Chapter 26: Hospital and Pediatric Rehabilitation Services

Question 1

Acute Care (Acute rehabilitation)

Answer 1

Those wherein therapy services are ordered directly from a medical service or unit
Example: Intensive care neurology and neurosurgery, oncology or cancer care, general surgery, orthopedics, heart and pulmonary services, and, in many children’s hospitals, transplant services).

Question 2

Pediatric Rehabilitation Services

Answer 2

Often located within a specific location of the hospital that may include special facilities with bedrooms and bathrooms to enable effective independence training with lifts, mobility devices, and other durable medical equipment
Spaces for individual and group intervention, socialization, and group engagements are often available as well

Question 3

Outpatient Services

Answer 3

Include both regularly scheduled specialty clinics that address children and families ongoing needs, and individual child services in community-based satellite clinics or school-based programs.

Question 4

American Medical Association’s Current Procedural Terminology (CPT) Codes & Healthcare Common Procedure Coding System (HCPCS)

Answer 4

his system uses preestablished rates of reimbursement for diagnostic groups using the Healthcare Common Procedure Coding System (HCPCS) for billing that is based on the American Medical Association’s Current Procedural Terminology (CPT) codes.
Payers do take these guidelines into consideration when authorizing care for inpatient stays.
The OT should be aware of payment limitations when providing care and clearly communicate with families when establishing treatment plans and scope of services being anticipated and provided.

Question 5

Centers or Medicare and Medicaid Services (CMMS)

Answer 5

Designate requirements for services that are organized and paid to provide “medical rehabilitation.”
To meet CMS guidelines for rehabilitation, rules are placed on such systems that mandate specific program emphasis, dedicated space and personnel, admission and discharge procedures, service intensity, goal setting, and monitoring of progress toward goals.

Question 6

Child life Specialists

Answer 6

Attend to children’s emotional and developmental needs. They may help reduce the stresses of a hospital stay by assisting families in coping with the hospital experience by providing information about play, child development, and adjustment to illness, disease, and disability.

Question 7

Child Protective Services

Answer 7

OT’s are required to report any suspicion of abuse to designated personnel within the hospital setting, who, when appropriate, contact community support services such as law enforcement personnel

Question 8

Children’s hospitals

Answer 8

Hospital-based services may include either or both inpatient and outpatient care for the ill and injured, as well as prevention or wellness programs designed to reduce the need for future care.
Hospitals in which pediatric patients are served generally fall into three categories: general hospitals, trauma centers, and children’s hospitals

Question 9

Most rehabilitation programs also pursue voluntary accreditation by groups such as the

Answer 9

Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the Commission on Accreditation of Rehabilitation Facilities (CARF) as well as government agencies, such as the Occupational Safety and Health Administration (OSHA) that set standards regarding hospital operations.

Question 10

Compensatory Techniques

Answer 10

In the rehabilitative approach, occupational therapists teach clients compensatory techniques that use existing skills to restore occupational performance.

Question 11

Critical care units/ Intensive Care Units

Answer 11

Critically ill patients who require continuous monitoring and frequent medical attention and patients who often need special equipment to maintain or monitor vital functions are admitted to one of these

Question 12

Neonatal intensive care units

Answer 12

Often in hospitals that offer labor and delivery services that include OT

Question 13

Pediatric intensive care units

Answer 13

ICU for kids

Question 14

Dependence

Answer 14

Book says this is negative soooo?

Question 15

Levels of Independence

Answer 15

Describe varying degrees of dependence on personal assistance, adaptive environments, and the use of assistive technology (AT) device

Question 16

Interdependence

Answer 16

Important consideration among family members when concerned with the integration of an individual back into his or her home

Question 17

Interreliance

Answer 17

Term to express shared needs between family members may be termed

Question 18

General acute care

Answer 18

Tend to be designated by medical specialty
Children of various ages, with different types of conditions and treatments, may be served in the same acute care unit.
Similarly, children requiring different types of surgery may be admitted to the same general surgical unit for preoperative and postoperative care.
Designating units in this manner generally enables physicians and other members of the medical team to use their patient-care time and equipment more efficiently.

