Return to work after severe burn injury – a five year audit

Akane Katsu1, Andrea Mc Kittrick2, Dr John Vandervord3

1 Department of Occupational Therapy Royal North Shore Hospital St Leonards NSW 2065 Australia, Akane.Katsu@health.nsw.gov.au
2 Department of Occupational Therapy Royal North Shore Hospital St Leonards NSW 2065 Australia
3 Head of Department of Plastic Reconstructive and Burn Surgery Royal North Shore Hospital St Leonards NSW 2065 Australia

Background

Return to work (RTW) is often seen as outcome measure of severe burn injury indicating community reintegration1, 2. Various studies have investigated the barriers to RTW post burn injury2-4. The severe burn injury recovery process is long and affects the individual’s occupational and societal roles. It is important to consider how assistance may be provided to promote RTW in the clinical setting.

Method

A five-year retrospective audit of patient records was conducted to review RTW rates and the type of occupational therapy provided. Adult patients admitted with greater than 15% TBSA burn injury and had received occupational therapy treatment were included in this study. Demographical, burn injury, LOS, rehabilitation, work status data were collected and analysed.

Results

RTW rates are affected by pain, impaired mobility and neurologic problems. Patients were also less likely to RTW when they had fewer supports. Occupational therapy intervention specific to RTW after severe burn injury included early education, referral to other services and liaison with rehabilitation coordinators.

Conclusion

Given the many barriers that this patient population face in the RTW process, the approach to enabling RTW for the severely burn injured should also be multi-focal, comprehensive in evaluation and integrative5. While RTW is an important component of the occupational therapy rehabilitation at this burns unit, further steps to improving clinical practice have been identified through this audit.

Key Words

Return to work, severe burn, adult, rehabilitation

References

1 Schneider, J. C., Bassi, S., & Ryan, C. M. (2011). Employment outcomes after burn injury: A comparison of those burned at work and those burned outside of work. J Burn Care & Research, 32(2), 294-301.

2 Oster, C., Kildal, M., & Ekselius, L. (2010). Return to work after burn injury: burn-injured individuals’ perception of barriers and facilitators. J Burn Care & Research, 31(4), 540-550.

3 Esselman, P. C., Wiechman Askay, S., Carrougher, G. J., Lezotte, D. C., Holavanahalli, R. K., Magyar-Russell, G., Fauerbach., J. A., & Engrav, L. H. (2007). Barriers to return to work after burn injuries. Arch Phy Med Rehab, 88(12 Suppl 2), S50-56.

4 Fauerbach J. A., Engrav, L., Kowalske, K., Brych, S., Byrant, A., Lawerence, J., Li, G., Munster, A., & de Lateur B. (2001). Barriers to employment among working-aged patients with major burn injury. J Burn Care Rehabil, 22(1), 26-34.

5 Stergiou-kita, M., & Grigorovich, A. (2013). Guidelines for vocational evaluation following burns: Integrated review of relevant process and factors. Journal of Occupational Rehabilitation, 23(4), 476-503. doi:http://dx.doi.org/10.1007/s10926-013-9428-y

Biography

Akane Katsu is a registered occupational therapist with over ten years of burn rehabilitation experience. She has special interests in multi-trauma care, long-term rehabilitation outcomes, facial/neck burns and early therapy intervention in severe burn injury management.

About ANZBA

ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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