After midterm material Flashcards
Who administers the state licensure exam of Physical therapy?
Federation of State boards of physical therapy (FSBPT)
Each state has the ability to decide whether or not administer what test?
Jurisprudence exam
Define Law
principles or rules established by an authority applied to a defined population
What are the three types of law?
criminal, civil/tort, administrative
what is criminal law
dispute with government for an act/crime
what is civil/tort law
private disputes: ‘individuals and oranizations’, and organization-organization
what is administrative law?
governs an org and operation of executive branch of government and their interactions with public legislatures and the judiciary
who is our governing agency?
Department of Health
Describe the Board of Physical Therapy
Interpretation and enforcement of rules and regulations that guide the practice of PT in Florida
The Board of Physical therapy practice is appointed position by ________, and confirmed by _______ _______
governor; Florida Senate
Who makes up the BoPT?
7 (5 PTs: florida resident, 4 years of practice, one may be full-time faculty) (2 that have never been a healthcare practitioner)
What falls under State and Federal Law?
Practice Acts- State Administrative codes- State General Business Laws Medical Laws labor laws Criminal/Tort Laws
Where can we access the laws related to PT?
FS Chapter 486
Where can we find the florida Statutes?
FS Title 32 Ch 486
Title 32 is the regulations of professions and occupations
Ch 486 relates to physical therapy practice
Where can we access Florida Administrative Codes?
64 B17
Chapter 486 is also referred to as what?
Practice Act
In reference to Chapter 486, who can PTs accept referrals from, and what three ways can PTs accept this referral?
MDs, DOs, Podiatrists, Chiropractors, Dentist
Must refer within their scope of practice, referral MUST be in writing (even on napkin), and PT can refer to other PT’s (but is not recognized within the law)
According to Ch 486, what information can be found for PT/PTAs regarding florida state law regulations?
Legislative Intent Definitions Examinations for licensure Licensing (application, renewal, revoking, reactivation) Continuing Education requirements Fees for licensure exemptions Prohibitive acts (including sexual misconduct)
Can a Physical Therapist penetrate viable skin?
Only if it is necrotic
Can a PT treat without a practitioner of record?
Yes, no more than 21 days
What two ways can a PT supervise a PTA?
General supervision (when performed for board certified orthopedic: MD or DO, physiatrist, chiropractor) Onsite supervision (when performed for all others regulated by Florida Statute: MD or DO, podiatrist, Dentist)
What qualifications must be met to have a PT license?
18 y/o, good moral character, graduation from accredited school of PT, diploma, passed board examination, and be entitled to licensure without examination
What are the requirement for licensure application?
$100 max fee to apply for NPTE
fill out required form
3 attempts to pass (if you don’t add’l education req’d)
2 additional attempts to apss (if not, NEVER sit again)
How can your licensed be issued?
$150 max fee if you have taken the exam
$175 if you apply without taking the exam
Pass the NPTE
Be licensed in another state (territory)
How often is your license required for renewal?
Biennial
No greater than $200
What happens when you need to reactivate your license?
Apply for reactivation
Complete the requirements: 10 Classroom hours for each year inactive, pay fees
What are the qualifications required for a PTA licensure?
18 y/o, good moral character, graduated from accredited school of no less than 2 years, and pass board exam
What are the Continuing Education Requirements?
24 hours every 2 years, each licensee is responsible for maintaining their own records, subjected to random audits by the board to substantiate your cont. edu., courses must be approved by APTA, hardship exceptions can be made
What is considered sexual misconduct and what are the consequences?
ATTEMPTS or INDUCES or ENGAGES in sexual activity/misconduct.
you can lose license
You have burden of PROVING YOUR INNOCENCE
Refusal/Revocation/Suspension can be the result of what?
Being unable to practice with reasonable skill/safety (substance abuse, illness/mental/physical condition)
If probable cause exists, submission to an exam is req’d
if suspended, individual has opportunity to demonstrate skill/safey
record or orders of the Board cannot be used against individual in any other proceeding
What are prohibited acts, according to Chapter 486?
practice without active license (does not include suspension or revocation)
misrepresent yourself to get license
mislead public into thinking you’re a PT
Knowingly conceal information relating to violations in this chapter
What is the Florida Administrative Codes and what purpose to they serve?
Rules; that organize rulemaking procedures by guiding the board in how to do their job, and outline specifics of the administration of the profession
According to 64 B17, how many hours of home study can you have (within 24 CEUs)?
