Professionalism Flashcards
Develop professional relationships/Maintain professional competency
Professional Code of Ethics
PRINCIPLE 1: BENEFICENCE
PRINCIPLE 2: NON-MALEFICENCE
PRINCIPLE 3: AUTONOMY
PRINCIPLE 4: JUSTICE
PRINCIPLE 5: FIDELITY
PRINCIPLE 6: VERACITY
PRINCIPLE 7: INFORMED CONSENT
PRINCIPLE 8: CONFIDENTIALITY & PRIVACY
PRINCIPLE 9: COMPETENCE
PRINCIPLE 10: COMPLIANCE WITH LAWS AND REGULATIONS
1.Beneficence
Recreational Therapy personnel shall treat persons served in an ethical manner by actively making efforts to provide for their well-being by maximizing possible benefits and relieving, lessening, or minimizing possible harm
- Non-maleficence
Recreational Therapy personnel have an obligation to use their knowledge, skills, abilities, and judgment to help persons while respecting their decisions and protecting them from harm
- Autonomy
Recreational Therapy personnel have a duty to preserve and protect the right of each individual to make his/her own choices. Each individual is to be given the opportunity to determine his/her own course of action in accordance with a plan freely chosen. In the case of individuals who are unable to exercise autonomy with regard to their care, recreational therapy personnel have the duty to respect the decisions of their qualified legal representative
- Justice
Recreational Therapy personnel are responsible for ensuring that individuals are served fairly and that there is equity in the distribution of services. Individuals should receive services without regard to race, color, creed, gender, sexual orientation, age, disease/disability, social and financial status.
- Fidelity
Recreational Therapy personnel have an obligation, first and foremost, to be loyal, faithful, and meet commitments made to persons receiving services. In addition, Recreational Therapy personnel have a secondary obligation to colleagues, agencies, and the profession.
- Veracity
Recreational Therapy personnel shall be truthful and honest. Deception, by being dishonest or omitting what is true, should always be avoided.
- Informed Consent
Recreational Therapy personnel should provide services characterized by mutual respect and shared decision making. These personnel are responsible for providing each individual receiving service with information regarding the services, benefits, outcomes, length of treatment, expected activities, risk and limitations, including the professional’s training and credentials. Informed consent is obtained when information needed to make a reasoned decision is provided by the professional to competent persons seeking services who then decide whether or not to accept the treatment.
- Confidentiality and Privacy
Recreational Therapy personnel have a duty to disclose all relevant information to persons seeking services: they also have a corresponding duty not to disclose private information to third parties. If a situation arises that requires disclosure of confidential information about an individual (ie: to protect the individual’s welfare or the interest of others) the professional has the responsibility to inform the individual served of the circumstances.
- Competence
Recreational Therapy personnel have the responsibility to maintain and improve their knowledge related to the profession and demonstrate current, competent practice to persons served. In addition, personnel have an obligation to maintain their credential
- Compliance with laws and regulations
Recreational Therapy personnel are responsible for complying with local, state and federal laws, regulations and ATRA policies governing the profession of Recreational Therapy.
Purpose of Code of Ethics
A guide for promoting and maintaining the highest standards of ethical behavior. The Code applies to all Recreational Therapy personnel. Acceptance of membership in the American Therapeutic Recreation Association commits a member to adherence to these principles.
Licensure
Most restrictive form of credentialing. It requires a governmental agency to enact legislation that defines professional practice.
Which states require licensure for RT?
NH, NJ, NC, OK, UT
Certification
Accepted form of credentialing in RT. (NCTRC is responsible for development and implementation of certification standards)
What are the two paths to NCTRC certification?
Academic path: 1.Completion of Bachelor degree or higher with concentration in recreational therapy (therapeutic recreation) in addition to specific support coursework
2.Completion of a minimum 14 week / 560 hour internship supervised by a CTRS
3.Pass the NCTRC Certification Exam
Equivalency path:
1.Completion of Bachelor degree or higher
2.Completion of specific coursework in recreational therapy (therapeutic recreation) and related areas
3.Paid work experience that uses the therapeutic recreation process
4.Successful completion of the NCTRC Certification Exam
CTRS Annual Maintenance
After successfully completing the exam, the person is considered a CTRS and may use those initials on his/her name.
