Exam 3 Review Flashcards
SOAP NOTES
Subjective
what your family or caregivers report to you at the start of your session
Objective
measurable and observable data
what you did goes in Objective
Assessment
our judgements and our opinions about what the patient did
outcome of what you did goes in Assessment
Plan
what are we going to do next time
short term goals and long term goals, what are you focused on right now
What are ethics
system of moral values
rules and standards governing the conduct of a person
doing the right thing professionally because it is the right thing to do
why do we need ethics?
to treat people fairly ?? i did not write down notes for this
what do ethics mean?
system of moral values
rules and standards governing the conduct of a person
Documentation
chronologic accountin gof what happened in your session
written form of communication to discuss everything about patient
Documentation is a written form of communication that proves the need for skilled service
Safety questions
Proper body mechanics for the safety of patient AND YOURSELF
Body Mechanics:
- make an object lighter if possible, get help if needed
- position body as close to object as possible, straddle legs
- use legs to lift, not back
- position yourself as close to shelf if you are placing item on shelf
- pivot, don’t twist!
- keep weight centralized, move feet instead of moving waist or hips
- push! don’t pull!
- Golfer Tee Lift: one hand on a secure structure, bend forward, allow one leg to lift off of floor for counter balance
Different fields and specialties we have as a choice
orthopedics
pediatrics
rehabilitation
neurology
sports
administrative
burns and wound care
teaching
cardiopulmonary
oncology
professional lecturers
traveling therapist
consultant
adaptive sports
aquatics
women’s health
most popular field
Orthopedics ?
then in-patient hospitals ???? wh ???
least popular field
no idea x.x
what is the role of the APTA?
american physical therapy organization
51 chapters, 18 sections, special interest groups
Goals of APTA
1. promote pt care and service through establishment, maintenence, and promotion of ethical principles and quality standards for practice, education, and research.
2. influence policy in public and private sectors.
3. enable pt practitioners to improve, skill, knowledge, and operations in the interest of furthering profession (15 credits every year, no repeat classes)
4. develop art and science of pt, including practice, education, research
5. facilitate a common understanding and appreciation for the diversity of the profession and communities we serve
6. maintain stable and diverse financial base to fund programs, services, and operations that support mission (no federal money funds APTA)
Vision statement: transforming society by optimizing movement to improve the human experience
FSBPT?
They’re the ones who make your licensure exam !!
the federation of state boards of physical therapy
What is a CORF?
Comprehensive Outpatient Rehab Facility
outpatient services are based on a rehab philosophy and team approach.
at minimum have physical therapy, a doctor, and psych and social services.
“a medical facility that provides outpatient diagnostic, therapeutic, and restorative services for the rehabilitation of your injury, disability, or illness. CORF care is commonly known as outpatient rehabilitation care. CORFs must provide medical care, therapy, and certain social or psychological services.”
HINT
can’t corf unless you carf
What is a CARF?
commission on accreditation of rehabilitation facilities
“It is a private, not-for-profit organization that accredits rehabilitation programs with some of the following services: Adult day services. Assisted living. Behavioral health services.”
focus on functional outcomes of rehab facility. inpatient or outpatient. corfs are usually also carf.
slander
you SAID it out loud, verbal, SAID LIES that defamed
defamation
the action of damaging the good reputation of someone; slander or libel.
