Client-specific Flashcards

Deliver and monitor a client-specific physiotherapy program

1
Q

Some AHA duties and requirements:

A

Read clients charts;
Transfer patients;
Apply physical agents such as heat, cold and electrical stimulation to muscles;
Instruct clients in functional skills;
Observe and report changes to a client’s condition;
Could be involved in discharge planning and follow-up care and documentation.

Allied Health Professional must maintain a level of general supervision by being immediately available via phone, beeper or nearby office or clinic setting. Additionally supervision occurs through regularly scheduled meetings to review client care plans.

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2
Q

Obtain information about the client-specific program:

A

You will be provided with clear instructions as to:
The needs of the client;
What treatment the physiotherapist will be providing for each contact with the client;
Specific information about the client’s program;
Time required to complete the program;
Equipment required;
Advice regarding any specific issues relating to the client (such as limitations they might encounter when performing the program).

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3
Q

Determine client availability:

A

Confirm with the client that they are able to participate in the scheduled session.
This can include asking if they are well, and how they have recovered from earlier treatment sessions.
You will also outline what is expected during the current session and seek from the client confirmation that they expect be able to complete the session planned for that day.

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4
Q

To remember which bone is radius vs ulna:
Foramen:
Mass:
Force:

A

ulna = under
hole in bone for veins/nerves to travel through.
a unit of weight (example: 1 gram (g), or 1 kilogram (KG).)
Force relates to a change in the rest or motion of an object and is measured in Newton’s.

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5
Q

Energy:

Speed:

A

ability to produce a force/to perform (measured in kilojoules.
Speed is the distance travelled by a moving object in a set amount of time. For example meters in 1 second or kilometres in 1 hour.

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6
Q

Power:
Work:

A

the rate of performing work
a force expressed through a distance independently of time. For example the number of kilojoules used to perform a physical task.

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7
Q

Momentum:

A

a concept in physics:
the product of the mass and velocity of an object, quantified in kilogram-metres per second (kgm/s).
E.g.: a car has a large momentum, and it takes a large or prolonged force to get the car up to a speed of 50kmh, and would take a similarly large or prolonged force to bring it to a stop. In comparison, a motor bike, which is lighter than the car, would have less momentum, and therefore require less impulse to start or stop.

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8
Q

How many sessions does a treatment plan cover?

A

The Physiotherapist will have a treatment plan that will usually cover several sessions with the client.

Appointments might be once or twice a week, over several weeks until the client has recovered from the injury they have.
Other clients will see a Physiotherapist on a long term basis to manage reoccurring or chronic problems.

As an Allied Health Assistant your role will be to take direction from the Physiotherapist for each client that you are assisting. The Physiotherapist will explain what tasks need to be performed by both yourself and the client and also any additional information that you will need to know.

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9
Q

Prior to commencing session:

A

Discuss with each client the activities that you expect them to undertake, this may also involve demonstration of the activity as well.
Take the client through each exercise providing feedback on several points.

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10
Q

Feedback to provide the client as they do exercises:

A

How they are performing the tasks;
Correct any poor technique;
Progress through the session and how much remains;
Point out improvements/progress made during session, and when compared to earlier sessions (if applicable).

Liaise with the physiotherapist as needed.

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11
Q

Client consent:

A

Clients must be given sufficient information to enable them to make informed decisions about their health care.

In general, a client is asked to consent, or give permission, to a program of healthcare related to their presenting condition.

Informed Consent:
refers to consent (permission) that is clearly and unmistakably stated either in writing or verbally.

Implied consent:
refers to circumstances where it is reasonable for the health professional to infer that consent has been given by the client.
For example, if a client presents to a physiotherapist, discloses health information, discusses intervention options and then settles on a particular program of healthcare, this will generally be regarded as the client giving implied consent to that program of healthcare (used under Part VB, Physioplus).

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12
Q

Therapeutic exercise:

A

any physical activity that is undertaken to assist in rehabilitation and to improve or maintain well-being.

Therapeutic exercise can include activities that are prescribed to correct injury or to improve muscle function. The exercises can be restricted to specific muscles or more general, but will have the overall aim of improved physical condition.

The prescribed exercises can include:
    endurance training,
    resistance training,
    flexibility training
or a combination of these three modalities.

The aim will be to enhance the client’s physical status. From a rehabilitation perspective this can include achieving goals such as independent walking, joint mobilization, improved balance or improved circulation.