Annual renewal and recertification are two important processes a CTRS must be aware of.
Professional Organizations
The American Therapeutic Recreation Association (ATRA)- is the only national membership organization representing the interests and needs of therapeutic recreation specialists.
COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES (CARF)- an independent, nonprofit organization focused on advancing the quality of services you use to meet your needs for the best possible outcomes. Provides accreditation services worldwide at the request of health and human service providers.
JOINT COMMISSION (JC)
An independent, not-for-profit organization, The Joint Commission accredits and certifies nearly 21,000 health care organizations and programs in the United States. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards
CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS)
The Centers for Medicare & Medicaid Services, CMS, is part of the Department of Health and Human Services (HHS). They administer including: Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the Health Insurance Marketplace.
How long is the recertification cycle for a CTRS?
5 yrs
Annual maintenance application and fee process for a CTRS
Every year of the five year certification cycle, the CTRS must submit the annual maintenance and application fee. On the 5th year of certification cycle, the maintenance fee must be submitted as part of the recertification application.
What are the two options of recertification for a CTRS?
Option 1:
Professional experience and continuing education in Therapeutic Recreation.
-Minimum of 480 hrs of professional experience
-Minimum of 50 hrs of continuing education
Option 2:
Reexamination: Retaking and passing the national exam.
Specilization Area Designation for CTRS
Through CRTS is specialization area designation, certificates are offered the opportunity to be recognized for their advanced knowledge and advanced skills in a specialized area of practice. Recreational therapy professionals who acquire a higher level of education, knowledge and advanced skills in specific areas of specialization stand out among their peers. The specialization area would be noted under current certification to indicate experience and focus continuing education in the area. This process is available as an added option for those certificants submitting their recertification application.
Specilization areas of CTRS
Adaptive sports and recreation, behavioral health, community inclusion services, developmental disabilities, geriatrics, pediatrics, and physical medicine/rehabilitation.
Designation is valid for 5yrs and the criteria to receive designation is found on the NCTRC website.
What is NCTRC?
The National Council for Therapeutic Recreation Certification (NCTRC) is the premier credentialing organization for the field of recreational therapy. NCTRC sets standards for certification, including education, experience and continuing professional development.
https://www.nctrc.org/
What is ATRA?
The American Therapeutic Recreation Association (ATRA) is the only national membership organization representing the interests and needs of therapeutic recreation specialists, also known as recreational therapists.
www.atra-online.org
Legislation and regulations pertaining to RT/TR
Affordable Care Act
Americans with Disabilities Act
Section 504: Rehabilitation Act
Individuals with Disabilities Education Act(IDEA) Architectural Barriers Act (1968)
Apply concepts of cultural competence/intelligence
Implicit Bias- Bias that exists where rather than being neutral, we have a preference for or aversion to a person or group of people.
Cultural Differences- various beliefs, behaviors, languages, practices and expressions considered unique to members of a specific ethnicity, race or national origin.
Diversity- the practice or quality of including or involving people from a range of different social and ethnic backgrounds and of different genders.
Inclusion- the practice or policy of providing equal access to opportunities and resources for people who might otherwise be excluded or marginalized such as those who have physical or intellectual disabilities and members of other minority groups.
Dimensions of diversity
- race and ethnicity
- physical impairments and qualities
- sexual orientation
- gender
- age
Cultural Competency
A CTRS must be able to “work effectively with cultures other than their own by using a set of behaviors, attitudes, and policies that are congruent with that culture” (Anderson & Heyne, 2012).
CEUs (Continuing Education Units)
-Taking course for academic credit
-Attending TR continuing education programs at conferences/workshops
-Writing publications
-Making presentations at seminars and conferences or presenting guest lectures in courses
-Making poster presentations
Advocacy as a CTRS
-Clients/patients recreation services, reintegration to the community, specific needs in treatment meetings
-Advocacy for the profession
HIPAA
Health Insurance Portability and Accountability Act: health care personnel cannot release patient information unless given permission by the patient. The act went into effect into effect in 2001.
