OT Process, Ethics, Professional Standards & Responsibilities, Standars of Practice (CHs 3-4) Flashcards
The comprehensive process of obtaining and interpreting the data necessary to understand the individual, system, or situation. Includes occupational profile
Evaluation
Always same assessment content, administration, and scoring. Has established norms and validity. Has exact wording for direction giving.
Standardization
Combine major features of universal precautions and body substance isolation
Standard Precautions
Alcohol-based hand rubs have poor tolerance against what?
Spores (ex: C Diff), so wash hands using soap and water instead
Refers to transmission of infectious diseases through objects
Fomite transmission
3 categories of transmission-based precautions
Contact, droplet, airborne
Precautions employed if transmission can occur through direct client contact or through items in environment.
Contact Precautions
What are the contact precautions?
Isolation room, gloves, wash hands after, gown if clothes will have contact with client, use single-use equipment
Examples of diagnoses requiring contact precautions
MRSA, diarrhea, open wound
Precautions employed if transmission can occur through large particle droplets that can be generated by client during sneezing, coughing, talking
Droplet Precautions
Examples of droplet precautions
Mumps, rubella, pertusis, influenza
What are the droplet precautions?
Isolation room, respiratory protection (mask), gown and gloves advised
Precautions employed if client is known to suspected to be infected with serious illness transmitted by airborne droplet nuclei (small particle residue) that remain in air and can be widely dispersed by air
Airborne Precautions
Examples of diagnoses requiring airborne precautions
TB, measles, chickenpox
What are the airborne precautions?
Respiratory isolation room, respiratory protection (mask), gown and gloved advised
Does the tool measure what it was intended to measure?
Validity
3 types of validity
Face, content, criterion (concurrent, predictive)
Degree to which a procedure/assessment appears effective in terms of its stated aims. How well does the assessment appear to meet the stated purpose?
Face validity
Does the content in the evaluation represent the content that can be measured?
Content validity
Compares assessment tool to one that has already has established validity
Criterion validity
2 types of criterion validity
Concurrent and predictive validity
Compares the results of 2 instruments given at about the same time
Concurrent validity
Compares the degree to which an instrument can predict performance on a future criterion
Predictive validity
Establishes the consistency and stability of an evaluation
Reliability
Establishes same results will be obtained when given twice by the same administer
Test-retest reliability
Evaluation tool that attains client’s goals for intervention and measures to what degree goals are met and intervention outcomes after a specific time period. Uses interviews and rating scales during initial sessions to facilitate client’s participation in goal setting process by identifying intervention outcomes that are personally relevant.
Goal Attainment Scaling (GAS)
The reduction of the incidence or occurrence of a disease or disorder within a population that is currently well or considered to be potentially at risk. Goal is to promote wellness and maintain health.
Primary prevention
Early detection of problems in a population at risk to reduce the duration of a disorder/disease and/or minimize its effects through early detection/diagnosis, early appropriate referral, and early/effective intervention.
Secondary prevention
The elimination or reduction of the impact of dysfunction on an individual
Tertiary prevention
Goal directed tasks and behaviors that make up occupations. Doing processes that are directed toward a desired and intended outcome and require energy and thought to engage in an complete
Purposeful activity
Unconscious response to an individual that is similar to the way one has responded to a significant person
Transference
Individual responds in a manner that is expects and desired by the person who has a transference toward him/her
Countertransference
7 stages of group development
Origin, orientation, intermediate, conflict, cohesion, maturation, termination
Phase of group development in which the leader composes the group protocol and begins planning for the group
Origin phase
Phase of group development in which members learn what the group is about and make a preliminary commitment to the group
Orientation phase
Phase of group development in which interpersonal bonds and group norms are developed, specialized member roles, clarification of group’s purpose
Intermediate phase
Phase of group development in which members challenge group’s structure, purpose, processes, characterized by dissension and disagreements among members
Conflict phase
Phase of group development in which the group has a clearer sense of purpose after conflict, reaffirmation of group norms and values, increased group stability
Cohesion phase
Phase of group development in which members use skills to be productive and achieve group’s goals
Maturation phase
Phase of group development in which the group ends due to lack of engagement, inability to resolve conflict, administrative skills, goal attainment
Termination phase
Type of leadership in which the therapist is responsible for planning and structuring of what takes place in the group, use when member’s cognitive, social, verbal skills and engagement are limited, give clear verbal instructions and demonstrations
Directive leadership
What is the goal in directive leadership?
