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OT 720- Pediatrics > Pediatric Settings > Flashcards

Pediatric Settings Flashcards

Inpaitent,Outpatient, clinic, etc.

1
Q

Hospital-based settings

Stress/fear, financial burden and distance from home is apart of what type of care?

A

Family and child-centered care

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2
Q

Hospital based settings

What are some accrediting and regulatory agencies within hospital settings?
1. Centers for Medicare and Medicaid Services (CMS)
2. ____
3. Commission on Accreditation of Rehabilitation Facilities (CARF)
4. ____

A

Joint Commission (JCAHO)
&
Occupational Safety and Health Administration (OSHA)

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3
Q

Hospital based Settings

These are ____ for services
* Private insurance
* Medicaid
* CHIP (Childrens Health Insurance Program)
(state specific Programs)
CPT Codes (Current Procedural Terminology)

A

Reimbursments

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4
Q

Inpatient and Outpatient

Acquisition of skill and function or maintaining and imporoving skills is called?

A

Habilitation

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5
Q

Inpatient and Outpatient

Regaining skills and function that have been lost due to illness or injury is called?

A

Rehabilitation

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6
Q

Inpatient and outpatient

In which pediatric settings are we focusing on habilitation vs rehabilitation or both?

A

Habilitational setting: Typically; Early Intervention, School based OT, outpatient peds

Rehabilitation- ICU, SCU, Acute care

Both: Outpaitent

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7
Q

The Team

True/False: Family (including the child), Pediatric Medicine and Rehabilitation Specialist (PM&R), Other MDs, Inpatient Care manager (nurse), and therapy team are all apart of The Team

A

True

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8
Q

Setting Specifics

True/False: Documentation timeframes vary, but reguire documentation within 24-48 hours.

A

True

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9
Q

The OT Process: Specific settings

Acute Care:
* OT Profile- Gathering information (evaluation)
* Analysis of occupation ( Screening vs. assessment)- ____, ____, ____, & ____
* Goal setting- ____, ____ ONLY, often less Occupational based, but have Occupational goals; Family input is a challenge
* Intervention- managing vital signs, lines, team schedules, precautions
* Discharge planning/Targeted Outcomes: Home or Inpatient rehab; sometimes hard to predict.

A

Analysis of occupation- Time factor, space issues, medical and Functional status

Goal Setting- COAST, Short term only

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10
Q

The OT Process:

These other considerations are seen in what setting?

  • Screening/Consultation for equipment needs
  • Team communication
  • Cause of Admission
  • Children with Complex, chronic medical conditions Frequent ICU visits are common
  • Determination of inpatient rehab referral
A

Acute Care

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11
Q

The OT Process:

These other considerations are seen in what setting?

  • Productivity (no-shows, late policies)
  • Communication with other disciplines
  • Family involvement DURING assessment and ongoing sessions
  • Constant assessment & adapting intervention plan between during sessions
  • Discharge issues
A

Outpatient Rehab

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12
Q

The OT Process: Specific settings

These other considerations are seen in what setting?

  • Culture of rehab department can affect the role of OT, goals and timeframe, etc.
  • Usually require supervsision from family or “sitter” ____ hours/day
  • Diagnosis specific considerations (TBI, SCI, multi-trauma; ____ & ____)
  • Context (in room vs. therapy gym)
  • Meetings- daily, weekly, family present or not; formal vs. informal meetings; discharge meetings.
A

Inpatient Rehab

Supervision required 24 hours/day

Diagnosis specific considerations (TBI, SCI, multi-trauma; Precautions and Safety)

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13
Q

The OT Process: Specific Settings

Inpatient Rehab:

  • OT Profile- Gathering information
  • Analysis of Occupation- Usually need to complete and submit ____ within ____ hours.
    ____ (WeeFIM or similar) and ____ (MMT, ROM, pain and focused observation of relevant areas of OT domain)
  • Goal setting- COAST, usually Short-term and long-term goals.
  • Intervention- Scheduling tips/barriers, ____ Carryover between sessions (nurse/family communication)
  • Disharge planning/Targeted Outcomes
A

Analysis of Occupation- Usually need to complete and submit Evaluation within 24 hours

Standardized (WeeFIM or Similar) and non-standarized (MMT, ROM, pain focused observation of relevant areas of OT domain)

Intervention- Scheduling tips/barriers,Medication Management Carryover between session (nurse/family communication)

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14
Q

The OT Process: Specific Settings

Outpatient Rehab:
* Ot Profile- Gathering Information
* Analysis of Occupation- Usually need to complete and submit ____ within ____ to ____ hours (can vary)
* Goal Setting- ____, ____ & ____ goals (Based on expected number of visits). Family should be Intimately involved in GOAL SETTING
* Intervention- Frequency decisions, home programs/Carry-over, Can have intensive outpatient programs (daily,half or full-day)
* Dishcharge planning/targeted outcomes

A

Analysis of Occupation- usually need to complete and submit Evaluation within 24-48 hours

Goal Setting- COAST, Short-term & Long-term goals

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15
Q

The OT process

What are the three Cons to Goal Setting in Inpatient Rehab:

Goal setting- COAST, usually Short-term and long-term goals.
1. Difficulty ____ ____
2. ____ but not replicating other disciplines
3. ____ ____ can be a challenge

A
  1. Difficulty predicting progress
  2. Complementing but not replicating other disciplines goals.
  3. Family input can be a challenge
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16
Q

Specialty Clinics

True/False: Many specialty clinics are not “follow-up clinics” within a hospital organization.

