Exam 1 Flashcards
What does a clinical assessment of the hand include?
A thorough history
Who are they, goals, what they enjoy. Injury-related info
Systematic examination of the upper extremity
Knowledge of the disease process
What do we need to address in evaluation
Occupational Profile: Includes client and their occupational history (prior and current level of function, context, supports and barriers History and mechanism of injury Past medical history Prior level of function Symptom interview Physical assessment Functional assessment (doing a task) Psychological/cognitive assessment
standardized test strengths
Quantitative Research
Follow-up tests are consistent
Enhances professional credibility
Specific directions increase reliability
standardized test weaknesses
Not adaptable
Standardized on a limited population
Reading directions (unnatural)
Sometimes referred to as the 50th percentile. In test scores merely denotes a place in the middle of the distribution of scores
Norm
assesses the degree of agreement between two or more raters in their appraisals
Inter-rater reliability
assesses the degree to which test scores are consistent from one test administration to the next. Measurements are gathered from a single rater who uses the same methods or instruments and the same testing conditions.[2] This includes intra-rater reliability.
Test-retest reliability
defines how accurately a test really measures what it claims to measure.
validity
The ability of the test to accurately measure the presence of a condition. How well the test identifies the individuals who actually have the condition. Also known as a true positive
sensitivity
The ability of the test to accurately identify the absence of a condition. How well a test identifies individuals that do not have the condition. Also known as a true negative
specificity
A test in which all the questions, format, instructions, scoring and reporting of scores are the same for all test takers.
standardized test
this device has been used extensively to aid in the selection of employees for jobs that require fine and gross motor dexterity and coordination. It measures gross movements of hands, fingers and arms, and fingertip dexterity as necessary in assembly tasks.
Purdue Peg Board
a series of tests of eye hand coordination and motor abilities. The test package is commonly used in the evaluation of occupational fitness, disability evaluation and in rehabilitation. Purpose: measures the speed of gross arm and hand movements during rapid eye-hand coordination tasks.
The Minnesota Rate of Manipulation Test or Minnesota Manual Dexterity Test
composed of seven subtests that represent various hand activities and is an occupation based assessment. Purpose: Assess ADLs, dexterity, grasp and release, manipulation and strength.
Jebsen Test of Hand Function
purpose of the 9 hole peg test
Grasp and release, manipulation.
Functional test to measure the patients performance in grasping medium sized objects/blocks. Purpose is grasp and release, manipulation
Box and Blocks
designed to give a reading of levels of finger speed and dexterity.
The O’Connor Finger /Tweezer Dexterity Test
the information or an impression carried by the afferent nerve to the sensory motor cortex.
sensation
the ability to perceive, recognize and discriminate sensation as well as recognize a change in sensation or the presence of sensory impairment
sensibility
what is the order of return for sensory recovery
Pain and temperature Vibration at 30 CPS (low) Moving touch Constant touch Vibration at 256 CPS (high) Moving two-point discrimination Static two-point discrimination
a method of reimbursement in which payment is made based on a predetermined, fixed amount
Prospective Payment System (PPS)
What percent does Part A Medicare cover?
100%
What percent does Part B Medicare cover?
80%
Time based codes are billed in _____ of therapy
units
_____ codes are billed in units of service no matter how long the intervention was performed
untimed
___ codes are billed using Medicare’s 8 Minute Rule
timed
Must report what was done in ____ and in ____
minutes, units
The ___ are determined based on the total time in therapy.
units
Diagnostic codes that identify what the diagnosis is and where the individual is in their recovery.
ICD-10 Codes
For Medicare patients the _____ diagnosis is the primary diagnosis and the ____ diagnosis is the condition
functional, secondary
Functional Reporting Codes Required by Medicare (focuses on limitations)
G codes
Commonly used G codes
Mobility
Changing and sustaining body position
Carrying moving and handling objects
Self-care
The new codes set the stage for promoting optimal occupational therapy practice by requiring:
occupational profile
standardized assessments and other tests and measures,
Describing the full scope of occupational therapy
correct coding promotes ______ ______
distinct value
3 areas that determine overall complexity
Occupational Profile
Deficits in performance areas (physical, cognitive and psychosocial)
Amount of clinical reasoning involved
An individual must score high in ___ areas to be considered a high complexity evaluation.
all 3
What does the occupational profile include (AOTA standard)?
•client’s background
•context/environment
•meaningful interests
•needs and goals
•past level and types of occupational participation
Current level of occupational participation
When should the occupational profile be documented?
Beginning of every evaluation, re-evaluation, and time of d/c
Complexity level? An occupational profile and medical and therapy history, which includes a brief history including review of medical and/or therapy records relating to the presenting problem
low complexity
Complexity level? An occupational profile and medical and therapy history, which includes an expanded review of medical and/or therapy records and additional review of physical, cognitive or psychosocial history related to current functional performance
moderate
Complexity level? An occupational profile and medical and therapy history, which includes review of medical and/or therapy records and extensive additional review of physical, cognitive, or psychosocial history related to current functional performance
high
Complexity level? An assessment(s) that identifies 1-3 performance deficits (i.e., relating to physical, cognitive or psychosocial skills) that result in activity limitations and/or participation restrictions.
low
Complexity level? An assessment(s) that identifies 3-5 performance deficits (i.e., relating to physical, cognitive or psychosocial skills) that result in activity limitations and/or participation restrictions
moderate
Complexity level? An assessment(s) that identifies 5 or more performance deficits (i.e., relating to physical, cognitive or psychosocial skills) that result in activity limitations and/or participation restrictions
high
