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Intro The Physical Therapy Practice > Chapter 7 Laws and Regulations > Flashcards

Chapter 7 Laws and Regulations Flashcards

1
Q

Constitutional laws

A
  • highest authority from constitution, federal and state

- first 10 amendments including the Bill of Rights

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2
Q

What is the bill of rights?

A

To protect us from government overreaching, include freedom from unreasonable searches/seizures, from being tried twice for the same crime

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3
Q

Statutory laws

A

-Second highest the laws, And acted by Congress and state legislatures

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4
Q

Common laws ( and civil laws)

A

Legal precedents set by charges

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5
Q

Administrative or Regulatory laws

A

Laws enacted by administrative agencies at federal, state, and local levels like Medicare or occupational safety and health (OSHA)

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6
Q

American American disabilities act (ADA)

A

1-prevents discrimination against persons with disabilities in areas of employment, public accommodations, government services, and telecommunications.

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7
Q

Defines disability the (ADA)

A
  • physical or mental impairment that women it’s at least one major life activity (ADLs, ability to see, hear, speak, walk, care for self,, perform manual tasks, Engage in learning activities)

=== the person with a disability does need documentation of their disability===

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8
Q

American disability association title 1: Employment discrimination (1992)

A

1-For employers employing 15+
2-person cannot be discriminated against if they qualified to perform the essential functions of the job
3- qualified individual must be able to perform the essential functions of a job with or without reasonable accommodations
4-

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9
Q

What are some reasonable accommodations for the ADA Title I: Employment Discrimination 1992

A
  • Making physical changes examples would be ramps or modifying office /bathrooms
  • Providing sign language interpreters for deaf, readers for the blind
  • Providing quieter places to decrease distractions for mentally disabled
  • providing training/written Materials in BRAILLE , audiotape, large prints, reader
  • providing teletypewriters (TTYs) for you with telephones for the deaf, software programs for vision impairments/hand impairments
  • Time off for treatment of disability
  • must be done upon request unless employer can prove “undo hardship” such as excessively difficult, costly, Disruptive, or would fundamentally change business
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10
Q

Title II

A

Discrimination related to equal access to public and transport services

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11
Q

Title III

A

Discrimination related to public accommodations

  • includes all private businesses and services
  • does not include religious and some private clubs
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12
Q

Title IV

A

Discrimination related to equal access in telecommunications services

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13
Q

Title V

A

Miscellaneous, States are not exempt, advocates cannot be retaliated against

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14
Q

Individuals with disabilities education act (IDEA)

A

It is a law introduced in 1975 and modified in 1997 ensuring services two children with disabilities.

  • governs how states and public agencies provide early education and special education
  • children ages 3- 21 receive special Ed/services under part B
  • children birth-2 receive early intervention services with their families under part C
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15
Q

Purpose of IDEA

A
  • ensure that all children with disabilities have available to them a free appropriate public education
  • ensure the rights of children with disabilities are protected
  • provide for early intervention multidisciplinary services
  • ensure that parents and educators have the tools they need
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16
Q

What is PTs primary goal for children?

A

Identifying and serving children with disabilities by developing and implementing cost-effective services within schools setting and an overall quality of life

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17
Q

PT and PTAs provide what for children?

A

Early PT services for infants and toddlers and older children with disabilities in educational programs

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18
Q

What is the roles for PT/PTA early intervention with children?

A

(infant/toddler’s with disabilities)

  • consult with parents and providers to ensure effective services
  • train parents and others
  • multidisciplinary team assessments of children and their family
  • develop goals for individualized family service plan
  • screen, evaluate, assess infants to identify movement dysfunctions
  • program planning to prevent, alleviate, or compensate for movement dysfunctions, and provide individual or group services to goals
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19
Q

Licensure Laws contain what?

A

1- Enacted by all states to give licensees the exclusive right to practice their profession and protect consumers against professional incompetence.

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20
Q

Licensure Laws are called “practice acts” for:

A
  • Licensure educated in US been in foreign countries and relicensure
  • continuing education
  • temporary licensure
  • reporting of unethical conduct
  • restrictions, if any, on direct access
  • provisions defining ground/procedures for disciplinary action
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21
Q

More on Licensure Laws

A
  • violations punishable as criminal offenses and form basis for civil malpractice lawsuits
  • PTs are licensed in all states, PTAs and all but 48 (certified into remaining states)
22
Q

What are the minimum state regulations to become a PTA?

A
  • require a graduation from CAPTE accredited program
  • require NPTE (as developed/ directed by the FSBPT)
  • provide title protection
  • provide for disciplinary action
  • many require jurisprudence exams (separate exams over the states specific practice art)
  • Licensure includes defined scope of practice
  • State laws define the amount of PT direction and supervision (also the number of PTAs each PT is allowed to supervise/Length of time between PT/PTA consultations)
23
Q

Occupational safety and health administration (OSHA)

A

-Federal government agency concerned with the health and safety of workers

24
Q

What are OSHA’s duties?

