Core Competencies for Entry Level Practice in Acute Care Flashcards
These competencies are presented in five sections:
Clinical Decision-Making
Communication
Safety
Patient Management
Discharge Planning
In acute care, clinical reasoning serves as the foundation for:
competency in all areas – including communication, safety, discharge planning and patient management
ENTRY-LEVEL MEDICAL RECORD REVIEW AND DOCUMENTATION
medical record serves as the official record of the patient’s past and current status along with a documentation of all procedures the patient has experienced
one of the primary sources of patient information for the PT to gain information about the patient as well as to share pertinent details of the patient’s therapy session
Determine patient’s level of function prior to admission or onset of acute symptoms:
Functioning
Need for assistance
Endurance/activity tolerance
Fall history
Current exercise regime
Airway clearance program
Cognition:
arousal; orientation; attention; memory; calculation; language; construction; abstraction; speed of processing; problem-solving; motor planning; command following; delirium; and Confusion Assessment Method (CAM) positive
Speech and language ability ➔
aphasia, word finding, apraxia, dysarthria
Cardiopulmonary:
edema; respiratory rate; heart rate; heart rhythm; blood pressure; oxygen saturation; jugular venous distension; ECG observations/telemetry; dyspnea; posture/chest shape; cough; sputum/hemoptysis; nail appearance; auscultation; supplemental O2/ respiratory equipment
Appearance:
skin color; muscle wasting/temporal atrophy; positioning upon entering room
Musculoskeletal ➔
strength/myotomes, ROM, posture
Neurologic:
balance; gait quality; cranial nerves; vision; tone; coordination; reflexes; sensation; tremor; vestibular testing
Integumentary:
edema; skin integrity; burns/wounds; sensation; capillary refill
Pain:
at rest; with activity; with recovery; quality of pain; interventions to address pain
Functional mobility:
rolling; supine to/from sit; sit to/from stand; transfers; ambulation; stairs; curb; wheelchair mobility
Therapeutic Exercise =
Strength
Aerobic/ endurance /cardiac /pulmonary
Flexibility
ROM
Functional mobility training =
Rolling
Scooting
Supine to/from sit
Sit to/from stand
Transfers between surfaces ➔ bed to chair, wheelchair to commode
Pressure relief
Locomotor training, as indicated =
Gait training, with or without assistive devices
Stair training
Wheelchair mobility & management
Neuromuscular re-education =
Balance
Coordination
Vestibular interventions & exercises
Select and perform appropriate education intervention for patient, family or other caregiver:
Role of therapy
Impairments/limitations
Barrier modification
Health/injury risk factor modifications
Adaptive equipment
Energy conservation
Pain management
Relaxation techniques
Safety
Precautions
