Standards of practice Flashcards
COTA roles: initiation of treatment
- A COTA is not permitted to initiate assessment of a client. Allowing client to be seen by COTA without OTR assessment is an ethics violation and liability risk.
- A COTA can select and implement therapeutic activities that meet the goals set by OTR
COTA roles: evaluation
- A COTA may contribute to the evaluation process by performing delegated assessments (cannot select assessments) and delivering reports and observations and client capacities to the OTR.
- The OTR can then analyze feedback from COTA and incorporate it into evaluation process.
COTA and evaluation documentation
OTR must document evaluation results and not the COTA.
-However, COTA must be able to understand the evaluation results and be able to offer client-centered input into the evaluation plan
COTA and discharge
COTA does not determine when services should be discontinued, that should ultimately be the OTR.
-COTA may measure outcomes and offer clients discharge resources and is able to contribute information to a discontinuation plan
Domain (OTPF)
Domain describes the occupation areas where OT process is applied.
-includes context, environment, performance skills, and performance patterns (habits, routines, rituals and roles).
Process (OTPF)
Evaluation and intervention to achieve client centered outcomes.
Steps of developing a professional development plan:
- Self-assessment/ reflect on current performance
- Review progress towards previously set goals
- Determine what resources exist to meet goals
- Modify previous goals and set new goals
- Take action to meet goals
- Document completed professional development activities
Parts of Medicare
- Part A: covers stays at hospitals and inpatient rehabilitation facilities
- Part B: Covers outpatient care
- Part C: includes extra benefits not included in A and B
- Part D: prescription drug benefits
SOAP notes
- S: Subjective; gives clients perspective on condition, treatment, or experience (“Client reports that ____”)
- O: Objective; measurable data obtained during treatment session
- A: Assessment; interpretation of subjective and objective data from session (includes 3 P’s- problem, progress and potential)
- P: Plan; frequency and duration of continued treatment
COAST goal
- C: Client
- O: Occupation (e.g. cutting meat); should contain specific and measurable information that relates to problems statement
- A: Assistance level (e.g. independently)
- S: Specific conditions (e.g. using a rocker knife or an inner-lip plate)
- T: Timeline (e.g. one week)
RUMBA goal
Reasonable, Understandable, Measurable, Behavioral, Achievable
Ethics in practice (Beneficence, nonmaleficence and Autonomy)
- Beneficence: “OT personnel shall demonstrate a concern for the well-being and safety of the recipients of their service
- Nonmaleficence: “OT personnel shall intentionally refrain from actions that cause harm.”
- ->Example: a OTR dating a patient or treating a family member would cause the patient-therapist relationship to be compromised and therefore potentially put client in harms way
- Autonomy: “OT personnel shall respect the right of the individual to self-determination.”
Ethics in practice (Social justice, procedural justice, veracity and fidelity)
- Social justice: “OT personnel shall provide services in a fair and equitable manner.”
- Procedural justice: “OT personnel shall comply with institutional rules, laws and AOTA standards applicable to profession.”
- Veracity: “OT personnel shall provide comprehensive, accurate, and objective information when representing the profession.”
- Fidelity: “OT personnel shall treat colleagues and other professionals with respect, fairness, discretion, and integrity.”
Purpose of screening before evaluation
Screening determines whether a client would benefit from an occupational therapy evaluation
TRICARE
TRICARE provides health coverage for the military
CPT Codes
CPT codes are used to denote procedures and services completed in the outpatient setting
OT Approach: Create and promote
Doesn't assume disability, instead serves to enhance performance in all persons in a community -Example: Providing a fall prevention class to older adults in senior center to encourage safety
OT Approach: Establish and restore
Expect change, either by developing skills or restoring skills/ability
-example: work with client to establish morning routines needed to arrive at work on time
OT Approach: Maintain
Keeps skills consistent; preserves performance
-Increasing lighting in home hallway to maintain safety for low vision client
OT Approach: Modify, adapt/compensate
Revise the context or activity demands to support performance in natural setting
-Modify the clutter in a room to decrease a clients distractibility
OT Approach: Prevent
Addresses those at risk for occupational performance problems either with or without disabilities
-Prevent social isolation of employees by promoting after-work activities
Reliability vs. Validity
- Reliability indicates how well an assessment produces consistent scores over time and across raters
- Validity: indicates the degree to which an assessment measures what it states it measures
Resident Assessment Instrument
Part of the Minimum Data Set required by Medicare regulations for skilled nursing facilities
Levels of evidence
Level I, systematic reviews, meta-analyses, and randomized controlled trials; Level II, two-group, nonrandomized studies (cohort, case controls); Level III, one-group, nonrandomized studies (pretest–posttest designs); Level IV, descriptive studies that analyze outcomes (single-subject and case designs); and Level V, case reports and narrative literature reviews.
-Only evidence at Level I and Level II can make claims about efficacy