Task attainment
Type of leadership in which therapist shares responsibility for group and group process with members, use when members’ skill levels and engagement are moderate, collaboration with members to select group activities
Facilitative leadership
What is the goal of facilitative leadership?
Members acquire skills through experience
Type of leadership in which therapist functions as resource to members, members set agenda and structure, skills and engagement are high
Advisory leadership
Goal of advisory leadership?
Members understand and self-direct process
Relieving of one’s emotions by expressing feelings
Catharsis
Type of group that enables the therapist to evaluate group interaction
Evaluation group
Type of group with goal of skill development, task is a tangible end product, therapist assists clients in acquiring the knowledge, skills, and attitudes needed to perform a specific activity
Thematic group
Type of group in which there is discussion of specific activities that members are engaged in outside of group
Topical group
Type of group in which therapist facilitates self-awareness, insight, reflection, self-exploration through group task
Task-oriented group
Continuum of groups consisting of parallel, project, egocentric-cooperative, cooperative, and mature groups
Developmental group
Type of group that enables members to perform individual tasks in the presence of others
Parallel group
Role of therapist in parallel groups
Direct leader
Type of group used to develop an ability to perform a shared, short-term activity with another member, interaction required
Project group
Role of therapist in project group
Less direct
Type of group that enables members to select and implement a long-range activity which requires group interaction to complete, first level where client chooses task
Egocentric-cooperative group
Role of therapist in egocentric-cooperative group
Role model
Type of group that enables members to engage in a group activity that facilitates the free expression of ideas and feelings, fulfillment of needs is more important than task completion, develop sense of trust, cohesion, belonging
Cooperative group
Role of therapist in cooperative group
Advisor
Type of group that enables members to assume all social, emotional, functional roles and tasks, emotions and task completion are of equal priority
Mature group
Role of therapist in mature group
Peer/group member
Occupational therapy personnel shall demonstrate a concern for the well-being and safety of service
recipients. Examples: appropriate eval/intervention specific to needs, EBP, following scope, steps to ensure proficiency, terminate services when no longer beneficial
Beneficence
Occupational therapy personnel shall intentionally refrain from actions that cause harm, avoid impaired practice, report necessary things, avoid dual relationships and conflicts of interest
Nonmaleficence
Occupational therapy personnel shall respect the right of the individual to self-determination, privacy, confidentiality, and consent. Right to refuse services, HIPAA
Autonomy
Occupational therapy personnel shall promote fairness and objectivity in the provision of OT services. Examples: appropriate supervision, advocacy, respond to request for services in reasonable amount of time, do not accept gifts altering therapeutic relationship
Justice
Occupational therapy personnel shall provide comprehensive, accurate, objective information when representing the profession. Refrain from communicating false, fraudulent, deceptive, misleading information.
Veracity
Occupational therapy personnel shall treat clients, colleagues, and other professionals with respect, fairness, discretion, and integrity
Fidelity
Therapist knows correct action to take, but existing barrier prevents therapist from taking correct action
Ethical distress
2 or more potentially morally correct ways to solve problem
Ethical dilemma
Deliberately hurting a patient physically, mentally, or emotionally
Abuse
Deliberately withholding services that are necessary to maintain an individual’s physical, mental, and emotional health
Neglect
Stages of practitioner misconduct
Reprimand, censure, ineligibility, probation, suspension, revocation
OTAs can expand their role by establishing what?
