Acute Care Considerations Flashcards

Question

Collaborate with team:

Answer 1

Situation Background Assessment Recommendation: SBAR

Answer 2

Official record of the patient's past and current status along with a documentation of all procedures the patient has experienced One of the primary sources of patient information for the PT to gain information about the patient as well as to share pertinent details of the patient’s therapy session Maintain confidentiality of protected health information based on ethical and regulatory guidelines, including HIPAA and the APTA Guide from Professional Conduct and Code of Ethics

Answer 3

Confirm PT orders Admission note: H&P from other providers Patient demographic: Age, Gender, Height/weight Admission date and reason for admit Past medical history Reason for PT consult Information pertaining to discharge (ex: prior level of function, home setting) Social history, including home set up Consult/specialist notes Lab values Vital signs

Answer 4

Gather and analyze medical information to determine an image of the patient to determine prognostic and management strategies Gather data on timing to see patient, if mobilization is indicated

Answer 5

Clear documentation that reflects decision making All relevant aspects of patient encounter to be understood by team Immediately following care Use judgement if oral and written communication is necessary

Answer 6

IIntensive Care Unit (ICU) Acute Care Unit (ACU) = Hospital, Medical Center Acute Rehabilitation Facility (ARF) Inpatient Rehabilitation Facility (IRF) Sub-Acute Rehabilitation Facility (Sub-acute) Skilled Nursing Facility (SNF) Long-Term Acute Care (LTACH) Home with Home Health Home with Outpatient Home

Answer 7

Short LOS PT value added service Hospitalist and Interventionist Wide variety of patient conditions, team Complex patient population Set goals to prepare for DC and educate Bedside Care Levels of Care- Critical Access, Trauma Center, Academic Medical Center

Answer 8

Acute Care: Patients receive minutes per day of treatment, often focused on stabilizing immediate medical concerns. Subacute Care/Inpatient Rehab: In contrast, hours per day of therapy are provided, especially in inpatient rehabilitation, where patients engage in more intensive therapy sessions.

Answer 9

Acute Care: Patients typically have a short stay of a few days due to the high acuity of their conditions, and the focus is on stabilizing them before discharge or transfer. Inpatient Rehab: Patients stay for a few weeks, as the goal is more focused on recovery and rehabilitation, often post-acute care or surgery.

Answer 10

Acute Care: Patients in this setting are typically very ill or post-surgical with immediate, critical medical needs. Subacute Care/Inpatient Rehab: Patient acuity decreases as they improve, requiring less intensive medical care but more rehabilitation support.

Answer 11

Acute Care: The environment is high-volume, fast-paced, and unpredictable, as many patients are seen for urgent or emergent conditions. Inpatient Rehab: The patient volume is lower, and treatment is more scheduled and coordinated to meet the rehabilitation needs of each patient, often with structured sessions.

Answer 12

Life-threatening injuries and illnesses Team of specially-trained health care providers -> 24 hour care Function and Mobility in the ICU

Answer 13

patient requires and is able to tolerate and participate in a comprehensive level of rehabilitation services (3 hours minimum of rehab) requires close rehabilitation medical supervision and available 24- hour daily medical attention Necessary services cannot be provided in an alternative, less costly, setting Cannot access necessary care outside a comprehensive rehabilitation setting.

Answer 14

Interdisciplinary specialized care Physiatrist or equivalent > 3days/week, available 24/7 for emergencies 24 hour rehabilitation nursing care Need for > 2 disciplines PT/OT/SLP Must also have SW, psychology, rec tx, access to voc rehab, prosthetics/orthotics

Answer 15

Tolerate > 3 hours PT/OT/SLP 5 days/week or 15 hours/week Need at least 2 disciplines Benefit from > 3hours of therapy (active participation) Measurable improvement

Answer 16

Intended as a relatively brief start to rehab LOS typically 5-30 days Expected discharge: SNF or Home

Answer 17

Intended as a longer stay then ARF LOS typically 2 weeks - 2 months Expected DC: SNF or Home

Answer 18

Inter-disciplinary team Specialized care Focus on community re-entry Availability of hospital services Capitated reimbursement encourages short LOS

Answer 19

Cost $$$$$ Too fast-paced for many patients Hospital-based (not home)

Answer 20

Chronic Hospital Patients need acute care services long-term > 28 days average length of stay Often used for ventilator care, wound care, TBI (esp. coma stim)

Answer 21

Can be in a hospital transitional care unit (TCU) or in a skilled nursing facility (SNF) Need skilled nursing or therapy Covered for 100 days maximum Medicare Paid per diem—incentive to keep patients longer Typically 1-2 hours PT/OT/SLP daily Often 1-2 RN/shift + CNAs Limited nursing care, infrequent physician visits

Answer 22

Cost ¢¢ Can stay longer if needed Option for residence post-discharge

Answer 23

Long LOS Less therapy Limited RN Limited physician visits Away from hospital services (unless TCU) NH environment High rehospitalization rates

Answer 24

Not skilled care Considered resident’s “home” Rules accordingly Typically after SAR stay (after 100 days exhausted in SNF) NO PT/OT/SLP paid for Residential Disabled or elderly patients with limited family support

Answer 25

Must be unable to leave home for rehab services -> strict criteria Medicare pays capitated rate Typically 2-3 x/week visits Limited home health aide coverage(typically 5-10 hours/week)

Answer 26

Cost ¢ Convenience Adaptation to home setting Slow paced “No place like home”

Answer 27

More expensive than OP tx Limited equipment Less aggressive Limited goals Need for family support Nursing care primarily for teaching family to do care

Answer 28

Mobile patients Varied settings—hospitals, free-standing Can be sub-specialized — e.g., sports, neuro, cancer, male/female health issues Can be up to 5 days/week

Answer 29

Cost ¢¢ Community level goals Equipment

Answer 30

Time limits set by insurance(# visits capped) Transportation needed Limited physician supervision Not typically inter-disciplinary

Answer 31

Can be specifically licensed and CORF accredited Inter-disciplinary “Day hospital programs”—may have RN Typically 4 hrs 3-5 days/week Often sub-specialized—e.g., TBI or Cancer rehab

Answer 32

Private pay and little regulation Support provided by CAN and LPN On site nursing supervisor Meals Medications Rooms, cottages may be attached to other services