to promote and support their

performance of activities.

• Train on home programme on usage

• Minimize contact when donning & doffing

splints, instead give instructions

• Keep appropriate distance when training on

use of prescribed device

- Train client how to clean and disinfect device

- Advice client not to share their device

Hand function

rehabilitation

4) Hand function Rehabilitation

-Hand therapy aims at restoration of hand

function.

• Both patient and therapist must observe

hand hygiene.

• Ensure all equipments needed are clean and

disinfected before and after use.

• Patient to use gloves for each activity.

• Have correct PPE.

Cont.…

• Minimize contact instead give instruction

during therapy session or use videos.

• Maintain social distance.

• Give home program to minimize hospital

appointment.

• Rebook non urgent clients.

Driver

Assessment and

Rehabilitation

5)Driver Assessment and Rehabilitation

- It aims at identifying and facilitating the

driving skills for persons abled differently.

• Minimize exposure in our setting

• Wear correct PPE

• Practice social distance

• Reschedule non urgent care

• One client at a time with accompany of only

one care giver

Activities of Daily

Living Training

6)Activities of Daily Living Training

-Aims at facilitating independent in activities

of daily living.

• Encourage a lot of directed movements and

limit physical contact during performance

• Use of immediate family as caregiver in

performing some tasks for understanding

and demonstration.

• Patient family education for carry over

skills.

Mental health

7)Mental health

-It aims at alleviating mental issues that

interfere with occupational performance.

• Encourage use of informant report

especially because of the mental status.

• Assess the cognitive status if using self

report during assessment.

• Use of activities to address level of

performance

Cont. • Always clean and disinfect tools used after

sessions

• Patient- family education for carry over

skills

Sensory integration

8) Sensory integration

-It aims at modulating sensory processing

• The caregiver should be in a mask always

• Only one care giver to bring the client for

appointment.

• Care giver and clients should observe hand

hygiene.

Cont.• The work station should be cleaned and

disinfected at all time.

• Therapists should be on correct PPE before

attending to patients.

• All therapy equipment should be cleaned

and disinfected at all time.

Cont.• No group therapy sessions.

• Care giver must accompany a child below

18 years.

• Give home programme to minimize

appointments to the hospital.

• Environmental modulation to reduce

destruction and interruption during the

session and waiting.

Lymphedema and scar

Management

9) Lymphedema and scar Management-Aimed at reducing edema and scar management

• Both patient and therapist must clean and sanitize hands.

•Observe social distance.

•Minimize body contact.

•Give proper instructions on how to use and maintain the pressure garment.

•Any pressure garment brought for repair must be clean and disinfected.

•Observe risk mitigation measures.

Acknowledgement

Special thanks of gratitude to all occupational

Therapy staff–KNH, Research and Programs-

KNH,MOH Kenya, WFOT and WHO for their

extraordinary support in making these

presentation a success.