chapter 3 Flashcards
Guide to Physical Therapist Practice
-1st edition of clinical guidelines for PTS created in 1997 by APTA.
-defines pt practice
-defines the roles of PT and PTA,
-defines terminology,
-creates roadmap for PT diagnosis & prognosis & POC
-describes settings and practices
Guide to Physical therapist practice 3.0
-created in 2014, so that the language is more consistent with the ICF
patient and client management model has 6 elements
1)examination
2)evaluation
3)diagnosis
4)prognosis
5)intervention
6)outcomes
patient
individual who receives healthcare vices, PT is chosen for them
client
individual who is not injured but can benefit from a PT’s advice and services.
Examination
process for gathering subjective and objective data about the patient/client
3 components of examination
1) patient/client history
2) systems review
3) tests and measures
evaluation
dynamic process in which the PT makes clinical judgements during examination.
-evaluation results in diagnosis, prognosis, and interventions.
interventions
skilled techniques and activities that make up treatment plans
discharge
the process of discontinuing interventions in a single episode of care.
goals
functional activities that are the intended response to PT intervention
outcome
the actual functional activity that is achieved by the physical therapy episode of care.
how is the value of physical therapy documented?
by measuring preintervention and postintervention outcomes.
components of physical therapy examination and evaluation
1)patient/ client history
2) systems review
3) tests and measures
4) diagnosis/ physical therapy diagnostic process
5) impairments
6)activity limitations
7) participation restriction
8) disability
9) prognosis
10)interventions
impairments
abnormalities or dysfunctions of body structure or function.
EX- muscle spams, inflammation of ligament
activity limitations
inabilities of patient/client to function in their environment.
EX- brushing hair, dressing ADL
participation restriction
challenges a person faces to interact with the world around them
-EX- inability to work, attend church
disability
inability to perform in activities related to a person job, home, or community. it changes their social roles
EX-inability to care for their home
ICF
international classification of functioning, disability and health
- medical and social model that focuses on a persons well-being and function, not just their disease/ disorder.
components of ICF (6)
1)health condition
2)body functions
3)body structures
4)personal traits
5)environmental traits
6) activity
medical diagnosis
determined by physician who identifies an illness or disorder in a patient.
EX- pneumonia
physical therapy diagnosis
determined by PT. end result of evaluating patient from examination, which the PT determines the most appropriate intervention strategies.
EX- treating endurance problems
3 components of PT intervention
1) Coordination
2)Communication
3)Documentation
discharge
the process of ending physical therapy services when goals and expected outcomes have been achieved.
discontinuation
process of discontinuing interventions because 1)patient/client declines intervention
2) patient/client is unable to continue to progress towards goals because of medical complications/ $
3) PT determines patient/client will not benefit from physical therapy.
Acute care facilities
-practiced in hospitals where patients usually remain for a short period of time.
-less than 30 days
-fast paced ever changing environment
primary care facilities
healthcare practice provided by a primary care physician. PT supports the physician as part of the primary care team.
subacute facilities
intermediate level of care for medically fragile patients too ill to be cared for at home.
-offered in subacute hospital or a skilled nursing facility.
3 types of SNF’s
1) providing subacute care (a higher level of care than in extended care)
2) providing transitional care (hospital based SNF)
3) providing extended care
Transitional care SNF
discharged to home, assisted living facilities, or extended care SNFs.
Extended care SNFs
freestanding or may be part of a hospital
-provide services on a daily basis, 7 days per week.
outpatient
ambulatory care
-medical offices, surgery centers, and outpatient clinics.
-less costly than inpatient
rehabilitation hospitals
provide rehab to patients who have a disability, affecting their maximal functional capacity.
chronic care
-long term facilities
-60 days or longer
-treat patients who have permanent or residual disabilities caused by nonreversible phytological health conditions
hospice care
offers care for patients who are terminally ill and dying.
home health care
provided to patients in their home environments (homebound)
-every 30 days a new evaluation needs to be done
school system
works with teachers and parents to develop IEP for student who has a disability. POCA so that they can attend to the teacher.
Practice areas of physical therapy
1) orthopedic physical therapy
2) neurologic physical therapy
3)cardiovascular and pulmonary physical therapy
4)pediatric physical therapy
5)geriatric
6)integumentary
7)ONCOLOGY
8) women’s health
9)clinical electrophysiology
Policy
a broad statement that guides the decision-making process.
-represents a principle, law, or decision that guides actions
example of a policy
-time off
-dress code
-vacation
procedure
defined as specific guides to job functions for all departmental personnel, visitors, and patients in order to standardize activities with a high level risk.
example of procedure
-equipment management, cleaning/maintenance
-safety and emergency procedures
-hazardous waste management
Departmental meetings
-Staff/departmental meetings
-team meetings: scheduled weekly involving interdisplinary team members (nurse, OT, PTA, etc.)
-supervisory meetings: between PT and PTA
- strategic planning meetings: planning for future, time-related
Budget
A financial projection for a specific time period of the amount of funds allocated to cover specific aspects of operating a building.
operating expense budget
financial projection related to daily organizational/departmental organization.
EX- salaries, benefits,utilites
capital expense budget
financial projection related to the purchase of large items for future use.
EX- buying a treadmill
accounts receivable budget
financial projection assessing expected benefits from future operations.
EX-$ owed to company
accounts payable budget
financial projection assessing money owed to a creditor that provides services/ equipment to company.
4 different costs
1) Direct costs
2) indirect costs
3) variable costs
4) fixed costs
direct costs
costs directly related to the provision of PT services.
EX- salaries, equipment
indirect costs
EX- housekeeping, laundry
variable costs
not fixed and can vary depending on volume of services
EX- linen or utilities cost, which increases with number of patients
fixed costs
EX- rent
Quality Assurance
activities and programs implemented in a clinic to achieve high quality levels of care.
Primary prevention
preventing disease before it happens
EX- wearing a helmet
secondary prevention
identifying disease before it becomes a problem
EX- mammograph, IB test
tertiary prevention
-preventing disease from getting worse
EX- therapy, medicine
