Ethcs / Ax/ Tx info Flashcards
List the advantages, disadvantages, and limitations of standardized assessments.
Advantage: Can provide clear evidence of disorder
Scores can be used to justify services
Disadvantages: Requires assessor to administer same items in the same way
Limitations: Most are not culturally sensitive
Require translation from test scores to real world implication
List the advantages, disadvantages, and limitations of non-standardized assessments.
Advantage: Often more “real life” and “functional”
Can be specifically tailored to your clients expressed needs, interests, and environments
Can provide more information about more communication/swallowing environments
Disadvantage:In settings where a score is needed to justify services, these may not cut it.
Limitations: May not cue to presence of less expected difficulties the way standardized tests can, more difficult to analyze for patterns
Ex. CAPE-V, Rosetti, OASES
Compare norm and criterion referenced assessments.
Norm: translate a raw score on a test into standard scores, percentiles and age or grade equivalents - where in the “normal” population does this client fall? i.e., PLS-5, CELF-5, REEL-4
Criterion: Determine what items on a list a client can do, that they are expected to do by a certain age or within a certain ability. I.e. Rosetti, Cognitive Linguistic Quick Test (CLQT)
Provide the general scope of an OT and what some indicators for referrals might be.
Supporting individuals in activities of daily living including personally meaningful activities such as work and leisure. Often very functionally based.
Pediatrics: fine motor, sensory, self-feeding, self-regulation
Adults: fine motor, daily living skills, return to work, return to driving, pacing, fatigue management/energy conservation, environmental modifications
Provide the general scope of a PT and what some indicators for referrals might be.
Rehabilitation of gross motor function
Pediatrics: balance, gait, difficulties with gross motor activities
Adults: balance, gait, difficulties with gross motor activities
Provide the general scope of an audiologist and what some indicators for referrals might be.
Hearing testing, hearing aids, cochlear implants, aural rehabilitation
Pediatrics: language and/or attention concerns with no known underlying cause
Adults: family or self report of difficulties with attention and/or responsiveness
Provide the general scope of a psychologist and what some indicators for referrals might be.
Mental health professional- does not prescribe medication can perform:
Psychoeducational assessment
Neuropsychological assessment
Assessments for mental health conditions
Psychoeducational assessment: indicators of developmental disability, learning disability and need for confirmation to access supports in school
Neuropsych: understand cognitive implications of ABI, often for funding purposes
Describe the pheonix theory of family attendance.
6 aspects
A - Family composition (the family vehicle): number of adults who contribute to care, the parents’ age, and the number of children in the family.
B - Health complexity (working condition): accumulated child, sibling, and parent physical and mental health.
C - Service complexity (the road): number of organizations and professionals.
D - Process of attendance, participation, and engagement (parent gears): skills, feelings, knowledge, values and beliefs, logistics, parent-professional relationship.
E - Factors that affect the process (grease and grit): child, parent, professional, or organizational factors that affect gears.
F - destination (child health and happiness)
Define and compare direct vs. indirect intervention. Provide examples for each.
Direct intervention: The SLP is eliciting specific targets from a child/client/patient. Aims/targets are written for the child
Examples: Articulation therapy, apraxia therapy with PROMPT, VNEST (aphasia) Semantic Feature mapping (aphasia)
Indirect intervention: The SLP works with communication partners and trains them to change their strategies to elicit more from the child/client/patient including typically by changing their communication to facilitate child’s communication. Aims/targets are written for the parent
Examples: Hanen, Communication Partner Training, Supported Conversation Training, Lidcombe, Palin, Play Project
What do you do if a client’s goals don’t match reality?
We never really know what clinical reality is → might think there’s no chance someone can do it, or somebody can’t do it, and you could be totally wrong
definition of clinical reality changes with experience
Educate in a gentle way over time, they have assessment results etc
Component skills → wants to be a pilot? what are all the skills you need to be a pilot?
steps along the way → want to go back to being a prof? what is the first thing you need to do? and next?
Need to keep breaking the component skills down until you can think “in a half hour session, can I work on this?” -then you’ll have a decent target –if you can design a task to work on a target in the session
When might you discharge someone who still needs services?
Patient or client requests the discontinuation
Alternative services are arranged, or reasonable attempts have been made to arrange alternative services
The patient or client is given a reasonable opportunity to arrange alternative services
Restrictions in length or type of service are imposed by an agency
The patient or client is unwilling or unable to pay and reasonable attempts have been made to arrange alternative services
Discharge criteria are imposed by the employing agency
The member reasonably believes that he or she may be physically or sexually abused by the patient or client and reasonable attempts have been made to arrange alternative services.
When are you not required to maintain a patient health record?
Another member of a multidisciplinary team who is a member of a professional college maintains the record
Consultative nature to a member of a regulated college
What are the ethical responsibilities of an SLP according to CASLPO?
