TOTA and OT Schools
Contingency Measures
In Response to COVID-19

Content01 TOTA Contingency Measures…3
02 School Adaptations…8

Nationwide Occupational Therapy
General guideline
Articles posted on the TOTA website“How do therapists response to COVID-19”
in Chinese, English and Japanese version

about workplace, living, one’s rights, advanced
studies, international prevention programs etc.

Specific guideline

Set up “COVID-19 Area ”
on the TOTA website
provide relevant information for members andpublic as a reference“Contingency measures for home-basedand community-based occupational
therapy service in response to COVID-19”

Information on free on-line OT programsfor clinical practice and education“Epidemic prevention plans in response toCOVID-19 document”

3Professional Educatio
Survey schools and placement units’ opinions about
adaptation program’s ratio and set up the standard
Formulate “Adaptation Program Standard for Fieldwork
Level II Occupational Therapy Clinical Training”
Held Forum for planning clinical training adaptation
program in response to COVID-19” with schools andclinical placements→Postpone the schedule of clinical training→Integrate clinical practice materials from clinical placements to enrichadaptation teaching contents→Provide a sample of affidavit letter for risk of clinical training during
COVID-19 pandemic for schools and placement units

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Contingency Measures with Government Agencies

Promotion→Assist National Health Agency to promote epidemic prevention
policies and measures

Adaptation program for fieldwork level II practice→Provide Ministry of Educa on about the con ngency mechanism
for clinical training and the possible max ratio for the substitutive
programCompensation, subsidy, and relief packages for OT centers→Ask Ministry of Health and Welfare for providing compensation and relief
package for the closure of occupational therapy centers

Student vaccination→Ask Taiwan Centers for Disease Control to allow students for vaccination
before fieldwork level II practice5International Community Interaction

Assist the promotion of WFOT’s survey
Assist the promotion of WFOT Occupational therapy andrehabilitation of people affected by the COVID-19
pandemic
Webinar: Taiwan Occupational Therapy Association partners with Association ofCaribbean Occupational Therapists to discuss COVID-19

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Contingency Measures for Projects
After Level 3 Alert
Taipei City Vocational Assessment ProjectTaipei City Job Accommodation Project
Taoyuan, Hsinchu and Miaoli Resource Center
Delay Disability Counseling Network Project
Taipei City Vocational Assessment Project7

School Adaptations
In Response to COVID-19

On-line teaching

Synchronous

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Asynchronous

lectureGroupdiscussion

Role play

Simulatedpatients forcase
practiceVideowatchingand practiceOnlineexam

Problembased casediscussion

Techniquedemonstrati
on andpracticeInternational Exchange Programs
1 Singapore Institute of Technology
Online forum for undergraduate
students at Chang Gung University
2 San Jose State University• Virtual summer program for Chang GungUniversity• Undergraduate/graduate students andclinical practitioners
3 University of Southern California
Online meeting for Asia University andUSC for undergraduate students

104 Master Degree Program - UM and CGU• Two master degrees program between
University of Minnesota-Twin cities,
Department of Kinesiology and Chang Gung
University, Department of OT• 1 year at CGU + 1~1.5 years at UM

Singapore Institute of TechnologyOpening

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Studentpresentation

Group
discussion

AgendaOnline interactive forum for undergraduate students: April 30th ,2021

San Jose State University
Course topics:
Integrating mindfulness
practice in clinical practiceWellness and Fall
Prevention ProgramsEA

OT in the Community:Sleep educationand treatment

OT Advocacy, Management andLeadership: from clinical practice

BFGC

At Risk Youth & Young
AdultsMental Health OT in thehospital and community

to academics

Occupational Justice:

D12

Occupational Therapy Services for
those who are Homeless;community services across thelifespan
Virtual summer program: August 2, 2021~August 13, 2021
Non Live (Asynchronous)/ Live (Synchronous)

International
Course Meeting
Asia
Univeraity(Asia University Vs University of Southern California)

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Online MeetingofAsia University & USC

International
Student Exchange

Master Degree Program - UM and CGUFirst year:
Chang Gung University,
Department of OccupationalTherapy,
Master degree

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FSecond year:
University of Minnesota,
Department of Kinesiology,
Master degree

Earn two master degrees program within 2~2.5 years

Study on client behavior under epidemic

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Thank you for your attention