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13
Q

Guide the client to complete the program:

A

Clear instructions will be provided by AHP regarding what tasks they expect the client to complete.
For example the client might need to undertake 3 sets of 10 repetitions of an exercise to develop strength in the quadriceps muscle.

Each client will have an individualized therapy program designed to address their specific treatment needs. The programs will include the specific exercises to undertake, sets and repetitions and the frequency. In some cases the client will be asked to complete some, or all, of the exercises at home in between appointments.

Repetition:
1 complete motion of an exercise.

Sets:
A group of consecutive repetitions.

Frequency:
How often the sets and repetitions are to be completed.

The frequency might range from undertaking the exercises only under supervision in the therapy clinic, to situations where the client is also performing the therapy tasks several times a day at home.

The goal/s of each session undertaken by the client, and of the overall program, is to work towards achieving the goals as set out during the initial assessment undertaken by the Physiotherapist. The goal/s can include treatment of specific injuries, management of chronic pain, cardiopulmonary fitness development. The long term goal of a treatment program will usually be to assist the client to achieve optimal function and or fitness.

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14
Q

The process of reporting information back to the Physiotherapist is vital because:

The type of information that needs to be reported to the Physiotherapist includes:

A

often the Physiotherapist has no knowledge of the outcomes of a session unless such information is accurately provided to them by the Allied Health Assistant.

should report:
•suggested adjustments
•client response
•client progress
•difficulties and concerns
•changes to program
•client outcomes
•any additional information.

The Allied Health Assistant should take care to document all relevant information about the client in accordance with organizational protocols.

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15
Q

Documenting client progress:

A

A physiotherapy assessment form will be filled out by the Physiotherapist when they first see a client.

After assessment the Physiotherapist will prescribe a treatment program for the client.
One of your duties will be to keep a record of what the client has done during each session on this form, as well as providing verbal feedback to the Physiotherapist.

Written records are essential to keep track of what each client does during their therapy session, and the record can be referred to in following sessions. Written records also provide an excellent progress report for the client and Physiotherapist to monitor the effectiveness of treatment.

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16
Q

Does the treatment need modification?

A

At the beginning of each treatment session you will:
talk to the client about how they are feeling;
talk about how long it took them to recover from the previous session;
ask if there are any new health issues, or concerns about the treatment.

Make a note of this on the client record, and then check with the Physiotherapist to see if there needs to be a change to the client’s treatment for the current session.

Keep a record of any changes that are made for future reference.

17
Q

Variations to the program:

A

If there are any changes to the treatment they need to be implemented immediately – make the necessary alterations on the client’s treatment plan, and then follow the new plan as advised by the Physiotherapist.

Rehabilitation clinics are dynamic environments where the needs of the clients can, and do change. Responses to treatment vary, and over time the Physiotherapist will alter the client’s treatment program based on their response to treatment.

Some clients will find the treatment process fairly easy and may recover more quickly than others. Each therapy program will be tailored to meet the specific needs of the individual client, and is evaluated for effectiveness on an ongoing basis – with changes begin introduced as needed.

18
Q

Identify and manage client adherence issues:

A

As a part of the initial assessment certain goals will have been determined, such as attaining full recovery from knee surgery.
If the client is compliant with the treatment plan they are far more likely to achieve the goal desired of a full recovery.

Discuss with the client if they have been undertaking any rehabilitation exercises that were set for them to do at home. If they have not done so, discuss this with them to determine what prevents them.
(example: client may report that there were high pain levels when performing exercise/s. report this to the Physiotherapist straight away as it may be necessary for further assessment to be undertaken.)

Some clients will express a lack of motivation. In these cases discuss the benefits to them of adhering to the rehabilitation program. Remind them of their goal of a full recovery, and explain that undertaking the treatment prescribed will enhance the recovery process.

Report any client misunderstanding or confusion
From time to time there will be occasions when a client is confused or does not understand what is expected of them.
When this occurs let the Physiotherapist know as soon as possible as further explanation will usually address the issue in a timely manner.
Bear in mind that some clients will be fatigued or suffering from emotional distress, especially if they are recovering from accidents / surgery. This may impact on their ability to understand and remember instructions. It may be necessary to explain / demonstrate the same exercise several times before they are able to adhere to the activity independently.

