Chapter 16: Mastery of the Environment & Work

Question 1

Omnibus Budget Reconciliation Act (OBRA)

Answer 1

Mandates that physical restraints cannot be used without proper justification, agreement, and documentation

Question 2

Principles of Universal Design

Answer 2

Equitable: design is useful and marketable to people with diverse abilities. Flexibility in use: design accommodates wide range of preference and abilities. Simple and intuitive use: easy to understand regardless of cognitive abilities or language. Perceptible information: variety of modes to communicate (uses picture, verbal, tactile), high contrast etc. Tolerance for Error: provide warnings, design minimizes hazards. Low Physical Effort: design can be used efficiently with a minimum of fatigue. Size & Space for Approach & Use.

Question 3

Minimum doorway clearance width for w/c

Answer 3

minimum is 32 inches, ideal is 36 inches

Question 4

Hallway width minimum

Answer 4

36 inches

Question 5

360 w/c turning space requirement

Answer 5

60 inches x 60 inches

Question 6

Pathway and walkway minimum width

Answer 6

48 inches

Question 7

Ramps width and slope

Answer 7

width 36 inches, slope ratio 1:12 (for every 1 inch of vertical rise, 12 inches of ramp is required)

Question 8

When are 4’x4’ landings (level platforms) indicated?

Answer 8

If the ramp is excessively long for resting, if the person using the ramp has limited UE strength or cardiopulmonary capacity, sharp turns.

Question 9

When are 4’x4’ landings (level platforms) indicated?

Answer 9

If the ramp is excessively long for resting, if the person using the ramp has limited UE strength or cardiopulmonary capacity, sharp turns.

Question 10

Lofstrand Crutches

Answer 10

Proximal arm has closure around it instead of support in axillary region.

Question 11

Bed mobility post hip replacement

Answer 11

May not be permitted to roll onto non operated side. This may result in internal rotation of operated hip. May require abductor pillow between LEs.

Question 12

Bed mobility post CVA

Answer 12

Side lying for sleeping: Humeral flexion and slight abduction, may require pillows between knees

Question 13

Supplemental Transportation

Answer 13

Volunteer, nonprofit, or community-based transport for older adults and people with disabilites. Based on being available, acceptable, accessible, adaptable, and affordable.

Question 14

SAFETEA-LU Act

Answer 14

The safe, accountable, flexible, efficient transportation equity act: A legacy for users. Established safe routes for walking and biking to schools.

Question 15

Community mobility intervention: Systems-level intervention

Answer 15

Addressing community mobility by consultation with transportation systems on issues such as design and accessibility.

Question 16

Primary programs

Answer 16

focus on protecting healthy workers against a targeted condition before the condition occurs.

Question 17

Secondary programs

Answer 17

emphasize early detection and intervention with asymptomatic workers at risk for work-related medical problems or treatment of workers with mild medical symptoms or reversible stages of injury. Comprehensive injury prevention programs incorporate all three phases of prevention programs (primary, secondary, and tertiary) and may include worksite and ergonomic interventions.

Question 18

tertiary prevention program

Answer 18

occurs after the worker sustains an injury, illness, or disease. It includes treatment of medical problems and attempts to restore maximum function in the workplace and prevention of injury, illness, or disease-related complications.

Question 19

Ergonomics Intervention: Engineering Controls

Answer 19

Modifications of the environment, the workstation, and setup. e.g. workstation checklist, workstation components such as the keyboard

Question 20

Ergonomics Intervention: Work Practice Controls

Answer 20

Modification of work habits through adaptive devices or strategies. Implementing factorywide stretching exercises is an example of work practice controls.

Question 21

Ergonomics Intervention: Administrative Controls

Answer 21

Changes in line speed, staffing, physical demands of job, enforcing rest breaks, worker education, etc.

Question 22

Work Readiness Program

Answer 22

Identify goals for work and makes a plan for returning to work. Used only for RETURNING to work, not in transitional programs. Work readiness programs help individuals who want to work identify vocational options that match their interests, skill, and abilities.