Contingency measures in the practicesettings in response to COVID-19:
Physical, Pediatric, and mental healthPresident Ching-Yi Wu, ScD, OTR
Taiwan Occupational Therapy Association

I. Contingency measures in thephysical and pediatric settings inresponse to COVID-19

Infection control for Therapists• Self-health management• measure body temperature every day, report if there is a fever• Isolation and triage measures• arrange different resting areas and treatment rooms for therapists with different duties• Mask and other personal protective equipment when needed,• e.g. goggles, face shield, gloves• Hand hygiene• wash hands before and after every patient contact• Online education courses• Staff required to receive courses related to COVID-19 epidemics

Infection control of Environment• Checkerboard seating, install dividers, or reduce group size
• in the therapeutic room to maintain social distance• Sterilize therapeutic equipment after use
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Infection control for patients• Isolate and triage• Both for in-patients and out-patients• Health management• Measure body temperature, ask TOCC and wear a mask

when entering the therapeutic room

• Only one person to accompany a patient• Minimize chatting during therapy• Getting the patient’s PCR report or negative antigen

test result• taken within a week at the first time of therapy or before

conducting therapy

4Flow of Therapy
In-patient
Medical review,is the client beingquarantined?

Yes

No

Out-patient
Conduct bedside
rehabilitation withpersonal protectiveequipment

Real nameregistration system:
NHI card or in writing
Measure client andcaregiver’s temperature,is there a fever?

Inform the client torehabilitate in thetherapeutic room

Yes
Stop therapyNo
Measure client andcaregiver’s temperature,is there a fever?

5NoEnter therapeutic room,
adopt checkerboard
seating

Yes

Stop therapy, informthe primary nurse

Ask TOCC for any risk
NoEnter therapeutic room,
adopt checkerboard
seatingYes

Stop therapy

Personal Protective Equipment Sequence of donning
The main objective of this sequence is to reduce the risk of self-contamination during doffing
personal protective equipment. It can be modified according to the situation and characteristicsof the department and equipment donned.

1.
2.
3.
4.
5.
6.
7.
8.
6

9.

Perform hand hygiene
Put on the first layer of gloves
Put on shoe covers (if needed)
Put on gown
Put on surgical mask or N95 mask (with fit check)
Put on cap
Put on the second layer of gloves (make sure it covers the cuffs of the gown)
Put on face shield or goggles
Check the completeness of equipment

Personal Protective Equipment - Sequence of doffing

Remove the firstlayer of gloves

Use handsanitizer

Use handsanitizer

Use handsanitizer
Remove faceshield or goggles

Remove cap

Use handsanitizer

Wash hands

Use handsanitizer

Use handsanitizer

put ona new mask

Remove mask
7

Remove gown

Remove thesecond layerof gloves

Removeshoe covers

89Modification of Working Model• Supporting Role
• Staff support administrative work of PCR screening, vaccination and TOCC, scheduled by thehospital’s infection department• Clinical work
• All onsite clinical services suspended, staff are encouraged to apply for off site work
• All regular administrative and clinical meetings held online• Provide consultation and support to the clients and families via phones, LINE and other forms oftelecommunication

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Self initiation of staff to promote self health• Virtual casual chatting during lunch breaks• Regular online meeting mutually sharing lessons learned from online services• Mutual psychological support through LINE group11

Innovative Service in Pediatrics during the Pandemic• Team work on FB Fan Page focusing on assisting the families to adjust to newlifestyles• Online consultation, focusing on• re-arrangement of daily routines• work with families in creating meaningful home based co-occupations• child’s participation in school’s online courses• management of child’s challenging emotions and behaviors• provide psychological support

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Innovative Service during the Pandemic• Organizing Online lectures and conferences for caregivers• parent skills training• preparation for child’s school entry• Reviewing home video clips sent by families who seek for consultation• activity grading and adaptation• consideration of personal and contextual factors

13II. Contingency Planning for
Occupational Therapy Servicein Mental Health Units
in Response to COVID-19 epidemicObjectives
Maintain sufficient treatment capacity-- for acute and chronic psychiatric patients to receive treatment stably during
COVID-19
Ensure the non-stop service during COVID-19-- provide various type of supportive services for psychiatric patients incommunity to replace the original service on the basis of a group form

Provide strategies for lifestyle modification and stress coping during
COVID-19-- for the frontline workers and patient’s caregiver
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For Hospital –Staff and Activity Space Arrangement
Control of Staff• Isolation and triage measures• Fixed occupational therapists responsible for fixed wards work in different and fiexed offices• Therapists lead ward groups in wards• avoid cross infection between therapists and patients