The primary ethical obligation of SLPs and Auds is to practice their skills for the benefit of their patients/clients
We have an ethical obligation to respect clients as persons
What are the SLP responsibilities in regard to support personnel?
a) Be an Initial or General member in good standing, without terms, conditions or limitations that preclude the supervision of support personnel
b) Have sufficient and ongoing direct contact with patients to develop a professional relationship, evaluate and update the plan of care, and ensure effective and safe delivery of quality speech language pathology services
c) Be available on a regular basis to review and discuss specific patients, issues and provide additional support to the support personnel when requested
d) Ensure that informed consent has been obtained from the patient or substitute decision maker to receive services from support personnel and that the consent is documented in the patient record. The consent process should outline the support personnel’s roles and responsibilities
e) Ensure that the support personnel has the knowledge, skill and judgement to provide the intervention assigned. If the support personnel requires additional training/education, the SLP must ensure that it is provided
f) Define his/her role as supervisor to the support personnel, patient, family and employer
g) Discuss the roles and professional boundaries to the support personnel. This includes, but is not limited to: what may be communicated to patients and other professionals, record keeping content and responsibilities, and use of an appropriate title
h) Be competent in the areas of clinical practice that he/she is supervising
i) Perform a risk analysis when considering the type of tasks assigned. This would include risk to the patient, the patient’s progress and risk to the support personnel
What are the SAC standards in regards to practicing?
Professional competence: meet national membership requirements and hold provisional registration, provide service in scope of practice, considering educational level, training, expecerice, and access to supervision and assistance, maintain and enhance professional competence throughout careers, and withdraws if compromised
Safety: take every precaution to avoid harm to patients or clients, and ensure employees and/or supervised personnel comply with relevant policies and procedures.
Business practices: ensure advertisements, promotions, sales, and fees for products and/or services are honest, appropriate, and fair, disclose all applicable fees, charges, and billing arrangements prior to providing services, and donor product and service contracts.
Scholarly, clinical and research practices: obtain approval where required, doesn’t delay with methods of assessment or intervention, use peer review process, acknowledge other professionals.
Ethical: understand application of professional ethical and practical standards, cooperate with investigations, refrain from advocating, sanctioning, participating in or condoning any act or person in violation of code or bylaws/policies, and report suspected violations.
What skills must an SLP demonstrate according to SAC to use support personnel?
Evaluate his/her own supervisory skills
Assess the support personnel’s competencies regarding the assigned task
Determine appropriateness of assigning tasks and areas of patient care to support personnel
Monitor the support personnel’s adherence to the obligations, responsibilities and boundaries associated with their position
Identify and communicate constructive feedback to support personnel, including strengths and areas for growth
What tasks can’t support personnel do?
Any task where the risk of harm is significant
Selecting, admitting, discharging or referring patients to other services
Reviewing a patient record where clinical interpretation is required
Collecting a patient’s health history where clinical interpretation is involved
Assessing speech, language or communication skills and communicating assessment results
Developing or changing patient intervention plans
Supervising other support personnel
Consulting with other professionals, families or significant others regarding specific patient care
Describe the supervision requirements for support personnel.
All support personnel must be directly observed providing patient intervention on a regular basis; however, not necessarily with every patient. Direct observation can be in person, via secure live video or video recordings as close to the therapy session as possible.
The SLP must provide guidance to support personnel as requested and to intervene in service-related matters as required.
The SLP must ensure that sufficient time is available to supervise effectively every support person for which the member has responsibility.
Describe the documentation requirements for support personnel.
The SLP will ensure that support personnel document necessary information and are informed of expectations related to record keeping.
The SLP must demonstrate that they review the support personnel’s documentation.
The SLP must document, either in the patient record or separately, the amount and type of supervision provided.
What are is the SACs code of ethics in regards to delegation and supervision of care?
a) Are responsible for all professional services they delegate to communication health assistants and/or students under their supervision.
b) Shall accurately represent the credentials of communication health assistants and students and shall inform patients or clients of the name and professional credentials of persons providing services.
c) May endorse a student or supervisee for completion of academic or clinical training or employment only if they have had direct experience with the student or supervisee, and only if the student or supervisee demonstrates the required competencies and expected ethical practices.
What is the SACs code of ethics regarding privacy?
a) Be familiar and comply with applicable federal, provincial or territorial privacy legislation in all of their clinical, administrative, scholarly and research activities. b) Ensure that any supervised personnel comply with appropriate federal, provincial or territorial privacy legislation.
c) Adhere to all relevant legislation and policies related to security, privacy, encryption, consent and documentation in the delivery of services via electronic technology
Provide the general scope of an OT and what some indicators for referrals might be.
Supporting individuals in activities of daily living including personally meaningful activities such as work and leisure. Often very functionally based.
Pediatrics: fine motor, sensory, self-feeding, self-regulation
Adults: fine motor, daily living skills, return to work, return to driving, pacing, fatigue management/energy conservation, environmental modifications
When can SLPs disclose PHI without consent?
Mandatory reporting to external organizations (CAS for child abuse, harm or risk to retirement or LTC residents)
Mandatory reporting to CASLPO (sexual abuse by a regulated health care provider, peer assessment by a peer assessor)
Risk of harm (elder abuse, danger to themselves or others, medical emergency)
Legal authority (subpoena, warrant, court order)
Auditing and accreditation