Ethics Question Framework Flashcards
Assigning a Task to PTA
- Educate the Pt about the difference between a PT & PTA
→PT assess & creates a program that is reviewed with the PTA
→PTA carries out the program as designed by the PT
→PTA cannot change/alter the program in anyway and must report to PT if any Pt qestions, concerns, or issues arise
→Educate the Pt about the benefits of using a PTA in their care
→Ensure my patient has the opportunity to ask question - Obtain informed consent from the Pt/SDM for the invovlement of a PTA in the delivery of their PT Rx
- Educate the PTA that Pt consent can be revoked at any time
- Teach the assigned task to the PTA
→ Demonstrate the task exactly as you want it performed
→ Enusre good body mechanics
→ Provide FITT/dosage - Ensure PTA is competent to carry out the assigned task
→Watch the PTA complete the task- Ensure good body mechanics
- Provide FITT/dosage
- I would correct and provide feedback as necessary
Assigning a Task to PTA (Cont)
- Teach the PTA to recognize any adverse Rx reactions (redness, swelling, increased pain) and how to proceed
→Cease treatment
→Immediately report to the PT
→Document situation in Pt’s chart - Document assigned task
→Identity of the PTA who performed the assigned task
→Detail of the assigned task
→Consent has been received from Pt to work with PTA
→Include a written supierivison plan- Method of communication: phone, email, or directly for consultation as needed
- Frequency of supervision/Pt reassessment
- Arrange for transfer of supervision to another PT in the event of planned or unplanned absence
→Any changes made/progression of the assigned task
- Reassess Pt and assigned task at timely interval
- Adjust Rx plan based on reassessment
Managing a Discrepancy with a Superior
- State the issue
→Use your knowledge of your professional standards to help identify the issue
- Discuss alternatives and agree on a plan
→Your alternatives should be in alignment with your professional standards
- State what you would do if the disagreement continued
→It is often appropriate to remove yourself from the situation (e,g, move to a different unit within the hospital, resign from a private practice)
→If possible→consider speaking to an alternate supervisor/higher authority
Recognize the Conflict Framework
- What is the connection betweeen the persons involved?
- Is there potential for financial benefit?
- Is there a conflict of interest?
- Can action be justified
→Can quality care still be provided?
→Can the therapist be fair and transparent?
Conflict Resolution Principles Framework
- Understand the issue
→Use Recognize the Conflict Framework - Discuss alternatives
→Make decisions with the Pt’s best interest in mind
→Help the Pt make an informed choice by offering alternatives and allowing them to ask questions - State that their decision will not affect future care
- Agree on an action and document
→Document the decision-making process and the decision
Professional Boundaries Framework
I Think, I Feel, I Want Framework
- Use when responding to a Pt crossing a boundary
- I think, I feel, I want to address the issue
→I think you didn’t mean to touch me that way
→I feel very uncomfortable when you touch me
→I want you to stop doing that
- If the Pt does not understand/crosses another boundary→Get someone else to treat the Pt
Informed Consent Framework
- Ensure my Pt is seated and in a comfortable position
- Obtain my Pt’s undivided attention
- Can’t gain informed consent if the Pt is distracted←I cannot be sure they heard and understood the proposed treatment
- If distracted by something: politely redirect them→explain why it is important that I have their undivided attention
- Educate my Pt about the proposed treatment by including…
- Their condition/injury
Explain the injury/condition that the Pt has and what PT can do to help - The nature of the proposed treatment
Explain what the Rx will consist of in layman’s terms and the mechanism behind its actions (e.g. explanation of how a modality works) - Risks & benefits of the proposed treatment
Start with stating risks and end with stating benefits (e.g. increase healing time) - Alternative courses of treatment
Provide them with 2 alternative options - Allow the Pt to ask any questions
Inform them that they have the right to revoke consent at anytime
- Ask my Pt: “Do I have you consent?”
- Verbalize the final decision
Will you/will you not proceed with treatment?
(See ‘Consent to treat chart’)
Risk Management Framework
- Identify the safety issue
- Respond to the safety issue
- Take the necessary steps
→Address the factors contributing to the safety issue
- Be transparent
→Communicate effectively with the Pt, other healthcare members, family members - Document the safety issue(s).
Risks in PT practice
Human
- Pt: communication ability, cognitive, balance, complexity of condition, stress, anxiety, pain
- PT: knowledge, skills, judgement, experience, communication ability, ability to monitor/observe/etc.
- Team: culture, communication, competence, trust, willingness to collaborate
Equipement
- Hardware: acupuncture needles, electrotherapy modalities
- Usage: proper maintenance & sterilization, adherence to established protocals, suitability for particular Pt etc.
Environment
- Inside of Pt care area: surface, lighting, waste disposal/sharp Mx, pace of change, workload demand, availability of resources & info
- Outside of Pt care area: walkways, steps, railings, waiting rooms, elevator, washrooms
Clinical Technique
- Nature of technique: Manipulation, tracheal suctioning, resistance training, amublation
- Applying technique: level of evidence, PT experience, suitability for the Pt, adherence to established protocols
Communication Strategies Framework
- Is there an issue that limits communication?
- Who will you be communicating with?
* Regardless of their communication limitation (state the limitation if appropriate), I would never exclude the Pt from the conversation - What strategies will I use to establish therapeutic communication?
* State scenario or pathology specific strategies
Communicating with a Challenging Pts/Family member Framework
- Identify the issue
* Is therer a safety issue? - Create, communicate, and document a plan of action
- Monitor the situation
Communicating with a Challenging Pts Framework-
Pt last minute cancel for mutliple times without reason
- Identify the issue
- Pt is not attending their scheduled appointment and is not giving enough notice to fill the gap in the PT’s schedule - Create, communicate, and document a plan of action
- Talk with the Pt about the importance of attending PT
- Review your policy around cancellation
- Identify if there is anything you can do to help
–> Childcare issue? Could they bring their child to the appointment?
–> Scheduling issue? Could you schedule their appointment after work?
- Docement your discussion iwth your Pt and how you plan to resolve the situtation? - Monitor the situation
- Is this something that continually occurs
- Were you able to reolve the situation - If unable to establish a solution and feel it is best to DC the Pt from your treatment
Responsible for transferring the Pt to another PT. Failure to do so could result in professional misconduct
- Pt should be provided with information as to where they might be able to obtain further services
- Pt should have a reasonable period of notice before you plan to DC them, unless in the vent of immediate DC (e.g. abuse/safety issue)
- Document the reason for DC & the plan of action