Infection Monitoring• Health management• measure body temperature and report symptoms of fever and diarrhea every day• Separate the office area
• to avoid excessive face-to-face contact

Equipment Sterilization• Use alcohol for sterilization• Use disposable sheath for the use of equipment
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Hospital – Content of Service
Modify the Flow of Group Activities• Require all patients to wear a mask during the entire activity• All patients wash hands before the activity starts• Encourage all patients to wash hands after the activity• Adopt checkerboard seating during the activity to maintain suitable social
distance

Redesign Activities• Mainly design activities that can be finished by oneself, reduce excessive
contact between patients• Integrate information of COVID-19 into activity topics, raise patients’
understanding towards the disease, reduce patients’ anxiety

17Community-Based RehabilitationModify Mode of Service In Response to COVID-19
Vaccination

Health Management
Measure bodytemperature every day,
wash hands frequently,
maintain social distance

Activity Suspension
Cooperate with
CDC’s epidemic alertlevel to decide if thedaycare activities aresuspended

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Cooperate withgovernment’svaccination plan,finish vaccination
ASAP to achieve herb
immunity

Change fromgroup service
toindividualizedservice

Distant Contact
Contact usingdistance or video call,increase the contact
during the suspensionof classes orquarantine

Reduce Community
Activities
Reduce community
activities that enter
public areas, reduce
the risk of infection

Community-Based RehabilitationIn Response to the Modified Mode of Service
Resources inventory of the Organization• Is the manpower capacity enough for the modified mode of service• Is there enough transportation to maintain the modified mode of service• After the modification of the mode of service, is the resources enough to support the service
sustainably

Client Need Assessment• Is the client’s lifestyle remains stable after the mode of service modification• Which part of the client’s service needs to be modified

External Environment Evaluation• Effect of the epidemic changes and government’s contingency plans to staff and risk
assessment for the service
19Community-Based Rehabilitation-Modification of Service Content
Provide home-based vocational rehabilitation

Provide individualized home-based rehabilitation, care and remind them to maintain home based lifestyle and provide emotional support via phone calls

Use technology to provide home visit, use Google Map for positioning, report special
conditions in Line groups, personnel aid with return visit and short-term hospitalization

Assist psychiatric patients in community to get registration, transportation, and vaccinated, andfollow up

AZ vaccine from Japan,ありがとうございます！
20Community-Based RehabilitationIn Response to the Modified Service Content
Maintain lifestyle• ADL: Daily life arrangement, leisure recommendation, supervision of personal hygiene,
home maintenance, finances management• Health maintenance: Return visit reminder/help with collecting medicine, organize
medicine, take medication regularly, weight and diet control, blood glucose monitoring• Work: Home-based vocation, workplace epidemic prevention measure reminder• Family: Family care skills practice and psychological support• Allocate resources: Help in various subsidies, apply for relief packages

Emotional Support• Supportive Interview• Out-patient medication adjustment (Video-call/in-person)• Accompany going out, take a ride

Crisis Management• Short-acting injection• Arrangement for hospitalization (Contact for bed and PCR test)

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Frontline Workers and Patients’ Caregivers
Care the Carer

Rest when needed-- maintain the best physicaland psychological status

Caregiver club-- to discuss stress inevents, share personal
experience, andmethods handling stress

Relaxation activities-- simple body relaxation
exercise, yoga with breath
control, light music withdrawing to express
emotions etc.

Positive andhealthy handling
methods-- in order to help carers
to go back to normal
work or life sustainably
and healthily

Reduce frontline health care workers or caregivers’ caring stress22For Frontline Workers and Patients’ Caregivers
Solve the hiatus ofin-person OT service dueto the risen epidemic alertlevel

Use of online programs,
provide social support

Record videos about relaxingactivities, provide frontline
worker and caregiver who
needs to use at anytime
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ProvideOT
service via
telehealth

Overcome thechallenges of time andspace with the use ofinternet and multimedia

Provide non-stop
occupational therapy
service during COVID-19

Acknowledgement• Appreciations to Chia-Chih Lu, Tzyh-Chyang Chang, Wan-Ying Chang, Te-Chun Chenfor preparing this powerpoint.

Reference• Website of Taiwan Centers for Disease Control

https://www.cdc.gov.tw/

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