9/9 - Patient Management Model Flashcards
what are the components of a SOAP note
S - subjective (pt report)
O - objective (physical exam)
A - assessment (STG, LTG)
P - plan (interventions, freq, duration)
at what level does the Nagi disablement model look at
level of person and society
what are the dimensions of the Nagi model of disablement
- active pathology
- impairment
- functional limitations
- disability
Nagi disablement model: what is the corresponding level of disablement to the dimension active pathology
cellular
Nagi disablement model: what is the corresponding level of disablement to the dimension impairment
body systems
Nagi disablement model: what is the corresponding level of disablement to the dimension functional limitations
whole person
Nagi disablement model: what is the corresponding level of disablement to the dimension disability
person’s relation to society
what has the goal been which led to a transition from Nagi to ICF
goal to move away from pathoanatomic processes
- instead say patient with ____
what are some examples of facilitators and barriers that are under environmental factors of the ICF
who do they live with
what support do they have
what is included in contextual factors of the ICF
personal factors
environmental factors
what is included in the functioning and disability of the ICF
body function/structures
activities
participation
what is included in the exam
hx
systems review
specific tests and measures
what is the definition of an eval
ability to pull all the info from exam in a meaningful way
- this is what makes you a skilled clinician
what is included in the history taking part of an exam (4)
chart review
discussion w interdisciplinary team
interview patient
review of systems
- questionnaire - PMH, comorbidities
- vitals
what is a systems review in an examination
screen of practice patterns that aren’t primary referral
- ms
- nm
- cvp
- integ
what is the goal of a systems review in an exam
identify any red or yellow flags present
red vs yellow flag
red - PT not appropriate, CI or reasons for referral
yellow - things to be conscious of to manage and utilize referrals when needed
what are 5 things covered in a ms systems review
gross ROM
gross strength
gross symmetry
height
weight
what are the two main things looked at in a nm systems review
gross coordinated movement
motor function
what components of gross coordinated movement do you look at in a nm systems review
balance
gait
locomotion
transfers
what components of motor function do you look at when doing a nm systems review
motor control
motor learning
what is involved in a cvp systems review
bp
edema
HR
RR
what is involved in an integ systems review
pliability (texture)
presence of scar formation
skin color
skin integrity
what do you assess in a communication ability, affect, cognition, language and learning style systems review
ability to make needs known
consciousness
orientation: person, place, time
expected emotional/behavioral responses
learning preferences
- learning barriers and education needs
why are learning preferences an important thing to cover in your communication systems review? give an example where this can be implemented
can adjust interactions accordingly
how you give HEP
- printouts
- video references
what are 6 most important tests and measures for MSK patients? why?
gait
joint integrity and mobility
muscle performance
- strength, power, endurance, and length
pain
posture
ROM
these all help get a sense of mobility
what is the clinical decision-making done following evaluation
additional examination
PT dx, prognosis and goals
referral
what is evaluation
thought process synthesizing all exam data
integrate test/measure data w hx
MD dx vs PT dx
MD - identify dz, disorder, condition at level of cell/tissue/organ
- pathoanatomic dx
- abnormal structure of anatomy
PT - identify impact of condition on fx at level of system (esp movement) and level of whole person
- ICF model language
what 2 tools do PTs use to classify an individual into a diagnostic category
systematic process
differential dx
what is a prognosis
optimal level that can be achieved w PT care in current setting
how is prognosis categorized
excellent
good
fair
poor
what would make a pt have a good prognosis
relatively young
motivated
good support
what would make pt have a fair prognosis
maybe have chronic condition
limited support/access
what would make a pt have a poor prognosis
likelihood of us facilitating interventions might not make a difference
- have to consider if they are appropriate for PT
what is an important thing to include when documenting a prognosis
need to include why
what is included in the POC
goals (STG and LTG)
interventions
freq and duration
outcomes
what do your goals need to be
SMART
Specific
Measurable
Achievable
Realistic
Time bound
what is the main difference in how you write STGs vs LTGs
STG - impairment
LTG - functional
what is the relationship between STG and LTG which should be taken into account when forming your goals
usually need to achieve STGs to achieve LTGs
- STGs should be important pieces to progress to LTG
- understand the impairments that need to be addressed to reach the desired functional level
what is included in interventions for your POC
coordination, communication, & doc
- admin & logistics
procedural interventions
- what we do w pts
patient related instruction
- pt ed
what is included in outcomes
functional outcomes
dc planning
what are 9 interventions
pt/client instruction (ALL PATIENTS)
ACT
assistive tech
biophysical agents
functional training
integ repair/protection
manual therapy techniques
motor function training
ther-ex
what are outcomes the result of
implenting POC
what domains are outcomes measured in (8)
path/pathophys (dz, disorder, condition)
impairments in body function/structure
activity limitations
participation restrictions
risk reduction and prevention
health, wellness, fitness
societal resources
pt/client satisfaction