12
1 CEU = how many contact hours? 1 contact hour = how many minutes?
10
50
What is the requirement of HIV education
No more than 3 hours and a minimum of 1
What is the requirement of Medical Errors education?
No more than three, and a minimum of 2
What are the four ethical principles that drive our approach to care?
beneficience, nonmalficience, autonomy, justice
what is beneficience
doing good
what is nonmalficience
do no harm
what is autonomy
the degree to which an individual can decide for themselves
what is justice
concept of culturally appropriate fairness when treating all patients
what are the two aspects of caring for maximum clinical effectiveness?
demonstration of care
motive of care
what is demonstration of care?
actions: beneficience
what is motive of care?
character: benevolent, desire to help
what is malady vs. illness
malady is a negative condition while illness is how malady is experienced by an individual
(two patients can have back pain but experience it differently)
not always a distinction between the two, they can overlap
what is the difference between pain and suffering, when considering the PT practice?
Pain determines the intensity and duration of treatment (high vs low pain tolerance), chronic pain typically has a higher threshold and pts will underreport how much pain they have
suffering is the interpretation of physical pain by the individual
Name the three strategies to reduce pain and suffering
Acknowledge presence of pain and suffering
Respect that the patient is experiencing it
demonstrate concern for the individual
what are the four ways of demonstrating concern?
empathy, sympathy, compassion, caring
Describe empathy
cognitive understanding of what another is feeling, “I could be you”
describe sympathy
emotion of concern, sharing of an individual’s sorrows or suffering, involves a perceived quality
describe caring (I know, I know…very broad)
direct regard for another’s well-being, active disposition to contribute to their well-being
describe compassion
deep sympathy in response to suffering with the desire to relieve it
what are the six problems with caring too much?
invades patient privacy threatens patient autonomy invites bias and favoritism create inefficiencies compromise objectivity carry over to personal life of PT (seems like a good extra credit question!)
family violence can be what type of abuse and who is at risk?
emotion and physical
children, elderly, women, disabled
what are common patterns of detecting abuse
central injuries- head, neck, chest, abdomen
defensive posturing- forearms
____% of perpetrators of domestic violence are ____
75
male
When to report child abuse
(Department of children ad families)
knowledge or reasonable suspicion of child abuse, abandonment or neglect by parent or person responsible for child’s welfare
when to report spousal/partner abuse
(Domestic Violence Hotlines)
health professionals must report gunshot or life threatening wounds or injuries
When to report older adult abuse
(Department of Elders)
known or suspected cases: Vulnerable adults (must report), or adults in general (with informed consent)
If abuse is identified what should you do clinically?
document objectively
describe demeanor of pt (crying, agitated, etc.)
use quotes when quoting what happened
photograph if possible
____% of children are sexually abused
20
____% of women and ____% of men were raped or physically assaulted by a current or former spouse
25, 7.6
____% of homicides of women are by a current or former partner
50
what is the definition of conflict of interest
situations in which individuals have interests that significantly threaten their role responsibilities or that would do so for a typical person in their role
According the definition of conflict of interest, what does “interests” refer to?
“situations in which individuals have interests that significantly threaten their role responsibilities or that would do so for a typical person in their role”
any and all potential benefits to the physical therapist
According to this definition what does “role responsibilities” refer to?
“situations in which individuals have interests that significantly threaten their role responsibilities or that would do so for a typical person in their role”
well delineated duties attached to formal assignment
According to this definition what does “typical person” refer to?
“situations in which individuals have interests that significantly threaten their role responsibilities or that would do so for a typical person in their role”
not a particular individual but a ‘typical’ person
What can COIs or the appearance of COIs have a negative connotation? (3)
Threaten responsibilities
undermine professional integrity
endanger trust of patients and public
How can Conflict of Interests threaten responsibilities?
Example: a PT working in one setting and then wanting to work for another company (home health) to make extra money
Not a COI unless you are sacrificing time from other patient at first job
How can COIs undermine professional integrity?
Example: If every PT left every day at 4
How can COIs endanger trust of patients and public?
example: rushing patient so you can get out early
What are the two recurring/routine Conflicts of interest? describe them.
episodic- conflicts that arise from choices made voluntarily (leaving early to go somewhere, coming in late)
systemic- conflicts that arise from the very structure of the practice or profession (ex: fee for service, MD referral, managed care, etc.)
