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Boardz > Professional Responsibilities > Flashcards

Professional Responsibilities Flashcards

1
Q

Elder Justice Act

A

Addresses/prevents abuse (physical, emotional, sexual, financial, neglect, abandonment)

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2
Q

Types of financial abuse

A

Financial neglect
Financial exploitation
Healthcare fraud

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3
Q

Financial neglect

A

Ignoring person’s financial responsibilities i.e mortgage insurance bills

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4
Q

Financial exploitation

A

Misuse/mismanagement of property/assets under false pretenses, w.o consent, with intimidation

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5
Q

Signs of abuse

A

Withdrawn, agitation, trauma response (rocking back and forth), scars, cuts, marks, preventable conditions (uti, dehydration, pressure ulcers), living conditions, financial loss, matting of hair or poor dental hygiene

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6
Q

Investigative Agencies

A

APS
Long term Care Ombudsment: advocates needs of residents in AL/LTC
National Center of Elder Abuse: how to report abuse, where to get help, state laws

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7
Q

Long term effects of Abuse

A

Early death
Decreased social/family ties
Financial loss
Depression

Tx small group and counseling

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8
Q

5 sections of ADA

A

Employment
State and local governments
Public transportation
Businesses open to public
Telecommunications

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9
Q

ADA Employment

A

Applies to companies with 15+ employees, equal opportunity to benefit from employment opportunities

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10
Q

ADA state and local governments

A

Education, transportation, recreation, healthcare, social services, courts, voting, emergency services, town meetings

Focuses on equality and integration

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11
Q

ADA exceptions to integration

A

Different treatment needed for person to participate
If it fundamentally alters nature of activity

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12
Q

ADA Business open to public

A

Built environment: weighs accessibility vs financial restraints
Readily achievable barrier removal = easily accomplished without difficulty or expense

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13
Q

Resident Rights

A
  1. Treatment with respect/dignity (make own schedule)
  2. Participate in activities
  3. Free of discrimination
  4. Free of abuse/neglect
  5. Free from restraints (side rails, chemical for staff convenience)
  6. Make conplaints
  7. Proper medical: informed in language you understand
  8. Participate in decisions
  9. Access your record or your legal guardian access records
  10. Make complaints about tx
  11. Representatives notified of changes accidents or transfers
  12. Info on services/fees
  13. Manage your money
  14. Privacy and proper living arrangements
  15. Spend time with visitors
  16. Access to social services: counseling, problem solving, d/c planning
  17. To leave or move out
  18. Unfair d/c’s: cannot make you leave when you are waiting for medicaid, need 30 days notice of plan and reason of transfers
  19. Participate in groups
  20. Have family/friends involved
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14
Q

Exceptions to d/c

A

D/c for health and safety of person or others
Health improved
Nursing home hasnt been paid
Nursing home closes

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15
Q

AOTA Code of Ethics: Core Values

A

Altruism, equality, freedom, justice, dignity, truth, prudence

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16
Q

AOTA Code of Ethics: Principles

A
  1. Beneficence: concern for well-being
  2. Non-maleficence: do bo harm
  3. Autonomy
  4. Justice
  5. Veracity: objective accurate info when representing profession
  6. Principle/fidelity: respect, integrity, fairness, discretion
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17
Q

PDPM

A

Patient driven payment model: determined by pt characteristics rather than minutes

Payment=primary reason for admission (dx) + MDS assessment (section GG)

25% limit for group/concurrent per discipline, clinician judgement for mode of intervention

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18
Q

Concurrent treatment

A

See 2 pt’s together, interventions different for each client, not used for novel intervention, but for mastering skill

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19
Q

Group treatment

A

Skilled and medically necessary, intervention should be the same or similar

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20
Q

PDGM

A

Patient driven group model (2020), pt characteristic determine payment vs # of tx

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21
Q

PDGM Groups

A

12, based on dx, clinical characteristics, admission source, episode timing, functional impairment determined by OASIS (outcome and assessment information set) M1800s, comorbidity adjustment

Document ICD of comorbidity you are treatinf

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22
Q

OASIS

A

Cannot be initiated by OT, outcome and assessment information set, OT can contribute within 5 days of completing, OT educate other disciplines on assessing self-care

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23
Q

M1800S. Of OASIS

A

Grooming, UBD, LBD, bathing, toileting t/f,, t/f, ambulation/locomotion, risk of rehospitalization

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24
Q

Medicare Home Health Flexibility Act

A

Not signed yet but would allow OTs to start OASIS on therapy only cases

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25
Q

Civil Money Penalty

A

Grants available to skilled nursing home for training, tech to increase quality of care, finances through fine due to noncompliance with govt reg

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26
Q

Letter of medical necessity

A

Advocacy to determine approval or reimbursement of a service-/ Equipment

Clof, limiting factors, why equipment/services is needed, risk if not provides and resources that support its needed

27
Q

Documentation Audits

A

CMS: MAC medicare administrative contractors
Supplemental medical review, comprehensive error rating test, unified program integrity contractors (fraud base)

HMO humana UHC anthem, medicare advantage

28
Q

Common reasons for deni

A

No or late response
Missing technical components
Duplication of services
Excessive services
Documentation did not support medically nevessity

29
Q

Prior authorization denials: medical necessity

A

Lack info, overlapping authorizations, excessive frequency/durations, lack of overall function, lack of documented skilled interventions

30
Q

Commercial payor denials

A

Specific intervention code not allowed

31
Q

Medicaid

A

State rub or through state run managed care

May reimburse in bundle or fee for service
Need standardized test or detailed clinical observation