Question 23

Work Hardening

Answer 23

interdisciplinary, real or simulated work, address productivity, safety, physical tolerance, and behaviors. CARF accreditation required.

Question 24

Work Conditioning Program

Answer 24

One discipline provides services, real or simulated work, addresses flexibility, strength, and endurance.

Question 25

Job Demand Analysis

Answer 25

Defines the actual demands of the job through questionnaires, interviews, observation, assessments, official job description, all at the workplace. It is essential to determine which parts of the job are essential vs marginal.

Question 26

Work Tolerance Screening

Answer 26

Assesses a client’s physical and cognitive abilities to meet the demands of a job they got offered.

Question 27

Worksite Evaluation

Answer 27

On the site assessment to determine whether a client can return to work after disability and if they need reasonable accomodations

Question 28

Indications to perform a Functional Capacity Evaluation:

Answer 28

To identify worker restrictions and to determine whether the person has the capacity for a job. A means to confirm or rule out a diagnosis, to limit physicians liability, to determine whether a worker is a candidate for remedial/vocational rehab, to see if the worker has been abused by the system, to determine reasonable accommodations, to determine impairment and disability ratings.

Question 29

Functional Capacity Evaluation (FCE)

Answer 29

provides information about a client’s physical abilities to complete a specific job activity. The core of all return to work programs. Assessment of a person’s ability to work through review of medical charts, interview, musculoskeletal screening, physical performance, formation of recommendations, and report generation. Not recommended for novice clinician to perform.

Question 30

Indications to perform a Functional Capacity Evaluation:

Answer 30

To identify worker restrictions and to determine whether the person has the capacity for a job. A means to confirm or rule out a diagnosis, to limit physicians liability, to determine whether a worker is a candidate for remedial/vocational rehab, to see if the worker has been abused by the system, to determine reasonable accommodations, to determine impairment and disability ratings.

Question 31

Vocational Evaluation

Answer 31

may be conducted for a person who has not worked previously, who has been injured and is preparing to return to work, or is unable to return to a previous job. Vocational evaluation may be general or specific addressing a person’s potential for work or readiness to return to a specific occupation.Assesses person’s capacities and interests for work in new work settings.

Question 32

Workbench Heights

Answer 32

Precision work: above the elbow, light work: just below the elbow, Heavy work: 4-6 inches below elbow.

Question 33

transition-related evaluation

Answer 33

uses situational observation, interview, and activity analysis to determine a match between the client’s abilities and expected occupational performance.

Question 34

disability rating

Answer 34

considers the worker’s impairment and the impact of the impairment on the client’s ability to perform preinjury for any job and considers the unique characteristics of the job. (Impairment rating does not take into account the unique factors relating to worker vocation.)

Question 35

impairment rating

Answer 35

relates to the percentage of whole-body function and translates to a final monetary settlement for an injured worker. Impairment rating focuses on permanent quantifiable physical loss related to injury when the client is considered to be at the maximum medical endpoint (after all therapy)

Question 36

Fitness-for-duty tests

Answer 36

completed by occupational medicine physicians after injury

Question 37

Job coaching

Answer 37

provides vocational evaluation to identify a client’s vocational interests and abilities along with physical and mental tolerances for general job activities

Question 38

Work tolerance screenings

Answer 38

Usually done after someone has a job offer. Assesses physical and cognitive abilities to meet demands of job. identifies limitations in the worker’s ability to meet the activity demands of essential job functions, such as weights, distances, forces, angles, repetitions, and tools. .

Question 39

hierarchy of functional return

Answer 39

gradual gradation of tasks from gross to fine motor movements, increased resistance, and repetition from simple to complex tasks with postural changes to promote neuromuscular reeducation. E.g.: Manipulation of small objects, performance of reaching tasks, lifting objects with increasing speed and resistance from floor to waist

Question 40

Four characteristics of successful implementation of a successful work injury prevention program

Answer 40

ongoing management support, supervisory support, employee participation, and ongoing support and reinforcement of program

Question 41

Work therapy

Answer 41

work tasks to improve function during the acute rehabilitation phase of recovery.