Midterm Flashcards
What is is COLLABORATION and why is it important for SLP? Provide an example.
Collaboration involves multiple professionals from various backgrounds working together to provide comprehensive health services and deliver the highest quality of care to patients and their families. Collaboration is the key to successful patient care. In order to return to or maintain the patient’s highest level of functioning, SLPs must collaborate with other professionals to understand their individual goals and guidelines. Additionally, SLPs are able to mitigate communication difficulties between professionals and patients.
Example: A SLP in a rehabilitation hospital should collaborate with the patient’s physical therapist to keep the patient in a position that is comfortable and minimizes pain. Additionally, the SLP should collaborate with the patient’s occupational therapist to understand if the patient would be able physically to feed themselves.
Example: A patient with aphasia is unable to adequately advocate for themselves. You provide them with a communication board and collaborate with other professionals about how to utilize the board during communication interactions.
What is COUNSELING and why is it important for SLP? Provide an example.
Counseling is part of a person-centered approach that helps individuals and their families learn about and adjust to a disorder, condition, or situation and cope with their feelings, thoughts, and behaviors. Counseling is important for SLP because it helps people process their lived experiences so that they can respond with more agency and choice, encouraging self-acceptance and self-advocacy. Counseling is a powerful tool to help a client understand the purpose of therapy, encourage participation in therapy, and eventually result in “graduation” from therapy!
Example: A 16 year old client with a stutter never received proper counseling regarding their feelings about their speech and was never given the space to share how it impacts their everyday life. Because of this, the client became reclusive at a young age to avoid speaking and exposing their stutter, rarely interacted with peers, and became depressed. After receiving proper counseling from their new speech therapist, the client was able to accept the fact that they stutter and explain how it affects their everyday life. The SLP was able to make functional goals for the client that would allow them to feel more confident speaking to others.
What is PREVENTION/WELLNESS and why is it important for SLP? Provide an example.
Prevention and wellness involve adopting behaviors, routines, habits, etc. that actively work to maintain one’s highest level of functioning and prevent a decline in functioning. In the context of SLP, research and public education are important tools to foster the prevention of communication disorders. Research is crucial for equipping professionals with the knowledge they need to go out and educate the public effectively. Additionally, prevention involves reducing the incidence of a new disorder or disease, identifying disorders at an early stage, and decreasing the severity or impact of a disability associated with an existing disorder or disease.
Example: A school-based SLP holds a workshop with teachers to teach them strategies that foster language development in young children. These include (but are not limited to) frequent story-book time with lots of intonation and voices, engaging children in conversation, and how to provide indirect language stimulation within the classroom. The SLP also guides teachers on recognizing signs that may warrant a referral for speech therapy. To enhance the impact of these strategies, the SLP trains educators on how to communicate these approaches to parents, ensuring a supportive partnership in promoting children’s language skills.
Example: wearing PPE
ACUTE CARE: provide a description and three main activities of a speech-language pathologist
The acute care hospital setting is an inpatient center that is focused on the medical stability of a patient who is in critical condition.
Three main activities of a SLP in this setting include feeding and swallowing evaluations, diagnosing swallowing disorders, and stroke evaluations.
SKILLED NURSING FACILITY: provide a description and three main activities of a speech-language pathologist
The skilled nursing facility is a temporary inpatient setting for those who are no longer in critical care and are medically stable, but are still unable to be discharged home.
Three main activities of a SLP in this setting include feeding and swallowing evaluations, voice therapy, and aphasia therapy.
INPATIENT REHABILITATION HOSPITAL: provide a description and three main activities of a speech-language pathologist
An inpatient rehabilitation hospital is for patients who are relatively healthy, but need intensive therapy and are unable to be discharged home. In many cases, patients in an inpatient rehabilitation hospital are at risk of falling. Patients need the endurance to participate in 3+ hours of therapy a day.
Three main activities of a SLP in this setting include determining prognosis, providing swallowing therapy, and counseling patients on their status.