Gait Cycle
STANCE PHASE
Traditional: heel strike - foot flat - midstance - heel off - toe off
RLA: initial contact, loading response, midstance, terminal stance, preswing
SWING PHASE
Trad: acceleration midswing deceleration
RLA: initial swing, midswing, terminal swing
APTA
american physical therapy organization
51 chapters, 18 sections, special interest groups
member driven, over 100,000 members, both pts and ptas
runs only on dues, no outside funding, voluntary to join
it’s run by a ceo, it is a business
under hte ceo are six different divisions
public policy
education
member retention
communication and marketing
governance and administration
finance and business
pay our dues
51 chapters of the APTA, all the states and DC
every state has its own chapter that deals with local rules and regulations
house of delegates - the policy making body of the apta
18 sections organized by speciality,
ex: aquatics, pulmonary, education, women’s health
Nevada Physical Therapy Board
investigators, go to the board if having issues with anything or anybody
if you dont inform the board of moving or changing where you work within 30 days, you get in trouble on the nvpta list and get a hefty fine
Peer Review Resume
name and contact info at top and easily identifiable
correct spelling
contact info correct
objective stated and appropriate for PTA
graduation dates listed most recent first
employment with dates most recent first
job duties with good use of action words
professional license (date of licensure exam)
good grammar, spelling, and puncuation
no picture
on white paper, times new roman, 12 point font
neat and legible
modalities
Mechanical: massage, traction, compression, whirlpool, ultrasound
Electromagnetic: iontophoresis, diathermy, ultraivolet, lasers, e-stim, TENS
communication
application requirements for the program
2.5 gpa or better in prereqs
pt100, english, math, hhp or bio
B or better in HHP or bio
3 letters of recommendation
additional credits us hist and nevada constitution, com, psych
Libel
you WROTE it down, WROTE LIES down that defamed
What state has the highest ethical regulations?
nevada
nevada has unethical reputation ???
HIPAA
HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
Ethical Standard 1
Physical therapist assistants shall respect the inherent dignity, and rights, of all individuals
no discrimination
no biases
acknowledge and accept a person
Ethical Standard 2
PTAs shall be trustworthy and compassionate in addressing the rights and needs of patients/clients
client first, patient before self
incorporate individual and cultural differences of patients/clients
is not rude to ask, show respect
inform patients, informed consent
Ethical Standard 3
PTAs shall make sound decisions in collaboration with the physical therapist and within the boundaries established by laws and regulations
objective decisions in patient’s/client’s best interest, evidence based practice
go to school, licensed, take exam
knowing our role and scope
shall not engage in conflicts of interest that interfere with making sound decisions
no performing what above, no telling those higher what to do
practice act: supervised by physical therapist,
Ethical Standard 4
PTAs shall demonstrate integrity in their relationsihps with patients/clients, families, colleagues, students, other health care providers, employers, payers, and the public
integrity with everybody
tell truth, no lying, documentation
no diagnosing patients
can say someone appeared sad, cannot say “was depressed”
can quote patient saying “Im depressed bc my dog died”
no exploitation over those you hold authority over
will watch out for other professionals, discourage that conduct and report illegal or unethical acts when appropriate
a lot of unethical clinics
report suspected cases of abuse to pt and authority
no sexual relationships w patients/clients, supervises or students
six months after ?
no harassment verbally, physically, emotionally, or sexually
Ethical Standard 5
PTAs shall fulfill their legal and ethical obligations
nrs nac for nevada ethics, local state and federal laws
ptas support pts, respect authority to ensure autonomy
have to have mentorship to be published, walk you through steps on how to create your paper
looked over by team of ethics specialists
if a coworker has impairmetns of any kind you must discuss it so no one gets hurt etc
if colleague is unable to perform prof responsibilities safely you must report this
Ethical Standard 6
PTAs shall enhance their competence through the lifelong acquisition
ptas keep learning
continuing education
stay competent
continue education o keep up with change sin terminal degrees as well
be proactive, outreach,
Ethical Standard 7
PTAs shall support organizational behaviors and business practices that benefit patients/clients and society
do whats right because its right thing to do
no accepting gifts !
each facility has its own rules, but golden rule is about no gifts over 20 bucks, but even that is frowned upon
done to avoid an air of favoritism both among clients and other coworkers
food is something shareable ?
must disclose financial interest, ex get equipment from private facility or if doctor partially owns outpatient surgery center type thing
skilled service
evidence based practice
must be shown in documentation
nevada is a fee for service state, if you want to go to a clinic and pay in full you can get treatment, but if you want insurance to cover it you must be referred ?