Normalization
Individuals with disabilities should have the same opportunities to recreation and leisure service that anyone without a disability in the community possess.
Collaboration with interdisciplinary teams
Evidence-Based Practice (EBP)
Evidence-Based Practice (EBP) is a clinical decision-making tool to help practitioners in making well-informed decisions about the care and treatment given to their patients or clients.
Marketing in RT
Defined- About influencing behaviors of the agency’s target group
Two types of marketing: Internal and External
Internal: Selling staff members on the organization, focuses on employee buy in ( internal marketing is the foundation for external marketing)
External: Aimed at external publics outside of the organization designed to market themselves to target groups (government agencies and general public)
Internal marketing
when a company “sells” itself to one of its largest groups of stakeholders — the employees.
External marketing
the action or business of promoting and selling services or products, including market research and advertising to clients and potential clients.
Four P’s of External Marketing
Products- RT services provided
Price- Cost of RT services
Place-setting where services were provided (hospitals, clinics, schools, and home health care)
Promotion- the services, benefits, price and setting of services are communicated (advertising, public relations, and personal selling)
When is the international therapeutic recreation month?
February
Marketing in RT
-Responsibility of all recreational therapists to promote profession
- When designing volunteering programs (attracting and retaining volunteers who assist with the RT programs).
Affordable Care Act (ACA)
Federal legislation passed in 2010 that includes a number of provisions designed to increase access to healthcare, improve the quality of healthcare, and explore new models of delivering and paying for healthcare. Making it illegal for insurance companies to deny coverage due to pre-existing conditions.
Americans with Disabilities Act (ADA)
Created in 1990
-Civil rights for people with disabilities, with reasonable accommodations in public places
-defines disabilities, ADVOCACY
-Title 1: Employment
-Title 2: Public Services (Government services and public transportation)
-Title 3: Public accommodations and services operated by private entities
-Title 4: telecommunications
-Title 5: miscellaneous provisions
Individuals with Disabilities Education Act(IDEA)
Created in 1975 under the name of Education for All Handicapped Children Act is a law that makes available a free appropriate public education to eligible children with disabilities throughout the nation and ensures special education and related services to those children.
Section 504: Rehabilitation Act
Created in 1973, it is a federal law that protects the civil rights of individuals with disabilities. Individuals should not be discriminated against solely by reason of handicap. This law is closely intertwined with IDEA. Children with disabilities who are not eligible for special education may qualify for accommodations under Section 504.
PL 90-480 - Architectural Barriers Act (1968)
Any building built with any federal money had to be accessible to people with physical disabilities.
How do RTs stay informed on current research?
-Scholarly publications (American Journal of Recreation Therapy, Therapeutic Recreation Journal, Annual in Therapeutic Recreation)
-Textbooks
-Research presentations and conferences (ATRA, CTRA)
Theory Based Programming
Theories of intervention that are important in program development. (i.e. self-efficacy, perceived freedom, stress coping)
Educate internal/external stakeholders of scope of RT/TR practice
- Interactive Workshops and Presentations
- Collaborative Case Studies
- Offer opportunities for allied professionals to take part in continued education workshops or training sessions focused on recreational therapy
- Share Success Stories
- Create an open dialogue for discussions and feedback sessions where allied professionals can voice their questions, concerns, and insights about recreational therapy..
Care Plan
A systematic assessment and identification of a resident’s problems and strengths, the setting of goals, the establishment of interventions for accomplishing these goals.
https://www.cms.gov
Importance of Care Plans
-Document strengths, problems, and needs
Set guidelines for care delivery
-Establish resident goals
Identify needs for services by other departments
-Promote an interdisciplinary approach to care and assign responsibilities
-Provide measurable outcomes that can be used to monitor progress
-Meet federal and state requirements
-Meet professional standards of practice
-Enhance the resident’s quality of life and promote optimal level of functioning
Internal/ external stakeholders
Internal: consist of service workers, interdisciplinary team, administration and the board of directors.