OUTPATIENT: provide a description and three main activities of a speech-language pathologist
An outpatient center is for patients who have are medically stabile, are ready for discharge, will be safe at home, and have a reliable and safe way to transport to/from therapy. These patients require PT/OT/SLP to return to prior level of functioning and are focused on returning to their daily life activities. These patients need the endurance to participate in 3+ hours of therapy a day.
Three main activities of a SLP in this setting include intervention, counseling, and education.
HOME HEALTH: provide a description and three main activities of a speech-language pathologist
The home health environment involves patient who are medically stabile, are ready for discharge, can be safely discharged home, but their medical needs require home care. PT/OT/SLP disciplines visit 1-2 times per week to improve functioning in the home environment.
Three main activities of a SLP in this setting include targeting family driven functional communication goals, swallowing therapy, and determining prognosis.
“As the ASHA Code of Ethics specifies, professionals may practice only in areas in which they are competent, based on their education, training, and experience.” Provide two circumstances where this might be a challenge for a slp in a medical setting.
limited training in a specialized field
example: unable to diagnosis certain conditions- need to refer
changes in practice advancements of technology
example: learning telehealth
Do you think there may be a role of AI in future medical records or decision making for speech-language pathologists? Will that be a good development, a bad one, or neutral.
In my opinion, I do not think AI has a role in future medical records and/or decision making for speech-language pathologists. Not only does this open up the potential for breaches in HIPAA, but AI cannot clinically judge the complexities of the field of speech-language pathology. Furthermore, AI lacks the ability to make clinical decisions that incorporate the client’s unmeasurable performance, such as demeanor, behavior, attitude, personality, etc. I DO however think AI could be useful to provide SLP’s with information that guides their understanding of a patient or client’s diagnosis. While you should not take the information AI provides as fact alone, it can give you a basis of information to build off of using reliable sources. Therefore, my opinion about AI development within our field is neutral.
What are the two overlaps between SLP and OT?
Swallowing/feeding
Cognition
Scope of practice - PT
Gross motor ability, overall functional movement and ability, restoring mobility, strength and endurance, pain management, building healthy lifestyle
Scope of practice - OT
Fine motor ability, focus on helping people with everyday activities, restoring independence and quality of life, emotional regulation, self-care
Overlap between PT and OT
Motor skills, hand-eye coordination, overall coordination, motor planning, dyspraxia, balance
Multidisciplinary approach vs. transdisciplinary approach
Multidisciplinary - the patient is receiving services from different disciplines, but the respective professionals are staying within their boundaries
Transdisciplinary - the patient is receiving services from different disciplines, but the professionals integrate their treatment to form a holistic approach
Transdiscplinary
What is better: multidisciplinary vs. transdisciplinary?
A transdisciplinary approach is better because:
- holistic care
- encourages innovative problem-solving among professionals
- treats the patient as a whole, rather than fulfilling isolated roles
- functional for the patient
Nurse practitioner vs. physician assistant
Nurse practitioner - RN with bachelor’s or Master’s degree in a specialty area. Can write orders and can perform procedures under MD
Physician assistant - bachelor’s degree and completion of a PA program. Does not require RN degree. Collaborates with supervising physician, can be specialized,
Medicaid
Free or low cost insurance for low-income children, pregnant women, adults, seniors, and individuals with disabilities.
VARIES PER STATE, but overall jointly funded by states and federal government.
Medicare
Federally provided health insurance for those 65 or older, those under 65 and receiving social security disability insurance, or those under 65 with End Stage Renal Disease (ESRD).
Ran by Centers for Medicare and Medicaid Services.
Funded by social security and Medicare taxes.
Medicare Part B
Covers our services
80%
Can a patient have medicaid and medicare?
If you have less than $2,000 in assets, you can be on medicare and medicaid.
Medicaid will cover the other 20% not covered by medicare.
Why is it important for a SLP to know about the specialties among physicians? Do we work “for” or “with” these specialties?
Knowing about different specialties helps SLPs understand the medical context of their patients’ conditions and how to best coordinate care.
Referrals and Recommendations: Understanding the roles of various specialties allows SLPs to make appropriate referrals when needed and communicate effectively about patient needs and goals.
