L14 PTA and Discharge Flashcards
PTA
person who assists a PT in administration of PT.
associates degree with license
PT Aides
person who is not licensed, aids a PT or PTA by performing treatment related tasks
must be at least 18 years old with a high school diploma
A PTA can assist a PT…
by performing components of intervention and collect selected exam and outcomes data
Actions that must be completed by PT
- interpretation of referrals
- initial exam and reexam
- Eval, dx, and prognosis, creation of POC
- Determination of which services are to be rendered by PT or PTA
- Revision of POC
- Oversight of Documentation
- Referrals
What determines if you should you delegate to a PTA?
PTA’s experience, training, skills
client acuity
predicatability of consequences
laws
liability
frequency of reexam
Offsite Setting and PTA
PT must be accessible by telecommunication
must have scheduled meetings with PT/PTA
supervisory meeting once a month
PTA is prohibited from
initial eval
reexam
independently modifying POC
discharge
high velocity manipulation
PTA may provide
PT treatment (with PT supervision, after PT has performed eval)
Data gathering
Recommendations to PT
final summary of pt
Supervision
provide personal direction, assistance, advice, and instruction necessary to assure the competent PT services are provided
PT Aide delegation
Treatment related = PT/PTA should be within sight or earshot
Non-treatment = same building
You did not have time to have your pt perform the 6 min walk test during the first visit at eval. Who can perform the 6 min walk test at the 2nd visit?
PTA or PT
Who can creat a goal based on teh results from a 6 minute walk test?
PT
Who can supervise a pt as they perform balance training exercises?
PT, PTA, PT aide
Who can supervise a PT aide who is performing a treatment related task?
PT or PTA
Who can guard a pt the first time they ambulate in a therapy session?
PT
How often does teh PT need to perform a face to face exam with a pt being treated by a PTA?
once a month
Who can perform a discharge exam that includes a summary of the pts current status?
PT or PTA
Who can make the recommendation that a pt can be discharged?
PT
Who can discharge a pt from PT?
PT
When is it appropriate to end the POC in any health care setting?
goals met
pt progress has plateaued
patient asks to d/c
What causes plateau in progress?
- not achieving a therapeutic dose of intervention
- Not addressing the right impairments
- Pt has not been compliant
(1 & 2 can first change the POC, reevaluate, etc before d/c)
When is it appropriate to end a POC for acute care?
pts medical needs have been met for that level of care
What should you provide a pt when performing d/c?
CGT
discharge destination
DME/home modifications
HEP or continuing therapy
D/c destinations
Post acute–> DNF or IPR
Home
Assisted Living
Adult Family Home
Long Term Care
Inpatient Rehab Facility (IPR)
Requires pre approval from insurance
stepping stone back home
pts receive medical care but don’t have the same acuity compared to hospital
Services: 24 hour nursing, 3 hrs rehab, social worker
SNF
Covered by medicare A for up to 100 days
often progressing slower than rehab pts
Must have stayed in hospital for 3 midnights, and shows that skilled rehab or nursing is needed
Meals, social worker, meds, semi private room, skilled nursing
Adult Family Home
not paid for by insurance
small private facilities with 20 or fewer residents
nursing and medical care are not provided on site
Assisted Living
not covered by insurance
for people who need daily care, less than nursing home
provides levels of care, and have access to housekeeping, staff, activities, assistance, etc
Nursing Home/Long Term Care
provide services that focus on medical care, medical staff on site.
rehab is available
provide 24 hr supervision
not covered by insurance, need long term care
Continuing Care Retirement Communities
different levels of services
independent housing, assisted lviing, skilled nursing care all on one campus
Home Health
covered by medicare part A, delivered at home
nursing, OT, SLP, PT, home health aide are provided
pt must be confined to home and have POC reviewed by MD
Confined to home criteria
- Needs aid of devices to leave residence OR has condition that makes leaving contraindicated
- Normal inability to leave home
- Leaving home requires considerable and taxing effort
Can leave home…
for infrequent visits, to receive health care, religious services, adult daycare
Hired caregiver
- for help with tasks that are not covered by medicare under home health services (shopping, cleaning, laundry, meal prep)
Medicaid in OR helps to apy for this service, and a family member could potentially be paid to do so
HEP Tips
Goals should be to maintain gains in therapy and continue to imprve outside of therapy.
should be challenging enough to achieve these goals, but not outside of safety boundaries
give pictures, videos, or written descriptions
HEP can include
therapeutic activities
make sure to prioritize the most important and provide education about why you want it done
CGT
often concentrated in the week before discharge
should include how to safely perform activities that pt can’t do independently, and things to keep the pt safe (education about medical status)
When performing CGT, make sure to
Communicate
Demonstrate
Have CG perform