Question 19

General hospitals

Answer 19

Strive to serve the needs of the community in which they are located.
Given specific local populations, a wide variety of patients can be served in this type of hospital and this often includes the entire lifespan from infants to geriatrics.
OTs may serve both pediatric and adult patients.
Hospitals that offer labor and delivery services often have neonatal intensive care services that include OT services

Question 20

Guided learning

Answer 20

OT uses instructional aids, such as visual supports, visual modeling, touch cues, or verbal instruction.

Question 21

Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs)

Answer 21

have proliferated, and many families are now insured in these and other managed care plans.

Question 22

Prospective payment options

Answer 22

created within Medicare to better estimate and contain costs, can have strong impacts on reimbursement for services. This system uses preestablished rates of reimbursement for diagnostic groups using the Healthcare Common Procedure Coding System (HCPCS) for billing that is based on the American Medical Association’s Current Procedural Terminology (CPT) codes.

Question 23

Residential/Intensive day-treatment programs

Answer 23

Characterize another form of outpatient pediatric rehabilitation service.
These extended care programs focus on direct assistance with community reentry and participation.
Simulated or actual environments become the training site for skills that enable community participation and effective performance toward goals of independent living, education, and work activities.

Question 24

Interdisciplinary

Answer 24

(also referred to as interprofessional) care within a hospital or medical system is common and mandated by most regulatory mechanisms.
Success depends on a shared mission focused on energy and creativity.
The team holds family conferences on admission, at key decision points during the hospitalization, and at discharge to ensure communication and clarification of care recommendations with the family and local care providers.
Also conducts weekly rounds to review the progress of each child and discuss any changes in treatment plans that are designed for each problem.

Question 25

Learned Helplessness

Answer 25

A condition in which the child or adolescent stops engaging in activities that are painful or aversive.
The child becomes dependent on others rather than trying to engage fully.

Question 26

Occupational Safety and Health Administration (OSHA)

Answer 26

Set standards regarding hospital operations

Question 27

Palliative

Answer 27

Change in focus of treatment when cure is not an option
OT working with the dying child and his or her family must respect the cultural beliefs of the family, along with grief processes.
Can assist by suggesting energy conservation techniques to enable play and interacting
Positioning becomes important as the child develops increased weakness, difficulty with breath support, or pain, and the OT can help families problem-solve alternative positioning to be close to their child when comfort is of utmost importance
Important to respect the family and child’s wishes for withdrawal or continuation of services.

Question 28

Physical Agent Modalities

Answer 28

Include superficial heat or cold may also be used, whereas deep-heating techniques such as ultrasound are often avoided because children’s bone epiphyseal (growth plates) areas may be damaged

Question 29

Primary Prevention

Answer 29

Term used to denote efforts that decrease the likelihood of accidents, violence, or disease for everyone.

Question 30

Secondary Prevention/Tertiary Prevention

Answer 30

Refers to specific interventions, arrangement of care systems, and environmental modifications to prevent the onset of problems among at-risk populations.
Children admitted to the hospital are typically at risk for developing a number of secondary disabilities.

Question 31

Progressive exercise

Answer 31

For children and adolescents with musculoskeletal and lower motor neuron or motor unit disorders

Question 32

Rehabilitative approach

Answer 32

OTs teach clients compensatory techniques that use existing skills to restore occupational performance
Teach clients to use adapted routines and AT devices and modify environments to promote optimal manipulation, mobility, cognition, and communication function.

Question 33

Special care units

Answer 33

Children with infectious conditions may have a variety of diagnoses that require isolation conditions
Three conditions that require a child to be treated in a special care unit are (1) acute burns, (2) infectious diseases, and (3) bone marrow transplantation.

Question 34

Surgical intensive care units

Answer 34

The SICU provides a high level of intensive care to critically-ill patients from specialists who are affiliated with General Surgery, Orthopedics, Vascular Surgery, Gynecology-Obstetrics, Transplantation (liver, pancreas, bowel, and kidney), and Urology.

Question 35

Trauma Centers

Answer 35

Hospitals organized and certified to treat patients with more acute life-threatening injuries or disorders. Usually situated in large metropolitan areas, patients taken to trauma centers may have extensive musculoskeletal, neurological, skin, and internal organ injuries requiring multiple specialists.