Comprehensive Treatment Planning: Physicians lack a comprehensive understanding of the complexities surrounding speech and language. SLPs can contribute valuable insights to treatment plans by knowing how speech and language issues may be intersecting with a patient’s medical condition/s.
What are the four purposes of the medical record?
DOCUMENTATION procedure to protect the patient’s safety
Means to COMMUNICATE observations and plans among members of the care team
VERIFICATION of services provided to support billing
LEGAL record of events
What are the five etiologies of pneumonia?
Community-acquired pneumonia (CAP) - Acquired outside of the hospital or other health care facilities
Hospital-acquired pneumonia (HAP) - Acquired during a hospital stay unrelated to admission diagnosis
Ventilator Associated pneumonia (VAP) - Acquired while on the ventilator
Health care-acquired pneumonia (HCAP) - Acquired in people who live in long-term care facilities or in outpatient clinics
Aspiration pneumonia - Acquired from food/liquids in the lungs
Which etiology of pneumonia may be of concern to you as a speech-language pathologist?
While it is in the interest of the patient to be concerned about all etiologies of pneumonia, aspiration pneumonia is the most relevant to a medical SLP because if we do not prescribe the correct diet, our patients could aspirate food/water into the lungs and acquire this infection.
Is the purpose of contact precautions to keep you from getting sick from your patients?
While taking the necessary contact precautions benefits all parties involved, their primary purpose is to protect the patients from getting sick. Taking the right contact precautions lowers the risk of spreading infections/diseases from patient to patient, whose immune systems are already weakened.
Droplet precautions
Infection transmittable through air droplets = coughing, sneezing, talking, close contact with an infected patient’s breathing. Particles are 30 to 50 micrometers. A surgical mask is the necessary precaution.
Airborn precautions
Infection transmittable through airflow = Anthrax, TB, measles, chicken pox, COVID for healthcare workers. Particles are 5 micrometers or smaller and remain in environment for long periods of time. A N95 Mask is the necessary precaution.
Nasogastric (NG) tube
soft, plastic tube fed through the nose, throat and esophagus
ends at the stomach or small bowel depending on type and medical condition
Percutaneous Endoscopic Gastrostomy tube (g-tube)
soft, plastic tube placed through the skin of the abdomen into the stomach
What is GERD and why important to your profession?
GERD, or Gastroesophageal Reflux Disease, occurs when stomach acid frequently flows back through the esophageal sphincter and spills over into the airway. This risk is important to understand as a SLP because the stomach acid can cause serious scarring and burning of esophageal tissue.
What should you as an SLP be concerned about with your patients with cardiac diseases?
The brain requires a significant amount of blood to function. Cardiac issues can lead to small blood clots that may not present as obvious strokes but still pose significant risks. Additionally, a patient’s stroke or tumor could affect the brain regions that regulate heart function, potentially increasing the risk of blood clots and compounding any existing brain damage.
What are the scope of practice areas for SLP for patients with respiratory diseases?
A strong respiratory system is essential for (1) supporting speech production and (2) ensuring that the brain receives adequate oxygen to function effectively.
Can SLP’s diagnose neurological diseases? What should you do if we suspect such?
SLPs CANNOT diagnose neurological diseases. If you have reason to suspect a neurological disease, tell the patient’s doctor and discuss with them the possibility of doing a specialized test.
Can neuroimaging always be trusted to detect brain damage?
NO. Certain things, like anoxic damage, do not show up on neuroimaging. Additionally, contrast is not always used with neuroimaging, therefore certain damage may not appear.
What concerns should the SLP have with patients with renal disease?
In patients with renal disease, the kidneys are unable to effectively filter out toxins, which can accumulate in the body and subsequently impact brain function. This buildup can lead to cognitive issues, resulting in lethargy and slowed mental processes. It’s important for a SLP to be aware of these potential neurological effects because they can affect treatment progress and influence a patient’s communication.
How might a SLP be involved in assessment or intervention with persons with cancer?