What is the fee for service provider reimbursement model?
Ability to increase the number of procedures provided
less cost control mechanisms
over utilization can be an incentive to increase profits
what is the capitation reimbursement model?
inherent in system is an incentive to minimize use of service (restricted access)
Underutilization can be the incentive to increase profits of the MCO
What are the four components of integrity and wrongdoing?
sexual harassment
substance abuse
fraud and abuse in healthcare
whistleblowing
In regards to sexual harassment, what are the two categories defined in the EEOC (equal employment opportunity commission)?
Quid Pro Quo
Hostile Work environment
What is the definition of Quid Pro Quo
getting something for something
threats of harm or offers of benefit at the workplace (“go have drinks with me, and I’ll give you that week of that you requested”)
What is the definition of a hostile work environment
unwelcome sexual advances, requests or conduct that may unreasonable interfere with work performance or create an intimidating or offensive work environment
(needs to be made clear that the advances are unwanted, especially in a legal perspective)
Define substance abuse
anything that alters your ability to practice in a safe and competent manner
(includes: illegal drugs, alcohol, prescription drugs, “hung over”, “sleep-deprived”)
What is the definition of fraud and abuse? What is considered fraud?
Intentional misrepresentation of eligibility of:
Eligibility for goods/services or goods and services delivered/not delivered (billing for services not performed)
Abuse- misuse; to use wrongly or improperly
What is whistleblowing?
reporting problems to appropriate authorities
‘responsible’
when is whistleblowing appropriate?
when it’s morally permissible (serious harm to public is at stake)
When it is obligatory (when you have documented evidence that would convince authorities the situation exists; good reason to believe WB will lead to problems being corrected)
Understand that whistleblowing will result in personal ramifications
What are the five steps of whistleblowing?
Self-analysis (minimize bias) Discussion with person approach a supervisor take issue up the chain of commence (if not done, seem as non-credible) file a complain (must have evidence)
What are the four components of malpractice? and how many must be proved in court?
Relationship had been established
A duty was owed (as a therapist you owe a duty to a pt)
Breach of duty occurred (doesn’t treat pt with EBP to best of ability or working outside scope of practice)
Damages were suffered
ALL 4 must be proven!
Does a poor outcome constitute as malpractice?
Nope…it sure doesn’t (Good for us!) (Bad for them)
Goals for the APTA are proposed by who?
Board of Directors
The professional structure of APTA provides a three-tiered approach. What are they?
local, state, national
What are the three units at the state and national level? These represent the ________ of APTA
chapters, sections, assemblies
components
Approximately how many PTs are members of APTA
2/3
what is the most local organization unit in the structure of APTA? Where are they more commonly located
district
in locations with high population densities
What structural unit must “coincide with or be confined within the legally constituted boundaries of a state, territory, or commonwealth of the U.S. or DC”?
chapter
What unit is organized at the national level exclusively?
section
Membership in a chapter is based on what?
location of residency, employment, education, or greatest activation participation
automatic
How many chapters exist? How many sections exist?
51
18
Membership of a section is voluntary. However only ________can join
member of APTA
special interest groups are authorized by bylaws within what units? Where are they most common?
districts, chapters, and assemblies
most common in sections
What is the annual Combined Sections Meeting?
provides a mechanism for educational and business sessions
How does an assembly relate to a section?
provides a mechanism for members with common interests to meet.
how does an assembly differ from a section?
assemblies composed of members of the same class exist at state and national levels
How many officers of APTA and how many directors constitute the Board of Directors?
six officers
nine directors
who are the six officers of BoD?
president, VP, secretary, treasurer, speak of HOD and vice speaker of HOD
How many specialty areas have been approved by the HOD
8 (cardiovascular and pulmonary, clinical electrophysiology, geriatric, neurologic, orthopaedic, pediatric, sport’s, women’s health)
Foundation for Physical Therapy was established to promote what?
financial support for research in PT
the TriAlliance of health and Rehabilitation Professions was formed by what three professions to provide a greater strength when interacting with the government?
APTA
American Occupation therapy association
Speech-language-hearing association
What organization represents PT on a global level?
World Confederation for Physical Therapy
Member organizations are from 101 nations around the world
Which agency is responsible for coordinating activity among all state boards that regulation physical therapy?
federation of State boards of physical Therapy (FSBPT)