External: people or groups in the organization’s external environment that are affected by it like families, third party payers, insurance policies
Additional ways to become an advocate in RT
Join a professional organization
Network
Define your philosophy
Identify your issues and concerns
Articulate your positions
Make contacts with your legislators
Gather resources and information about RT, benefits, outcomes
Gain support of others
VOTE
Practice RT, using EBP
ATRA Standards of Practice
A guide for safe and effective recreational
therapy practice consistent with the ATRA definition of recreational therapy in the various settings where recreational therapy is practiced.
STANDARD 1: ASSESSMENT
The recreational therapist receives and responds, consistent with standards, regulatory requirements and policies for the setting, to requests, including referrals and physician orders, for assessment and treatment; and conducts an individualized assessment to collect systematic, comprehensive and accurate data necessary to determine a course of action and subsequent individualized treatment plan
STANDARD 2: TREATMENT PLANNING.
The recreational therapist plans and develops an individualized treatment plan that identifies goals and evidence-based treatment intervention strategies. The recreational therapy assistant, commensurate with qualifications, assessed competency and defined clinical supervision, helps the recreational therapist to plan and develop the individualized treatment plan.
STANDARD 3: PLAN IMPLEMENTATION.
The recreational therapist implements an individualized treatment plan, using evidence-based practice, to restore, remediate or rehabilitate functional abilities in order to improve and maintain independence and quality of life as well as to reduce or eliminate activity limitations and restrictions to participation in life situations caused by an illness or disabling condition. Implementation of the treatment plan by the recreational therapist is consistent with the overall or interdisciplinary patient/client treatment program. Under the clinical supervision of the recreational therapist, the recreational therapy assistant leads activities and engages patients/clients, individuals and/or groups, to achieve treatment goals and objectives.
STANDARD 4: RE-ASSESSMENT AND EVALUATION.
The recreational therapist systematically re-assesses, evaluates and compares the patient’s/client’s progress relative to the individualized treatment plan. The treatment plan is revised based upon changes in the interventions, diagnosis and patient/client responses.
STANDARD 5: DISCHARGE/TRANSITION PLANNING.
The recreational therapist develops a discharge plan in collaboration with the patient/client, family, significant others and treatment team members in order to discharge the patient/client or to continue treatment and aftercare, as needed. Under the clinical supervision of the recreational therapist, the recreational therapy assistant assists in the development of the discharge plan.
STANDARD 6: PREVENTION, SAFETY PLANNING AND RISK MANAGEMENT.
The recreational therapist systematically plans to improve patient/client and staff safety by planning for prevention and reduction of risks in order to prevent injury and reduce potential or actual harm. The recreational therapy assistant, commensurate with qualifications, assessed competency and defined clinical supervision, helps the recreational therapist to improve patient/client safety and to plan to improve safety and risk management.
STANDARD 7: ETHICAL CONDUCT.
The recreational therapist and the recreational therapy assistant adhere to the ATRA Code of Ethics in providing patient/client treatment and care that are humane and professional.
STANDARD 8: WRITTEN PLAN OF OPERATION.
Recreational therapy treatment and care is governed by a written plan of operation that is based upon the ATRA Standards for the Practice of Recreational Therapy, state and federal laws and regulations, requirements of regulatory and accrediting agencies, payers and employer’s policies and procedures as appropriate.
STANDARD 9: STAFF QUALIFICATIONS AND COMPETENCY ASSESSMENT.
Recreational therapy staff meet the defined qualifications, demonstrate competency, maintain appropriate credentials and have opportunities for competency development.
STANDARD 10: QUALITY IMPROVEMENT.
There exist objective and systematic processes for continuously improving patient/client safety and for identifying opportunities to improve recreational therapy treatment and care and patient/client outcomes.
STANDARD 11: RESOURCE MANAGEMENT
Recreational therapy treatment and care are provided in an effective and efficient manner that reflects the reasonable and appropriate use of resources.
STANDARD 12: PROGRAM EVALUATION AND RESEARCH
Recreational therapy staff engages in routine, systematic program evaluation and research for the purpose of determining the appropriateness and effectiveness of recreational therapy treatment and care provided.