SLPs most commonly will be working with patients whose cancers are central to areas involved in communication or swallowing, like the brain, the lungs, or the tongue. SLPs may work with other cancers that did not originate in areas related to communication or swallowing, but the cancer metastasized and traveled into the brain. Cancer treatment in itself can also induce cognitive dysfunction.
Can an 85 year who just had a stroke have any reasonable chance of benefiting from therapy?
Yes! A healthy 85 year old can benefit from rehabilitation to restore and improve mobility, communication, and daily living skills, even if modifications are necessary. This enhances the independence and improves quality of life, which ethically all patients deserve regardless of age.
Respond to the following: “SLP’s should not work with patients with progressive disorders because they are just going to get worse anyway no matter what we do.”
One aspect of treatment for individuals with progressive disorders is creating goals that do not simply focus on the patients prognosis, but rather target their current level of functioning. Goals can be designed to alleviate the symptoms of the progressive disorder by targeting communication and/or feeding and swallowing wants and needs.
Describe three ethical dilemmas that SLP may face with patients with dysphagia.
Patient/family disagree with your recommendations - a patient or their family may disagree with a recommendation for alternative ways for a patient to receive proper nutrition, such as tube feed. But without it, the patient may not be receiving adequate nutrition from swallowed food alone.
Surrogate not following patient’s wishes or their best interest - surrogate does not adhere to the desires of the patient for any number of reasons, or acts contrary to what the SLP believes is in the patient’s best interest.
Medical team or patient have personal biases - other contributing healthcare professionals or the patients family may have biases relating to feeding/swallowing alternatives. For example, they may think that you are “giving up” as a professional by recommending a feeding tube.
Would the type of Medicare your patient has influence your possible intervention options?
Yes: Medicare plans differ in terms of services covered. Not all patients will be able to pay for services out of pocket if their medicare plan does not cover it, therefore this could affect intervention options.
Does Medicare pay for all a patient’s medical bills?
NO: Medicare generally pays for 80% of billed services covered under the patient’s plan.
Make a prediction- Will Medicare be the same 10 years from now? Explain your answer.
No: Medicare will continue to change for a variety of reasons. Medicare policymakers will continue shifting in oder to bring down costs while maintaining quality care. It will continue to change as technology advances. Furthermore, the economy will change leading to the probability that Medicare will adapt accordingly.
Aging
Getting older, comes with normal age-related changes
Ex. Decreasing communication, decreasing swallowing abilities, decreased body system regulations
Dying
Typically seen as the last 5 years of someone’s life and the decline that comes with someone’s body shutting down
Ex.
Disease
Symptoms that are considered abnormal in terms of aging alone; caused by a patient’s health condition/disease/infection/etc.
Ex. Dysphonia in a Parkinson’s patient
Respond to the following statement from an SLP “Insurance/Medicare/Medicare are such a pain; I went to school to help people not fill out meaningless paperwork”
While the paperwork that comes with our profession may be overwhelming, it is a big aspect of our job. Insurance services are a big reason why we can help our clients. Without insurance, less individuals will be able to partake in therapy services due to the cost. Accurate paperwork can also contribute to the data that helps improve and enforce future policy changes in our career.
Additionally, inaccurate paperwork can lead to major discrepancies that affect how we get paid OR could even lead to us getting sued.
I am required to take this class because it provides essential knowledge and skills that are crucial for my development as a speech-language pathologist (SLP). The course covers a broad range of topics that can be used for a professional lifetime.
Understanding the concepts outlined in this class are important for me to thrive within this field, as they align with the American Speech-Language-Hearing Association’s (ASHA) Scope of Practice and Code of Ethics. The student learning outcomes of this class will prepare me to work effectively in various professional settings by equipping me to navigate the complexities of interdisciplinary teams, address diverse client needs, and engage in professional activity. For example, learning to analyze diversity issues and understanding the roles of various professionals in healthcare will enhance my ability to collaborate and advocate for my clients. Additionally, the emphasis on ethical practices and the prevention of violations will help me protect my professional reputation throughout my career.
Overall, this class is not only a requirement but also an invaluable opportunity to gain foundational knowledge and resources that will support my professional journey in speech-language pathology.