A

False: Many follow-up clinics ARE within a hospital organization

17
Q

This type of care is available and who is on the team varies. The role of OT is not consistent.

A

Specialty clinics or free-standing

18
Q

Specialty Clinics

OT Competencies for success in specialty clinics:
1. Extensive knowledge of the conditions in the clinic.
2. ____
3. Creativity, flexibility, ability to “think quick)
4. ____
5. Therapeutic use of self

A
  • Awareness of resource access across communities
  • Advocacy skills
19
Q

What are some examples of specialty clinics?

A
  1. Seating clinics
  2. Feeding Clinics
  3. Ortho Clinics
20
Q

ALL Hospital-based Settings

  1. Vital Signs
  2. Pain
  3. Self report: Children ____ of age and older can rank their pain using several validated scales:

What are the scales and what does the child?

A
  • children 3 years and older
  • Wong-Baker Faces Scale: 6 cartoon faces (0-10 scale) 0= “no hurt” and 5= “the worst hurt”
  • Visual Analogue scale: 10 cm. line with one end marked as the worst pain. The child is asked to make a mark on the line being measured in cm from the no pain end.
21
Q

ALL Hospital-Based Settings

True/False: Documentation cannot edit once the medical record. (initial eval, re-eval, daily notes, discharge summary, equipment justification, home programs)

Document progress towards goals each session (may not address all goals every session)
Can modify goals in daily notes at any time if they appear unrealistic

A

True

22
Q

ALL Hospital-Based Settings

Goals should be ____ and ____ even when the system is not set up that way.
- EMR: often have pre-populated goal templates
- Bad habits

A
  • Client-centered & Occupation-based
23
Q

ALL Hospital-Based Settings

Why do therapists have frequent review of goals? (2 points)

A
  • Intervention planning
  • Re-assessment
24
Q

Goal Examples: Identify what setting this goal is most suitable in

LTG: John will self-feed at least 80% of a meal with min verbal cues to maintain attention 5/7 days/week within 3 months

STG: John will self-feed for the first 5 minutes of a meal with moderate verbal cues to maintain attention 3x/week within 2 weeks.

A

Outpatient Rehab

25
Q

Goal Examples: Identify what setting this goal is most suitable in

The patient will reach and grasp a washcloth in supported sitting at edge of bed following verbal and physical cues, 2/3 times within 1 week.
LTG- are not often written in ____ due to the expected short length of stay

A

Acute care: ICU

26
Q

Goal Examples: Identify what setting this goal is most suitable in

LTG: In 3 weeks, the client will don and doff an overhead shirt in an unsupported seated position, with supervision for safety 90% of the time.

STG: The client will don an overhead shirt with minimal assistance, while seated in her wheelchair, 2/5x this week.

A

Inpatient Rehab

27
Q

Goal Examples: Identify what setting this goal is most suitable in

Often write recommendations vs. goals

A

Specialty Clinics

28
Q

ALL Hospital-Based Settings: Communication with TEAM

Which setting most fits the points given below:

  • Splint schedule
  • ROM
  • positioning schedule
  • transfer precautions
  • visual concerns
  • ADL schedule
  • feeding precautions
A

Acute/Inpatient

29
Q

ALL Hospital-Based Settings: Communication with TEAM

Which setting most fits the points given below:

  • Initiating and maintaining contact with team
  • home program carry-over
  • dealing with no-shows
A

Outpatient

30
Q

ALL Hospital-Based Settings: Communication with TEAM

Which setting most fits the points given below:

  • Who is following up with what?
  • Does the team communicate before presenting recommendations to family?
  • Who is in the room at the same time?
  • Communicating “next steps”
A

Specialty Clinic

31
Q

ALL Hospital-Based Settings: Communication with TEAM

Which of the following is NOT a focus of communication in an acute/inpatient hospital setting?
A) Splint schedule
B) ROM (Range of Motion)
C) Feeding precautions
D) No-shows

A

D) No-shows

32
Q

ALL Hospital-Based Settings: Communication with TEAM

In an outpatient setting, which of the following is important for team communication?
A) ADL schedule
B) Initiating and maintaining contact with the team
C) Transfer precautions
D) Positioning schedule

A

B) Initiating and maintaining contact with the team

33
Q

ALL Hospital-Based Settings: Communication with TEAM

What is a key consideration in specialty clinic communication?
A) Dealing with no-shows
B) Communicating next steps
C) Feeding precautions
D) Splint schedule

A

B) Communicating next steps

34
Q

ALL Hospital-Based Settings: Communication with TEAM

Which setting involves communication regarding who is following up with what and who is present in the room?
A) Acute/Inpatient
B) Outpatient
C) Specialty Clinic
D) All of the above

A

C) Specialty Clinic

35
Q

ALL Hospital-Based Settings: Communication with TEAM

What is a shared aspect of communication across all hospital-based settings?
A) Visual concerns
B) Communicating next steps
C) Home program carry-over
D) ADL (Activities of Daily Living) schedule

A

B) Communicating next steps

OT 720- Pediatrics (11 decks)

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