32
Q

OT goals

A

Functional measurable and linked to deficits or delay

33
Q

COAST

A

Client
Occupation goal relates to
Assist level
Specific condition
Timeline

34
Q

SMART

A

Specific, measurable, achievable, realistic, timely

35
Q

Progress notes

A

Formal/informal analysis of client’s response to treatment, address barriers and what can be done differently to account for barriers, update standardized testing, client/caregiver education, carryover of training

36
Q

Intraprofessional collaboration

A

Collaboration within discipline, OTA:OT

37
Q

Amount of collaboration of OT/OTA

A

Varies based on:
Client complexity
Knowledge/skills
Requirements of practice settings
Service delivery model
Payor requirement, cms requires collaboration at certain frequency

38
Q

Type of supervision

A

Direct face to face
Indirect: via phone, virtual interaction

39
Q

Occupational therapy aide

A

Delegated by ask by OT/OTA
Clerical work
Client related work: trained/competent, instructed specifically to carry out task, knows precautions/signs/symptoms, not billable functions

Need to document supervision

40
Q

Technical details to approve documentation

A

POC signed by MD in 30 days
10th supervisory note by therapist timely/completed fully

41
Q

OT skilled nursing facility evaluation checklist and quality measure

A

Guides evaluations and quality measures

42
Q

Strategies to reduce ageism

A

1) policy and law: lobby for policies within practice area
2) education: educate others to raise awareness (role playing, simulations, exercises to promote engagement, compassion, and empathy)
3)intergenerational intervention: opportunities with OT to collaborate with younger family members and integrate into activities

43
Q

Cultural competence

A

Gaining sufficient knowledge about each culture to act w/in norms

44
Q

Cultural humility

A

Shift from cultural competence
Lifelong learning and self-reflection when working/collaborating from different backgrounds, how do my biases (implicit) affect my practice, flexible, recognize role of power in healthcare

45
Q

Ways to practice cultural humility

A

1) recognize no culture is better than another
2) engage in self-reflection
3) be honest when you’re not sure
4) learn about other cultures

46
Q

Cultural competence vs cultural humility

A

Cultural humility consistent learning, recognizing gaps in knowledge without shame w. Deeper engagement vs cultural competence is knowing about culture focuses on differences

Cultural humility creates expectations for differentiation b/n and within cultures vs cultural competence emphasizes personal culture and how it differs from others (does not address implicit bias)

Cultural humility recognizes power dynamic vs cultural competence is silent on. Power issue

47
Q

4 Ms of age friendly healthcare

A

1) what MATTERs to pt
2) MEDICATION: deprescribe, review high risk med use, do not interfere with other Ms
3)MENTATION: monitor mental and cog well-being, document concerns, address change. Tx and prevent ID—dementia, depression, delirium
4) MOBILITY: ensure earl/safe mobility, create safe home environment for mobility, identify safe mobility goal

48
Q

Strategies to promote age friendly care

A

Client centered care

Communicate: consider communication needs, avoid assumptions regarding decisions

Written material: in preferred language and literacy level, watch for visual deficit, avoid jargon

Asses cog: reorient

AT/AE: dentures, hearing aids, AD, glasses

Asses mobility during meaningful times asks ie environmental distractors

Cultivate inclusion: needs vs. barriers, model inclusive practice

49
Q

5 steps to EBP

A

1) ID a question or need
2) search for evidence
3) appraise and synthesize evidence
4) apply evidence
5) evaluate

50
Q

Limitations to apply EBP

A

Intervention may be effective, but unable to use in practice due to things like needing special certification, intervention not aligned with what matters to pt, resources

51
Q

MOHO

A

Volition=motivation

Habituation=organizing occupations into patterns, routines

Performance capacity=physical/mental abilities

Factors in physical/social environment

Motivation, habits, and abilities can shift which alters throughput

52
Q

MOHO: organized

A

Adjust throughput in accordance with environmental factors for continued occupation

53
Q

MOHO: disorganized

A

Incongruence with volition, habituation, and performance capacity

54
Q

KAWA Model

A

Culturally sensitive uses river metaphor to symbolize one’s life, based on clients POV

55
Q

KAWA components

A

1)river = life’s flow
2) banks/rivers = physical/social environment
3)Rocks = problems
4) driftwood = +/- personal attributes and resources

Decrease rocks and focus on positive supports/personal attributes = water flowing = well being

56
Q

QUAPI

A

Quality Assurance and Performance Improvement

5 elements
1) design/scope
2)governance and leadership
3) feedback, data systems, and monitoring
4) performance improvement project
5) systemic analysis and systemic action

57
Q

QUAPI: design/scope

A

First step
Ongoing and comprehensive, full range of services and all systems of care

58
Q

QUAPI: governance and leadership

A

2 element: seek input from staff, residents, and family, governing body assures adequate resources to conduct QUAPI, staff account

59
Q

QUAPI: feedback, data systems, and montioring

A

Put’s systems in place to monitor care and services, feedback systems such as performance indicators

60
Q

QUAPI: Performance Improvement Projects

A

4th element
Concentrated effort on a particular problem problem in one area of the facility or facility wide

61
Q

QUAPI: systemic analysis and action

A

5th element
In depth analysis to fully understand problems, its cause and change, continual learning and improvement

62
Q

PDSA

A

Guides changes after Identifying need
Plan = objective measurable goal
Do = plan in motion, data collected throughout process
study = analyze/summarize data
Act = what next? Shift focus if goal achieved, if not why didnt the goal get achieved

63
Q

Screens

A

Document referral source and reason for OT screen

Client information: hx, experience, performance, health status, developmental dx, precautions, contrindications

Brief occupational profile: why seeking out, areas of occupation with success and challenge

Assessment (interviews, record reviews, observations)

Recommendations: professional judgments regarding need for complete OT eval

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