A

Developed protective standards and enforced standards.

25
Q

Bloodborn pathogen’s standard?

A
  • Protect workers against blood or infectious agents
    1. Have a plan to minimize risks of blood exposure and provide training
    2. Require use of universal precautions and provide PPE
    3. Provide work areas with minimized risk-sharps, containers, laundry equipment etc…
    4. Provide hepatitis B vaccinations and post exposure exams
26
Q

Universal precautions?

A

-treat all blood and body fluids as if they were infectious

=== include semen, vaginal secretions, cerebral spinal fluid, synovial fluid, saliva, etc.

27
Q

Methods of infection control?

A
  • work practices like careful hand washing immediately after removing gloves and before working with a patient
  • safe procedures for handling sharps, Use of sharps containers
  • immediately report any exposure to needle sticks/blood splashes
  • disposal and handling of contaminated waste
  • use of PPE, especially gloves, gowns and goggles
  • use of mouthpieces, resuscitation bags
  • use of disinfectants
  • labeling and signs
  • training and educations
  • Post-exposure follow up
28
Q

Domestic violence/abuse, Intimate partner violence (IPV) or battering:

A
  • occurs between people in intimate relationships and involves: Coercion, threats, Intimidations, Isolation, Emotional, Sexual, and physical abuse.
  • found in all races, religions, ages, socioeconomic groups and ethnicities
29
Q

More on domestic violence?

A
  • It is often not reported but involves more then 12 million women and men physically abused, raped or stocked by their partners, with about 1000 deaths.
  • it is estimated at 27% of women and 11.5% of men for physically or sexually abused by an intimate partner at some point in their lives, with greater than 15 million children in these families
  • One study found that 1 in 10 adults greater than 60 experienced abuse each year.
30
Q

What are some domestic violence patterns

A

=== the abuser always seeks power and control===

Physical and sexual violence–hitting, kicking, Forcing the partner against their will

  • using children as pawns, accusing their partner of bad parenting, threatening to take child away, using kids to relay messages
  • denial of the abuse, shifting the blame to their partner
  • coercion and threats, like hurting pets, children, even themselves
  • economic abuse–controlling all finances, refusing to share money, not allowing partner to be employed, demanding an accounting of all money spent
  • intimidation–Breaking things, instilling fear, abusing pets
  • emotional abuse–insults, name-calling, criticism

–isolation–limiting contact with family and friends

-controlling, treating partner as a possession or servant

31
Q

Most victims are reluctant to report domestic abuse

A

-not realizing impact of abuse, fear or partner/sharing, embarrassment

32
Q

Healthcare providers experience difficulty in helping

A
  • lack of knowledge of community resources
  • fear of offending the victim and jeopardizing the patient relationship
  • lack of time/training/feeling and able to help
  • victims appointments are in frequent
  • victim is unresponsive to question/offers to help
33
Q

Domestic violence results in not only physical injuries, but has devastating mental health consequences what is one?

A

-Post traumatic stress disorder, depression, suicide, Substance abuse, and anxiety disorder

34
Q

Signs of abuse?

A
  • the abuser always the accompanies the victim to appointments, refusing to leave their side and using verbal/Nonverbal communication to direct answers to questions
  • patient is noncompliant with the home program or frequent missed appointments, abuser canceling patient appointments
  • patient statements about not being allowed to take meds
  • patient changing therapist frequently
  • patient whacking independent transportation, access to finances, or ability to communicate by phone
  • abuser portraying themselves as good caregiver and constantly praising therapists
  • harassing therapist with threats of legal action, reporting to superiors
  • creating divisions among healthcare team
35
Q

More signs of abuse?

A
  • injuries -burns, lacerations, etc…
  • injuries during pregnancy
  • repeated and chronic injuries
  • unattended gynecological problems
  • symptoms of stress, anxiety, depression
  • hyper vigilant signs, easily startled, guarded
  • suicide attempts, self mutilation, eating disorders
  • car accidents
  • overuse of prescription painkillers
36
Q

Helping with domestic abuse how can I?

A
  • observe the victim for physical/behavioral clues
  • ask–question the victim and validate the abuse
  • respect the victims privacy
  • assess and treat the victim
  • keep accurate records and concise documentation of the abuse
  • support and follow up on the victims care
  • make available information about healthy relationships, parenting skills, and warning signs of abuse
  • inform the victims that domestic abuse can’t spread to other types of abuse
37
Q

PT/PTAs can help

Therapist have ethical duty to help:

A
  • if PTA has suspicions, these should be reported to the PT
  • ask direct questions about injuries, evasive behavior, fear of partner (ask when away from partner/family member)
  • consult with legal counsel to determine legal obligations to report the abuse (consult with patient to permit them to get to safety)
  • detailed documentation in the medical chart, can be evidence if need in court, includes details and photographs with informed consent.
  • establish department guidelines for identifying abuse and protocol for what to do when identifying abuse
  • have legally required notifications and release of information to the proper authorities available
  • have available a list of appropriate referrals for victims
  • provide in-service training in continuing Ed about domestic violence to our PT person now
38
Q

Questions to ask for domestic abuse?