Ethical Standard 8
PTAs shall participate in efforts to meet the needs of people locally, nationally, or globablly
The 8 Ethical standards
- show respect, no discrimination
- be trustworthy and compassionate
- make sound decisions, listen to PT, follow laws
- show integrity, no exploitation misconduct or harassment, report concerns
- fulfill legal and ethical observations
- lifelong learning
- foster good work environment
- help everyone everhwere
PT Role and Scope
- all patient treatment
- one making decisions regarding patient care
- supervizing ptas and pt techs
- their license and education is what gives them authority to make these decisions
- perform evaluations, reevaluations, and discharge planning
- can’t diagnose mental health conditions, cannot tell patient to take medicine
- can teach in pt or pta program
PTA Role and Scope
- works under PT, can’t make any changes without PT advisement and notations under plan of care
- NV 2000 hrs of supervision before you can be autonomous
- cannot supervise anyone, cnanot supervise techs
- provide treatment for patient as noted by PT
- document treatment sessions, everyone responsible for their own documentation
- can request modifications to treatment plans
- cannot practice outside of scope
- no medications or any diagnosis at all
- take continued education, 15 credit hours on a topic they specialize in
PT tech role and scope
- not graduate of any program
- work directly under PT, MUST BE PRESENT AND IN LINE OF SIGHT OF PT
- on the job training, should only be done by PT
- can make a hot pack but cannot put it on patient
- can take them into clinic and take back to car
- clean area and do laundry
- can observe exercises but cannot instruct or put hands on patient
- if pt calls out sick, they can’t do anything
- can supervise exercises, transfers, assemble equipment and accessories, but cannot put hands on patient. perform set up and clean up. hot pack is considered a modality and cannot put them on patient.
- cannot teach, no modalities, no procedures
- no judgemetn, no decision making regarding plan adn care and treatment
Scope
What you can practice, level of things you can do, what you can do in this setting
Nevada PT reassessment every
7th visit or 21 days
JCAHO
joint commission on accreditation of healthcare organizations
this body comes in and has its focus on outcomes specifically. did you do what you said you were gonna do, do patients have outcomes you say they’re going to have.
ACAPTA
academic counsel of physical therapy association
address academic concerns
ABPTS
American Board of Physical Therapy Specialties
can sit for certification of recognition of speciality area
cardiopulmonary
geriatrics
neuro
orthopedics
pediatrics
sports
womens health
acute care
musculoskeletal
aquatics
oncology
etc
CAPTE
Commission on Accreditation and Physical Therapy Education
unlv and csn’s capte board, through apta, there are also other boards
Foundations for Physical Therapy
people who give grants for research
World Confederation of Physical Therapy
how do other places practice and what we can learn
NRS
nevada revised statutes
NAC
nevada administrative code
How many hours do you have to complete documentation in Nevada?
72 hours
Common reasons therapists get sued
- falls (most common)
- burns
- forceful treatments
- de-hissing a wound
- infection from poor sterilization techniques
- using wrong technique or procedure on patient
- making promises
- incompetence
- equipment malfunction
- discrimination
- practicing outside of role and scope
- prescribing or recommending medicine
- no diagnosing
Malpractice insurance required?
yes
HPSO
Healthcare providers service organization
common health professional insurance company
What to be aware of with patients who may sue
- if they say they’re currently in a lawsuit
- if they’re only there because lawyer says it will help their case
- if they mention lawsuits every time you see them, or say they have been involved in many lawsuits
- if they complain of high back or neck pain but do not guard themselves?
- if they are overly friendly or don’t show improvement
How do we reduce our chances of being in a lawsuit?
- don’t leave patient in compromising position
- make sure they’re supervised, no slip and fall
- don’t leave them sitting on edge of table
- don’t leave them alone
- make sure all equipment is in good working condition
- don’t reveal too much personal information
- don’t promise cures, be realistic about outcomes
- men shouldn’t be alone with female patients and vice versa
- be very clear with all instructions, give written clear instructions always
- be kind to everyone
- tell pt if you see red flags, or finish treatment ASAP
- make sure any supervision that is needed is always done
- if strife exists with patietn, bow out and say you need a second opinion for the sake of the patient
SAFETY FIRST
keep area clean, no trip hazards, fall hazards, water, chemicals
if patient feels dizzy, lightheaded, or like they’re gonna pass out, take blood pressure and give water. don’t let patient diagnose their own wellness
