Midterm Flashcards
What is an Ontario health team?
A new model of care that provides more integrated care introduced by the province
Who defines OT scope of practice?
The regulatory college (COTO) trough provincial legislation
Definition is additionally supported by professional organizations/associations
What is the purpose of regulatory colleges?
They exist to protect public interests, they establish generic regulations, and the protect the controlled acts
Define the OT scope of practice
Assessment of function and behaviour and the treatment or prevention of disorders which affect adaptive behaviour in the areas of self-care, productivity, and leisure
What are the 14 controlled acts?
- Communicating a diagnosis
- performing a procedure under the dermis
- Setting or casting a fracture or dislocation
- Moving joints of the spine
- Administering a substance by injections or inhalation
- Inserting an instrument, hand, or finger into a body opening
- Applying or ordering a form of energy
- Prescribing or dispensing a drug
- Prescribing or dispensing vision devices
- Presribe a hearing aid
- Orthodontics
- Managing about
- Allergy testing
- Psychotherapy
When can an OT perform a controlled act?
It can only be performed if it is delegated, exempted, or there is an exception
However, it still must fall within the scope of practice and the OT must have the competencies to carry out the act and handle any possible side effects
It must be strongly documented with rationale to why the act is being perfumed
What are the two steps of delegation?
- Transfer of authority - the authorizer who can perform the controlled act under RHPA transfers authority to the OT (implementer)
- Provision of instructions - the authorizer provides specific instructions that must be followed
If you are delegated a task that falls outside of your scope of practice, the responsibility falls on the authorizer for delegating a task you cannot do
True or False
False
It is the responsibility of the OT to determine if they have the competencies AND it is within their scope of practice
What are exemptions?
Modifications to the legislation that grant direct authority for a specific task that falls within the parameter of a controlled act to a profession that is not otherwise authorized to perform the controlled act
Thus, an OT would not need delegation for these exemptions
What exemptions do OTs have?
Procedure below the dermis - acupuncture & vaccination (temp)
Psychotherapy
However, it still needs to fall within scope of practice and the OT must have the necessary competencies
What is an exception?
Circumstances in which an OT can perform a controlled act without delegation or exemption
When dealing with first and or temporary emergency services what are the exceptions to the controlled act?
Adminsitering injection/inhalation - Give an epi pen
Setting or casting a fracture or dislocation - set a split
Applying or ordering a form of energy - apply a defibrillator
When treating a member of your household what are the exceptions to the controlled act?
Communicate a diagnosis
Administer a substance by injection/ inhalation
Place an instrument, hand, or finger into a body opening
Describe the exemptions an OT has when assisting a person within their activities of daily life?
May administer a substance by injection or inhalation
May place an instrument, hand, or finger into body opening
The OT must have the competencies and it must be an ADL in order to be considered within the scope of practice
An OT student may perform acupuncture if they have the competencies and are under the supervision or direction of a registrant of the profession
True or False
False
A student may perform some controlled acts under the supervision such as psychotherapy but cannot perform acupuncture
What is a professional boundary?
The implicit or explicit separation of the professional relationship with a client from one that is personal
Why must OTs keep in mind the impact of power and trust when considering boundaries?
OT-client relationships are based on trust and the client feels they rely on them and would never do anything to harm them
This plus the inevitable power imbalance which allows OTs to make decisions that affect the client make clients vulnerable
What is the difference between a professional boundary crossing and professional boundary violation ?
Boundary crossing occurs when an OT initiates or allows a behaviour to persist in a relationship that compromises or sets a future course that may compromise the relationship (ex. feeling the need to buy the OT coffee)
Boundary violations occur when the nature of the relationship moves from professional to personal and is or can result in exploitation of the client (ex. borrowing money, sexual relationships)
What are the minimum standards for professional boundaries for an OT?
- Foster therapeutic relationships
- Assume full responsibility
- Anticipate, identify, and manage vulnerabilities
- Be aware of changes in therapeutic relationships
- Self-monitor and reflect
- Understand that client consent is never a defence
- Address and manage boundary violations
- Avoid providing service o family, partners, or people you know personally
- Avoid non-professional relationships with current clients
- Avoid personal relationships with former clients
- Maintain professional boundaries with students and subordinates
What constitutes of sexual abuse?
Any sexualized touching between a patient and an OT or health professional, regardless of consent
When must an OT report abuse?
Mandated to report any suspected child abuse or elder abuse when residing in a LTC or retirement home
What are the steps to filing an abuse report against a health professional?
- File report with the regulatory college
- Report must include your name, name of suspected health care provider, and an explanation of alleged abuse, and the victims name if consented
- Report must be filed within 30 day of awareness or occurrence of abuse
Define transference
Conscious and unconscious reactions that clients have towards you that are often based on prior relationships/experiences
Define countertransference
Conscious and unconscious reactions that health professionals have towards our clients based on our previous experiences/relationships but also values and attitudes