19
Q

Barriers (both real and perceived) preventing people from maintaining compliance:

A

Not understanding the benefits of undertaking the rehabilitation;
Pain or a set-back in recovery;
Overly demanding program;
Lack of self-efficacy (confidence in their ability to perform the exercise and to succeed);
Low motivation;
Lack of facilities / equipment;
Low funds.

20
Q

STOP if:

A

you notice any deterioration in capacity (such as a loss of range of motion or muscular strength);

the client reports concerns about exacerbation of injury or further injury.

Cease activity and report this to the Physiotherapist immediately.

Whenever you are unsure about something – it is best to stop and ask for assistance. The Physiotherapist will be able to answer any questions that you, or the client, may have before you resume.

21
Q

Keeping equipment clean/maintained

A

The Practice will have a policy that describes how therapeutic equipment is managed, including servicing and cleaning.

The cleaning and maintenance of equipment will be a part of the AHP’s day to day tasks.

In addition, therapeutic equipment should be tested regularly for safety and performance as recommended by the manufacturer.

The practice should maintain signed and dated records of safety and performance checks and service maintenance for all therapeutic equipment, including electro-medical equipment

22
Q

Infection control procedures will include:

A

Cleaning/disinfecting of treatment beds, face holes, electrical equipment, gym and therapy equipment, and benches;
Changing cloth/paper protective linen between clients;
Sterilising equipment;
Managing clients with wounds or infections;
Managing spills, including blood and body fluids;
Clinical waste management, including sharps disposal;
General waste management such as stained bandages

23
Q

Storing/obtaining equipment:

A

Once contact is made with the client in line with the protocols of the workplace, you can then make arrangements to obtain any equipment required for the treatment program.
Certain equipment may be kept in stock in the Therapy Department, while others may need to be ordered. You will discuss any relevant equipment details with the client while providing the necessary information and support required for the equipment.

Availability of this equipment should be checked prior to making the appointment for the treatment program and the equipment should then be gathered prior to the client’s arrival so that it is ready for use.

Safe storage of equipment provides a safe environment, and also allows ease of access when the items are needed.

24
Q

Equipment policies and procedures cover:

A

how therapeutic equipment is managed, including servicing, cleaning, monitoring, repairs and maintenance.

Strict adherence to these procedures is essential to ensure that:
all equipment is in good working order
hygiene and infection control prevention is managed
work health and safety standards are complied with
equipment servicing requirements are met.

25
Q

Manual handling of people:

A

Confirm instructions from the registered nurse or team leader and consult the care plan regarding movement of the client. Check identity of the client and any special needs

Explain procedure to the client and enlist their consent and cooperation

Wash your hands

Gather equipment required for the move

Enlist the help of other staff if required

Plan the procedure with the other staff

Ensure you respect the client’s privacy and dignity throughout the procedure, i.e. close the door if appropriate, ensure client is covered with clothing etc.

Minimise risks to the client and workers by using safe manual handling techniques, and team work

Carry out the procedure in a safe and efficient manner

On completion of the procedure, leave the client in a comfortable position

Leave the area tidy

Wash your hands

Clean equipment before storage

Store equipment according to workplace policies

26
Q

If a piece of equipment is faulty:

A

Remove from use immediately (using faulty equipment can lead to injury);
Clearly label that the equipment is faulty;
Inform other staff so they are aware of the fault;
On advice from the Physiotherapist, take further action to remedy the situation.

27
Q

If you are concerned about any piece of equipment, especialy anything electrical:

A

STOP what you are doing
Turn of the machine if it is safe to do so
Report this to the Physiotherapist immediately.

28
Q

Ways to maintain client privacy with documentation:

A

1) only collecting information that is necessary to provide quality health care
2) health service providers have a privacy policy that explain how they manage health records
3) ensuring only appropriate people can access the health information
4) clients have a right to access their own health records
5) maintain a culture of confidentiality – which means that health information is only shared with other’s on a need to know basis.

29
Q

principles of good documentation:

A
Use ink for permanence;
Be clearly legible to others;
Use correct English and spelling;
Factual/objective only;
Clear and concise;
Timely + complete (all info included within required timeframe);
Current/up-to-date;
Easily found (correctly filed, or saved in correct folder on computer)
30
Q

Written comments need to include:

A

The activities of the client during each treatment session
The outcome of the session
Issues or problems that were identified
and
Solutions that were implemented to address these issues