Service competency
Ability to use the specified intervention in a safe, effective, reliable manner to ensure consistency between OT/OTA
Service competency
Progression of supervision
close, routine, general, minimal
Functions as partially or fully self-employed individual who provides OT services
Entrepreneur
One or more members of a team work independently to evaluation, plan, implement treatment for a client. Limited communication and perspectives on case
Intradisciplinary
A number of professionals from different disciplines conduct assessments and interventions independent from one another with some formal communication
Multidisciplinary
All disciplines relevant to case collaborate for decision making. Eval and intervention done in each discipline but there is great understanding and direction toward a common goal
Interdisciplinary
Characteristics of interdisciplinary teams are maintained and expanded upon. Ongoing communication, shared decision making, evaluations and interventions planned cooperatively, one member may take on multiple responsibilities and role blurring is accepted
Transdisciplinary
Descriptive categories established by CMS that determine the level of payment at a per case rate
Diagnostic related groups (DRGs)
Most common form of managed care, requires enrollees to only see doctors within network and to obtain referrals before seeking specialty care
Health maintenance organization (HMO)
Form of managed care that offers a greater choice of providers, as choices increase percentage of payment decreases, more expensive plan overall
Preferred provider organization (PPO)
Who is eligible for Medicare?
65+, end stage renal disease/permanent kidney failure, long-term disability (ALS, MS) who have received government funded disability benefits for 24 months, retired railroad workers
What does medicare part A pay for?
Inpatient hospital, SNF, home health, rehab facility, hospice
What does medicare part B pay for?
Outpatient services
What must be completed to verify a person’s eligibility for MC home benefits?
OASIS
Does MC cover DME and AE?
Yes DME, no AE
State/federal health insurance for those with low income and/or disability
Medicaid
Identifies the confidentiality requirement of a student’s educational record
Family Educational Rights and Privacy Act (FERPA)
Model that views individual with disability as a person who has physiological insult resulting in reduced functional capacity
Medical Model
Model that views individual with disability as lacking knowledge/skills
Educational model
Model that views individual with disability as lacking skills, resources, and supports for community participation
Community model
Admission for medical/psychiatric diagnosis that cannot be treated on OP basis, initial onset/exacerbation, LOS; 1-7 days, focus on stabilization
Acute care hospital
Admission for medical/psychiatric diagnosis,Admission for medical/psychiatric diagnosis that cannot be treated on OP basis, has progressed from acute stage, LOS: 5-30 days, focus on functional improvements in performance skills and areas of occupation
Sub-acute care, intermediate care facility (ICF)
Admission for chronic or catastrophic illness or disability that require extensive medical care and/or dependency on life support/ventilators, LOS: 25+ days, intervention concerned with palliative care and prevention/treatment of complications
Long-term acute care hospital (LTACH)
Admission for medically stable disability that has residual functional deficits requiring skilled service, LOS: 1 week- months
Rehabilitation hospital
Requires skilled care, illness is stable with no acute symptoms, LOS: 1 month-lifetime, OT eval and intervention guided by MC standards
Skilled nursing facility/extended care facility
System-oriented approach that views limitations and problems as opportunities to increase quality, prevention emphasized, blame attributed to organization improvement needs not individual people
Quality improvement
What are the 5 Ps of marketing?
Product, price, place, promotion, position
Complete involvement of the researcher in the experience of the subjects in order to understand and interpret a phenomenon
Heuristic
The individual’s ability to place the needs of others before their own
Altruism
The desire to promote fairness in interactions with others
Equality
The desires of the client must guide interventions
Freedom
Treating each client respectfully as an individual by enabling the client to engage in occupations that are meaningful regardless of level of disability
Dignity
In all situations, OTS/OTAs/students must provide accurate information in both oral and written form
Truth
Use of clinical and ethical reasoning skills, sound judgement, and reflection to make decisions
Prudence
Difference between IDEA part B and C?
B: ages 3-21, C: ages 0-2
Making false statements or representations of material facts to obtain some benefit or payment for which no entitlement would otherwise exist
Fraud
It is a criminal offense to knowingly and willfully offer, pay, solicit, or receive any remuneration to induce or reward referrals of items or services reimbursable by a federal health care program
Anti-kickback statute
An advisor, helper, facilitator, outsider, change agent, evaluator-diagnostician, clarifier, trainer, planner, advocate
Consultant
