Classroom Stuff 3 Flashcards
Is a gait belt a piece of equipmetn?
a gait belt is a safety device
What are APTA Sections concerned with?
APTA Sections are concerned with areas of specific practice settings or interests
PT definition
a health profession whose primary purpose is the promotion of human health and function
Vision Statement of the APTA
transforming society by optimizing movement to improve the human experience
Min GPA to get into the program
2.5
common cause of total knee replacement / total knee arthroplasty ?
osteoarthritis
Are you automatically a member of your appropriate chapter of the APTA?
Yes, True
What is accreditation?
process by which programs and institutions are evaluated against a set of standards that focus on functional outcomes
Visa cards and the APTA?
yes
what are rehab services concerned with?
concerned with returning an individual to their highest functional level
Acute rehab hospitals operate under a ____?
team approach
What is the purpose of licensing?
to protect the public
is there a certificate of recognition of advanced proficiency in education?
false
What does indication mean?
why modality is beneficial to patient
Do PTAs define patient goals?
no
Scleroderma
inflammatory and fibrotic changes to skin, muscles, joints, tendons, cartilage, connective tissue
Legal issues are usually who vs who?
patient vs therapist
info about disclosure information
listed on a board with every person working
includes name, year of licensure, and license number
Common reasons therapists get sued
Falls
Burns
Forceful treatments (being too pushy, had patient doing too much and then getting hurt. Careful if patient has fragile tissue, if they rupture a tendon or tear a muscle. Extra Careful if patient is post operative)
De-hissing a wound/tearing open a wound
Infection from poor sterilization techniques
using the wrong technique or procedure on a patient
making promises
incompetence
equipment malfunction
discrimination
practicing outside of your role and scope
prescribing (or recommending) medicine
No diagnosing
What is the number one reason therapists get sued?
Falls
(better hope they land on us so we can say we did everything we could to prevent their fall and protect them)
Some Types of Burns
-mostly from hot packs, moist heat burns
- ultrasounds, high frequency sound wave, if you hold it still too long its going to burn
- if a patient has metal in their body (also careful to ask for a fracture)
- ultraviolet light can cause burns
Is Malpractice insurance a requirement?
yes
this is so people who sue you can’t take your home, vehicle, etc
HPSO
Healthcare Providers Service Organization
health professional insurance company
pretty much everybody uses, good coverage
Cost of HPSO
around 80-150 a year depending on profession
PTAs are around 85 a year
Do employers often offer malpractice insurance?
yes, they often do
around how much do you get per claim?
1 mil per claim and 3 mil per year
per time, per incident, per location, per occurrence, per lifetime
what do you do if you don’t have single employer coverage?
you must carry your own policy (if you are double covered, ppl might want to sue you even more)
does the school cover you with malpractice?
yes, dictated as law in a legislative act
What is malpractice?
malpractice is anything outside the normal or expected or accepted realm of practice
Negligence
carelessness, when you’re not following rules and protocols and being careless/reckless
abuse
intent
purposeful intent to do harm
doctor oath is do no harm, Hippocratic oath
Are PTs responsible for their staff?
yes
how does licensure work?
PTs have their own license and degree, they are homogenous to themselves and are responsible for supervising PTA and PTechs
Is the PT liable if a tech does something dumb?
yes, becasue the tech does not have a license
is the PT tech liable for the PTA?
the PTAs have their own license number
PT will be questioned if they are involved, but PTAs are autonomous
Does everyone need malpractice insurance?
yes
who sues?
everybody sues
What do you need to be aware of when talking to a patient?
- if a patient tells you that they are currently in a lawsuit
- dont say you’re a student and that you don’t have a license yet
-be aware if the patietn says the only reason they’re getting physical therapy is because their lawyer says it will help their case - if they mention lawsuits almost every time you see them
- if they tell you they’ve been involved in many lawsuits
- if a patietn complains of high back or neck pain but does not guard themselves ?
- if they are overly friendly or suspiciously do not show improvement?
What can techs not do?
techs cant put hands on patient, can watch while patient is doing exercises but cannot instruct
what do you do with a suspicious patient?
might be best to make them exclusively see the physical therapist
how do we reduce chances of being in a lawsuit?