A
  • I am concerned about your symptoms, has someone been hurting you? Did someone hit you?
  • you seem to be concerned about your partner, are you having problems with them? What types of problems?
  • how does your partner feel about you having PT?
39
Q

Questions not to ask for domestic abuse?

A
  • why would you stay with someone like that?
  • what could you have done to diffuse the situation?
  • why don’t you just leave?
  • what did you do to aggravate your partner?
  • did you do something to cause this?
40
Q

What is elder abuse?

A
  • when someone knowingly, intentionally, or by negligence causes harm to an older adult
  • can be physical, sexual, Negligence, exportation, emotional abuse, abandonment, or not confronting an elder’s self neglect
  • grants are available for staff training in elderly facilities
41
Q

What’s harassment in the workplace?

A
  • unwanted contact, possibly do to race, color, religion, sex, age, Or disability from supervisors, coworkers, Those who are not employees, such as patients
  • is illegal when it affects continued employment or is intimidating or hostile in nature
  • generally, the employee should express feelings to the person directly or to the supervisor (who has responsibility it is to prevent this from happening)
  • consequences for the perpetrator include referral for training/counseling, reprimand, demotion, reassignment, loss of employment or criminal case
  • PT/PTA should have response is ready for inappropriate patient comments. Don’t be shy to tell patients.
  • it is not legal for patients and therapist to date.
  • that comment is not appropriate in the clinical environment
42
Q

What is fraud?

A
  • knowingly misrepresenting the truth or concealing the facts to the detriment of another
  • billing for him provided services, referring patient to a clinic for financial gain.
43
Q

What is abuse?

A
  • often means misuse or unintentional, but can mean physical harm.
  • using inappropriate billing CPT codes, Providing unneeded services
44
Q

What happens if you fail to report suspected physical abuse?

A
  • healthcare providers are required to report suspected child, domestic or elder abuse.
  • failure to report may be considered a breach of duty
  • Report to supervising PT first and document all signs and symptoms
45
Q

Malpractice Law?

A

-liabilities-generating contact on the part of a clinician associated with an adverse outcome of patient care

46
Q

Legal responsibility with in the Pt/ Pta team?

A
  • every member of the team is responsible for knowing the state therapy laws, the state “practice art”
  • PTAs must know the state laws
  • Stating “the PTA told me to do it” does not get you off the hook
  • must report all inappropriate behaviors
  • PTA retains ultimate responsibility for any actions of the PTA
47
Q

What is vicarious liability?

A
  • it means the PT is ultimately responsible for the actions of the PTA
  • PT may also be held liable went to PTA is found liable
48
Q

Professional negligence

A

Substandard care

49
Q

Intentional misconduct

A

-It includes violations of ethics
-patient injury from abnormally dangerous a treatment activities or defective patient equipment/supplies
-PT and PTAs can both be sued but the supervising PT is the primary person liable PT/PTA supervising non-licensed staff are responsible for their actions
—sanctions can include:
Licensure restrictions / denial, fines, monetary awards

50
Q

What is negligence?

A

Failing to do what another competent clinician would have done under similar circumstances, failing to give reasonable care or providing unreasonable care

  • PT/PTAs and students are all liable for their own negligence, even if the supervising PT is also liable
  • occurs only one home to patient actually occurs
  • to prove negligence, the patient must prove that they were harmed when the therapist did something wrong or fail to do something that normally would have been done
  • therapist need to show that they perform correctly and safely, and this should be demonstrated in their notes
  • for example: if a patient became injured not following hip precautions, the PT/PTA Would have to demonstrate in documentation Proof of both giving proper instructions and the patient understanding them
51
Q

Healthcare malpractice?

A

Here are some examples of malpractice involving PT/PTA/students:

  • Burns due to lack of paddling/defective equipment (most common malpractice suit against therapist)
  • utilization of defective equipment
  • patient falls during gait training or exercise it injuries
  • any action inconsistent with the code of ethics
  • expert witnesses can be called and their question to answer:
  • would the treatment performed be what a competent therapist should do in that given situation?
  • patients have a 1-4 years statue of limitations after injury to make a claim
  • always make sure that employers have malpractice insurance (and they should) and therapist should consider taking out their own personal policies

Intro The Physical Therapy Practice (12 decks)

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