2 - Scope of Practice, Professionalism, Safety and EAP

Question 1

before you start an assessment on a client, you need to prepare yourself and your environment. Which 3 questions were mentioned on the slides?

Answer 1

What is your scope of practice?
How will you keep your client safe?
How to be professional? (record keeping and notetaking)

Question 2

in Canada, the only time scope of practice can be voided is _

Answer 2

if situation is life threatening and noone else is more experienced (good samaritan act)

Question 3

What is a scope of practice?

Answer 3

• provides a concise description, in broad, non-exclusice terms, of the activities and areas of professional practice
• does not list specific tasks or procedures because these can become outdated as practice evolves in response to changes in knowledge (tends to list things you CAN’T do cause CAN is too long)

Question 4

What happens when professionals work outside their SOP?

Answer 4

• risk the safety of clients
  Expose themselves to legal risk:
  1) If the trainer causes an injury
  2) Fails to refere a client to another more appropriate health care provider
  *liability insurance only cover SOP

Question 5

under the CSEP-CPT SOP, who can they work with?

Answer 5

apparently healthy people or people with one stable chronic condition who are able to exercise independently
(don’t need to be ambulatory, aka can be in a wheelchair but they should be able to do exercises on their own without 24/7 monitoring)

Question 6

What CAN a CSEP-CPT do in their SOP?

Answer 6

• conducts basic pre-participation health screening
• gathers info about client’s PA/lifestyle behaviours
• administers CSEP-PATH fitness assessment according to client’s goals and wishes
• develops a health/fitness related, client-tailored exercise prescription
• recognizes their own area of expertise and refers clients who fall outside that expertise

Question 7

what CAN’T a CSEP-CPT do within their SOP?

Answer 7

• use an ECG
• conduct an exercise test/design prescription that is >90% maximal effort
• create diet plans (can make general guidance but no explicit plans)

*work within knowledge even if their within SOP, should refer to someone more knowledgable or educate yourself

Question 8

what effect does the CSEP high performance specialist have on the CSEP CPT SOP?

Answer 8

• previous restrictions on maximal aerobic and anaerobic assessment protocols or exercise program development are lifted
• previous restrictions on muscular strentgth assessment protocols or program design that exceeed 90% of 1-RM are lifted

Question 9

who can CSEP-CEPs work with under their scope of practice?

Answer 9

work with clients with more than one medical condition or with unstable medical condition

Question 10

describe the CSEP-CEP SOP

Answer 10

• does everything a CPT can do
• work with clients with more than 1 medical condition or with unstable medical condition
• can work with youth, older-aged persons, and performance testing
• accept referrals from health care professionals
  suggest dietary practices for health and performance related fitness (NOT explicit diet plan just suggestions)
• monitor the use of common medication in response to exercise
• use ECG
• take finger prick blood samples (must comply with CSEP blood sampling policy)

Question 11

What CAN’T a CSEP-CEP do within their SOP?

Answer 11

• diagnose pathology or abnormal ECG tracings
• work with acutely injured or diseased persons who are not within their area of expertise

*if ppl are sent for a stress test they already have a cardiologist, have to follow up with them about issues CAN’T say anything

Question 12

What 4 things should we consider in terms of client safety and injury prevention?

Answer 12

• consider benefits vs risk
• ensure adequate physical activity readiness screening and monitoring of client
• err on the side of caution
• avoid high-risk/contraindicated exercises

Question 13

how do the risks of exercise compare to the benefits?

Answer 13

relative risk is low, especially when compared to the health benefits associated with physical activity
- lowest among young adults

Question 14

elaborate on “err on the side of caution”

Answer 14

• mild to moderate exercise intensity at the start of a program
• excessive intensity, frequency and duration offer very little additional benefit in terms of health status

Question 15

list the 4 components of facility & equipment standards

Answer 15

• equipment maintenance
• building maintenance
• safety & policy signs in clear view
• environmental factors

Question 16

describe equipement maintenance

Answer 16

• cleaned, functioning, intact, calibrated equipment
• cleaning done regularly + after use
• checking functioning and intactness at minimum once each day
• calibrating equipment based on manufacturer recommendations, a little less regular

Question 17

describe building maintenance

Answer 17

• flooring, mirrors, walls, exits, storage areas, lighting
• floor is clear
• mirrors are around, encouraging proper form for reduced risk of injury
• walls are safe and sturdy since people lean onto them
• exits are available and well-defined for clients
• storage areas for equipment
• good lighting to see risks

Question 18

Describe environmental factors

Answer 18

• stereo volume, air temp, etc
• stereo volume: might not hear instructions and increase risk
• air temp needs to not be too hot and humid since it could increase risk

Question 19

describe safety & policy signs in clear view

Answer 19

• esp, fire, privacy policy, etc.
• EAP = emergency action plan
• fire prevention
• privacy policies
  *all placed in plain view and accessible to everyone in facility

Question 20

what’s the best 1st step in preparing for emergencies?

Answer 20

avoiding emergencies
- always do physical activity readiness screening and ensure equipment is properly maintained
- conduct emergency drills and practice CPR scenarios on routine basis
- have emergency action plan (EAP) and know your role

Question 21

describe emergency action plans

Answer 21

• an EAP is required
• written document with proper procedures for caring for injuries and dealing with emergencies
• prepare to deal with CV and/or MSK complications
  *clearly defined and posted in a visible location

Question 22

what makes an EAP clearly defined?

Answer 22

• simple to follow, shouldn’t have to analyze the info for 10 minutes in the middle of an emergency
• presented ona signle page and posted somewhere so people can follow it
• summarized steps
• posted somewhere visible so you won’t have to go looking for it

Question 23

What should be included on the EAP?

Answer 23

• ambulance phone number
• loacl hospital or closest medical clinic
• name + phone of physician and next of kin
  Procedures for common issues like dizzyness, loss of consciousness, any other serious incident

Question 24

what should you do if a client is experiencing dizzyness

Answer 24

1) lie client in supine position & elevate legs
2) monitor BP (could also be low blood glucose so ask if they ate anything)
3) keep client in this position until his/her BP returns to the pre-ex level
*if no improvement suggest seeing doctor
*typically happens after the exercise

Question 25

what should you do if a client loses consciousness?

Answer 25

1) Initiate emergency procedures immediately, call 911
*if temporarly loss could take them to physician yourself

Question 26

what should you do if any other serious incident occurs?

Answer 26

• request emergency services
• provide emergency treatment CPR/AED

Question 27

What should you do if any adverse event occurs to your client?

Answer 27

complete an incident report form
- date, time, describe situation, how you tried to resolve it, how you tried to reduce risk before
- typically in university needs to be submitted to environmental health and safety office within 24 hours of occurence