- don’t leave the patient in a compromising position
- always make sure they’re supervised, no slip and fall
- dont leave them sitting on the edge of a table
- never ever ever leave them alone
- make sure all the equipment being used is in good working condition
- don’t reveal much personal informationa bout yourself or mistakes you’ve ever made
- don’t promise cures, always be realistic about outcomes
- men shouldn’t be alone with a female patient, female patients shouldn’t be alone with male patients
- be very clear with all instructions, give written instructions ALWAYS
- be kind to everyone, treat how you want to be treated
- if you see red flags, try and finish course as soon as possible, if your’e still seeing red flags then switch to PT
- not all patients and therapists are compatible, they might not like you
- make sure that supervision is needed is always done
- if there’s personal strife between you and the patient, then step out
- if patient says treatment isn’t working and they aren’t getting better, then tell your pt you need to switch
How to politely stop working with a patient
tell pt you’re uncomfortable and want to step out
tell the patient “I just feel like i’m missing something, i just want another therapist to come over and look at you with some fresh eyes and maybe they’ll have suggestions”
always spin it so that it’s in their best interest
tell patient that new therapist is going to give a second opinion, take the L and show concern
SAFETY FIRST
keep area clean, no trip hazards, fall hazards, water, chemicals. don’t experiment, be safe always
Be aware of patients general condition, what do you do if they say they’re feeling dizzy, lightheaded, or like they are going to pass out?
even if they say they’re okay, dont’ listen. take their blood pressure and give them water. don’t ever let a patient diagnose their own wellness.
How open should you be with patients?
be honest with your patient, but don’t be revealing
there are litigious ppl out there, so be careful about what personal info you share
be friendly, but don’t share super personal info
WRITE IT DOWN
write down everything, if you didn’t write it down, it didn’t happen. if you fill out an accident report then DOCUMENT IT in documentation that you filled out an accident report
what do you do if you feel like your patient can’t do something?
talk about it with the physical therapist
HIPAA
information cannot be disclosed without your permission. you cannot share info about your patients
What do you do if a patient starts talking about personal information in a public space?
- ask if they are comfortable asking about this out in the open or if they want to discuss it in another room
- try and encourage/guide them to somewhere more private
- if that info gets out then the patient can still accuse you of violating hipaa.
- WRITE DOWN if patient refuses a private meeting
How soon do we need to notify the Nevada PT board if we change jobs and/or move?
within 30 days.
Negligence
considered extreme departure of standards of care
Gross negligence action taken against you: formal complaint, hearing, discussion on reprimand. might end up suspended or requiring direct supervision.
Malpractice
extreme departure, implies intention and harm
Action taken: hearing, fine, remidiation
Incompetence
not performing within role and scope, lacking knowledge needed for patient care
professional incompetence: judgement or reprimand, if it’s severe enough your license will be taken
Revocation
you are done. no way to apply for license to come back
Does the website show current hearings?
yes, can look up hearings or business meeting son the agenda and it will tell you who is having a hearing and for why
What does it take to get licensed to become a PTA?
- attend an accredited school, two years in length
- clinical education along with didactic/book education, need hands-on education and practical experience
What does the FSBPT do?
They’re the ones who make your licensure exam.
How many points on the exam?
maximum of 800
600 minimum
how long is the exam?
4 hours
What are the security steps before the exam?
have to give id and thumbprint, your belongings will be put into a locker. your photograph will be taken. you’re allowed to bring a pencil and a paper. then you’re taken to your cubicle to take your exam. cameras in front and on top of you
Where do the questions come from?
from a bank of writers who write questions that are peer reviewed before they are approved
practice is a living thing that is evolving, so new questions must be brought in discussing new theories of practice
questions are randomly taken from that bank for each person’s exam. everyone’s test is different.
some topics on the exam
cardiopulmonary
lymphatic
metabolic endocrine
gastrointestinal
genitourinary
system interactions
How do you prepare for the exam?
- register on fsbt website to take exam
How often is the exam?
Happens four times a year
When do most students take it?
most studetns graduate in may, but take the exam early in April
What website is used for the exam?
prometric ?
???
Did they lower the amount of questions on the exam?
yes, used to be 200, is no 160
a certain number of questions are testing you as a testtaker, so they don’t count against you but they don’t count for you either
physical therapy board website for nevada
ptboard.nv.gov
can l
NRS
nevada revised statutes
NAC
nevada administrative code
Where can you get more info about the exam?
fsbpt.org
Approximately how much does it cost to graduate from the PTA program?
15,000
What are the approximate/ rough estimate fees for getting license?
Exam: ~400
admin fee: ~56
Lic fee: ~225
fingerprints: ~50-100
Exam registration: ~25
Total: 800+
How many chances do you have to take the exam?
5 chances
6 months between usually
the first time you fail, you can take it again right away, but every time after that you have to go to the board and ask for permission
Does CSN offer exam practice classes?
No
What requirements must you meet for licensing?
must be 18 years old, have a high school diploma/ equivalency
What if you have a criminal record or a felony?
if you have a felony, you cannot get licensed
if you have misdemeanors, you must go to the board and and they’ll decide if you’ll be allowed to be licensed.
they’re looking for your effort, if you’ve turned your life around, made gains and were a good student
What is involved in a federal background check?
last 7 years of where you’ve lived, any names you’ve had
you have to do a background check before your clinicals too
if you have any kind of record or cases that are active, you have to disclose that to the facility
Continuing education facts
15 hours of continuing education every year
(some other therapist organizations are 30 every two years)
have to show verification that you took the course, name the course, when you took it, and what you learned
sometimes you have to upload pamphlet of class unless the course is already pre approved for continuing education
sometimes it costs 50 bucks to have a course reviewed for the board to give credit for it, it has to meet the criteria
Renewal fees for licensing for PTs and PTAs
and when they are due?
