quiz 1 Flashcards
understand how the phrase “continuum of care” relates to the field of speech-language pathology
- there is a range of places it is practiced
- there is a shift on the emphasis of various skills and knowledge depending on where med speech pathologists deliver services
- acute care: they must be attuned to rapid changes in communication and swallowing and medical status
- chronic care: strenthen functional communication for patients whoe disease processes are relatively stable (rehabilitative or monitoring)
- palliative & hospice care: faciliate communication, nutrition, or comfort for people at this most vulnerable time
give several examples of different medical settings at which an slp may work
- university medical centers (academic facilities)
- community hostpitals
- outpatient clinics
- subacute care facilities
- rehabilitation settings
- home care
- nursing homes
- hospices
sunchor
know the concept of primary care within the currect medical system in the united states
primary care= the level of a health services system that provides entry into the system for all new needs and problems, provides person-focused (not disease-oriented) care over time, provides care for all but very uncommon or unusual conditions, and coordinates or integrates care, regardless of where the care is delivered and who provides it
- provided by physicians, np’s, or pa’s who serve at the point of entry into the health system
- slp’s don’t provide a pc function in terms of patient management or coordination of care, but it’s essential that they are available to provide key referral guidance and assistance to practitioners who provide this care to
ie make physicians aware of slp’s they can refer to
what are the 3 emerging technological areas in which the practicing slp may need to be proficient
- electronic medical record
- applications for clinical service delivery (apps)
- telehealth/telepractice
electronic medical record
patient records are available to all legitimate users even as they move from one site to another in the health system
- helps eliminate communication erros and reduces need for transmitting info via phone, fax, and mail
ensuring cognitive, communication, and swallowing info is well established in the medical record allow immediate access by all providers
applications for clinical service delivery (apps)
- can be used on highly portable computer technology (phones etc) allowing for extending clinical activities and patient interaction beyond the treatment room
size, adaptability, and user friendliness of augmentative communication tech has increased dramatically
telehealth/telepractice
- patients can be evaluated at a distance from the provider and patients in intensive care setting can be monitored by physicians in a different state
- brings services to people who are not mobile or either physical or transportation reasons (can increase freq of contact without requiring travel)
widespread access to internet, affordability of face to face communication, high quality of video and audio images make it used increasingly often
understand the consultation process under which an slp in an acute healthcare setting works
slp consultations can be requested from many services (otolaryngology and neurology are common ones)
- a written order/consult is needed to evaluate and treat an inpatient in acute care
- in most cases a 24 hr response time is expected
physcians, np’s, or pa’s generate requests, the need for slp can also be identified by other nurses, rehab professionals, or case managers
examine how the timing and urgency of an slp consult may change depending on the type of healthcare setting
it’s important for the assessment to occur after consideration of factors that may improve validity or impact safety
- patient may need to wait to recover from drugs or procedures to be tested
- with an urgent request, the results of a swallowing evaluation may determine the safest route of medication administration
what are possible considerations of caring for a pateint with a complex profile in an acute setting?
- multiple chronic conditions (risk of pneumonia, multiple Mx, reduced ambulation)
- poor mental status (can’t maintain arousal during meals, can’t recall safe swallowing strategies or attend to treatment)
- limited financial means (less rehab options, can’t afford medications)
- limited family/social supports (unsafe living envir., lack of assistance @ home for daily living, can’t drive to outpatient/medical appointments etc)
- advanced age (increased fragility and comorbidities)
- multiple chronic conditions
- poor mental status
- limited financial means
- limited family/social supports
- advanced age
know the nature of writeen documentation in an acute care setting, inparticular the elements of a consult report or “progress note”
subjective
objective
assessment
plan
patient/family education
subjective
(section of progress note)
- patient history
- complaints
- current status/presentation
- reason for consultation or visit
objective
(section of progress note)
- exam parameters
- tests given
- measurements
- diagnostic observation without interpretation
objective clinical data
assessment
(section of progress note)
- diagnosis/current state of the swallowing, communication, or cognitive deficit
- integration of all the objective data with slp interpretation
- changes from previous session
- proposed interventions and patient response
- severity and prognosis
plan
(section of progress note)
- recommendations to the consulting md regarding patient management
- direction respose to the consult question
- plans/rationale for ongoing intervention
- additional referrals recommended
- discharge plan/status and need for slp services
