Clinical Decision Making Flashcards
What does the frameworks in physical therapy guide?
decision making process
What does the frameworks of physical therapy provide?
Common language and terminology
What does ICF stand for?
International Classification of Functioning and Disability
What type of model is the ICF?
Disablement Model
What does the ICF help us understand?
The relationship between a disease or a pathology and the disability that results from that disease process
What are the two major components of the ICF?
- Functioning and Disability
- Contextual factors
What is functioning and disability?
Looking at the interrelationships between impairments and body structures and functions, activities, and participation
What are contextual factors?
Factors not specifically related to the health condition but may influence the relationship between the health condition and the ultimate disability
What are body functions?
The physiological functions of body systems (including psychological functions)
What are body structures?
Anatomical parts of the body such as organs, limbs and their components
What are impairments?
Problems in body function and structure such as significant deviation or loss of
What is an activity?
The execution of a task or action by an individual
What is an activity limitation?
A task a patient can’t do normally
What is an activity ability?
A task patient can do normally
What is participation?
Involvement in a life situation
What is a participation ability?
Life roles the patient is able to fulfill
What is a participation restriction?
Life roles that a patient is not able to fulfill
What are examples of impairments?
Motion
Force
Energy
Control
Other
What are examples of impairments?
Motion
Force
Energy
Control
Other
What is a motion impairment?
Limited joint range or motion of muscle length
What is a force impairment?
Muscle weakness
What is an energy impairment?
Limited endurance
What is a control impairment?
Decreased coordination, balance
What are the “Other” impairments?
Pain
Decreased sensation
Joint instabilty
Fracture
What are examples of activities?
Walking
Climbing stairs
Running
Standing
Bed mobility
What are examples of participation?
Housekeeping
Caring for self or others
Employment
Community activities
Leisure activites
What are personal factors?
Factors within the individual that may be facilitation (+) or Barrier (-) to independence
What are environmental factors?
Factors outside the individual that may be facilitators (+) or Barrie’s (-) to independence
What are examples of personal factors?
Personality
Motivation
Coping strategies
Temperament
Fitness
What are examples of environmental factors?
Equipment services
Physical environment
Family/social support
What is the patient/ client model?
walks us through the steps of how we as physical therapist help to manage ur patients’ health conditions
What is examination?
Collecting data about health conditions impairments, activity limitations, participation restrictions and relevant contextual factors
What are the examination components?
History
Systems Review
Tests and Measures
What are the components of patient history?
Chief complaint, symptoms
Current and prior functional status
Medical history, including medications, surgeries, etc
Relevant contextual factors like home environment, social support, etc
Patient goals
What is system review?
Reviewing the body systems such as cardiovascular, musculoskeletal, neuromuscular and integumentary and how they communicate, affect each other and their behaviors
What are tests and measures?
Examination tests and procedures
Standardized outcome measures
What are standardized outcome measures?
A standardized protocol that focuses on participation or activities and capture the amount of change in performance
What is a patient reported standardized outcome measure?
Asking the patient about their ability to do certain tasks
What is a performance based standardized outcome measure?
Asking a patient to actually perform a specific task
What is evaluating data?
Synthesizing the data, correlating findings and recognizing patterns to determine the severity and complexity of the problem
When and why is a referral necessary?
Necessary when outside our scope of practice or area of expertise because we can refer them to someone who can more adequately manage the issue
What is a PT diagnosis?
The outcome of the evaluation and indicates the impact of condition on function
What is a prognosis?
It is the outcome of evaluation that forecasts the optimal level of improvement, time needed to achieve and likelihood our patient will achieve
What is intervention?
Delivering care and monitoring response
What are outcomes?
Assessing the overall response to intervention with use of patient goals and the standardized outcome measure
What are outcomes?
Assessing the overall response to intervention with use of patient goals and the standardized outcome measure
What is Evidence- Based Practice?
The thoughtful integration of our best available evidence, patient client values or circumstances and clinical expertise
Why Evidence-Based Practice?
Pt school is short
Half of what you learn is wrong
Continual learning is a MUST
Why is half of what we learn is wrong?
Collectively as a profession, our understanding of the human movement is limited
What is continual learning?
Learning over the years to maintain practice at highest level
Why is clinical expertise not always reliable?
It is limited to your experiences and is subject to cognitive bias
Why is best available evidence more reliable?
It is designed to minimize bias BUT must be evaluated for quality and applicability
What is the 1st step to evidence-based practice?
Ask a focused clinical question
What is the 2nd step to evidence-based practice?
Assess/search for the best available evidence to answer your question
What is the 3rd step to evidence-based practice?
Appraise the evidence from applicability and quality
What is the 4th step to evidence-based practice?
Apply the evidence, along with your clinical expertise and patient preferences
What is the 5th step to evidence-based practice?
Assess the effectiveness of steps 1-4