100 for PTAs
150 for PTS
due at the end of july every year ?
Documentation
chronological accounting of what happened in your session
written form to discuss everything about patient
MAKE NOTE OF FOR EXAM
DOCUMENTATION IS A WRITTEN FORM OF COMMUNICATION ***THAT PROVES THE NEED FOR SKILLED SERVICE
facilitates effective treatment, prevents duplication of service
justifies reimbursement
is a legal document
allows communication between patient, treatment team, and family members
if it wasn’t put into the document then it didn’t happen
how do you fix errors in documentation?
you can’t change what’s already been done but you can add an addendum, say it’s an error and fix
you can/have to redact or black out names, but you can’t erase a note
to fix something, cross it out with a single line so you can still see the words, initial it and add date
if you close a digital note, then you have to add an addendum
must be precise, concise, and our plan must always include what are we going to do next time.
does documentation account for major part of daily schedule?
yes
can patients request copies of your notes?
yes, it’s their medical history
who might end up reading your notes?
PT
patient
insurance companies (sometimes you have to write justification letters for why equipment is needed for children)
school district might see notes if shared with school therapist
doctors might see notes, to justify why things must change
who sets documentation standards?
set by the facility, different places have different standards
they are also set by accreditation agencies. ex. outpatient vs rehab facility vs hospital etc.
How often must the PT see their patient?
every 7th visit or 21 days
Nevada Law: within how many hours must documentation be done by?
within 72 hours
are documentation programs often child/pediatric friendly?
no
SOAP NOTES
subjective
objective
assessment
plan
Subjective
- what your family or caregivers report to you at the start of your session
- “how are you feeling” “pain scale” “have you been doing home exercises”
- write if patient says they tripped and fell like things, if happens also grab pt
- patient’s perspective, their idea
- something patient states, has to be relevant to physical therapy
- state of mind things, could be explanation for bad session, use quotes and things to make clear that its the patients perspective
Objective
- what you did goes in Objective
- measurable and observable data
- tests and measures, exercises you did, and everything you did in your session
Assessment
- outcome of what you did goes in Assessment
- our judgements and our opinions about what the patient did
- “shows improved reaching to floor shown by not losing balance”
- patient able to walk 3 min on treadmill at 3 grade without becoming winded and requiring breaks
- heel toe, arm swing, whatever goals are
- “complained of pain anterior something distal to patella” be very specific
- you want to be able to duplicate things
Plan
- what are we going to do next time
- you want to be specific in your plan to show your skilled service
- short term goals and long term goals, what are you focused on right now
SOAP QUESTIONS ARE ON THE FINAL EXAM
KNOW THIS STUFF
Subjective
objective
assessment
plan
PROM
passive range of motion
CNS
central nervous system
C&S
culture and sensitivity
TID
three times a day
BID
two times a day
PRN
as needed
Hx
History
NPO
nothing by mouth
2 ° / 2
secondary to
THR
total hip replacement
TKR
total knee replacement
TAR
Total Ankle replacement
TSR
TOTAL SHOULDER REPLACEMENT
AKA
ABOVE THE KNEE AMPUTATION
BKA
BELOW THE KNEE AMPUTATION
RUE
RIGHT UPPER EXTREMITY
LUE
LEFT UPPER EXTREMITY
L
left
R
right
B
bilateral
C
contralateral
BRP
bathroom privileges
IR
intralateral
ER
external rotation
Flex ->
can also be a checkmark?
flexion
EXT ->
can also be a checkmark?
extension
NSAID
nonsteroidal anti-inflammatory drug
LE
lower extremity
UE
upper extremity
c with line on top
with
s with line on top
without
a with line on top
before
p with line on top
after
>
more
<
less
=
equal
diagonal =
parallel bars
+/-
with or without
+/- with diagonal =
with or without parallel bars
Sx
surgery
Tx
treatment or traction, means both
Hx
history
Dx
diagnosis
Med
medial
Lat
lateral
L/S
lumbar spine
C/S
cervical spine
T/S
thoracic spines
arrow pointing up
arrow pointing down
arrow pointing right
toward
arrow pointing left
behind
arrow pointing in both directions
to and from, or sit to stand
SPT
Student of Physical Therapy
SPTA
Student of Physical Therapy Assistance
MaxA
max assist
MinA
minimum assist
Mod A
modification assist
TA
transfer assist or total assist
FWW
front wheel walker
W/C
wheelchair
MaxA x4
means you need four people to help you assist
MaxA x6 = need six people to assist
etc with rest of the numbers
