Week 7: Practice standards 2 Flashcards
Practice standard 7: Infection control
Health care personnel implement measures to prevent the spread, transmission and acquisition of infectious agents or pathogens btwn patients/clients, from healthcare workers to patients/clients and from patients/clients to workers in health care setting
Minimum measures of infection control
- proper hand hygiene
- appropriate work practices
- use of personal protective equipment (PPE) where required
Resources for infection control
- Infection prevention and control Canada (IPAC Canada)
- Public Health Agency of Canada
- Ontario ministry of health and long-term care (MOHLTC)
- Public health Ontario
What is a boundary?
Define and separate your role as a health care provider from other roles in your life such as a family member, friends, neighbour or business partner
Set a clear distinction btwn your personal relationships and your professional relationships
What are professional boundaries dictated by?
- federal and provincial legislation
- college standards
- your employer’s policies
- yourself
Components of the therapeutic client relationship
- respect
- trust
- professional intimacy
- inherent power imbalance
How can health care providers establish and manage a safe connection with their patients/clients?
- Ensure boundaries are based on needs of patient
- Know and adhere to the standards of practice
- Make sure your personal views are secondary to your professional obligations
- Ensure the patient is the focal point of the therapeutic relationship
Who’s responsibility is it to always maintain the boundaries and a safe connection?
The kinesiologists (or any health provider)
**regardless of who is pushing professional boundaries in therapeutic relationship
Social media use by kinesiologists
- communicate online with same level of professionalism, honesty, integrity and respect as face-to-face interactions
- maintain professional boundaries
- within scope of expertise of the kinesiologist (posts shouldn’t undermine public health guidance, or a patients health, treatment or safety)
- maintain patient privacy and confidentiality
Social media use by kinesiologists even in a private capacity
Could still be subject to regulatory action if there is a negative impact on the profession or public
Factors that a regulator will consider when doing a contextual analysis of a registrant’s social media activity
- connection btwn conduct and practice of the profession that demonstrated a negative impact on profession or public interest
- whether the individual identifies themselves as a healthcare provider
- an analysis of the substance of the message
- the extent of the publication and the size and nature of the audience
- whether the posts are a breach of College standards
What would an analysis of the social media message include?
- tone, content, purpose
- whether statements made or true/fair
- does it contribute to public discourse about an issue
- its impact on the reputation of the profession
- does it contain misinfo, offensive language, or does not contribute to public discourse
Professional boundaries and prevention of sexual abuse
Every kinesiologist has a personal responsibility for establishing and maintaining boundaries within the professional relationship
It is the kinesiologist who is responsible for any abuse within the professional relationship not the patient/client
Definition of a spouse
- a person who is the registrant’s spouse as defined in section 1 of the family law act (ie. a person to whom the member is married)
- a person who has lived with the registrant in a conjugal relationship outside of marriage continuously for a period of not less than three years
As an Rkin, can you treat your spouse?
Yes
As a PT, can you treat your spouse?
No
If you were a dual health provider (Rkin and PT) which standard would you adhere to regarding treating your spouse?
Highest practice standard, so in this case PT (cannot treat)
Collaboration
To work together, especially in a joint intellectual effort; the concurrent treatment of a patient/client by a member and another healthcare professional
Concurrent treatment
The circumstance where more than one healthcare professional is administering or applying remedies to a patient/client for the same or related disease/ injury or the treatment of unrelated diseases/ injuries where the treatment of one disease/injury could affect the treatment of the other
Objectives of proper record keeping
- facilitate safe and quality care and treatment
- ensure access to up to date and accurate health info
- ensure continuity of care
- ensure accountability
- demonstrate judgement , reasoning and adherence to practice standards
- meet other requirements mandated by organization or law
What must records be?
- identifiable
- legible and understandable
- comprehensive
- accurate and timely
- accessible and retrievable
- secure and confidential
Retention of records
a) For patients/clients who are 18 years or older at the time of last contact: for a period of at least 10 yrs
b) For patients/clients who are less than 18 years old at time of last contact: a period of at least 10 years following the date at which the patient/client would have become 18
Supervision and education of students and support personnel- factors to consider
- the need to encourage autonomy and learning
- level of supervision appropriate to the assignment
- knowledge, skill and clinical reasoning of student/support personnel
- patient/client’s level of comfort working with the student/support personnel
- severity or risk level associated with patient’s condition
What are kinesiologists required to keep records of?
- Instruments or equipment that require regular servicing and are used to assess, treat or provide a service to the patient/client
- Financial records containing info on bills for services and clinical products
- Record for each patient/client that the kin assesses or treats with includes all relevant, reasonable and appropriate info
Components of documentation when making a progress note
S: Subjective
O: Objective
A: Analysis or assessment
P: Plan
SOAP notes- subjective
Info received from patient/client
What might subjective info include?
Opinions
Goals
Concerns
Feelings
Perceptions of own health
SOAP notes- objective
Observable info that the clinician gathers during their assessment and treatment session; based on what can be seen, measured or tested
What might objective info include?
Clinical tests and measurements that are observable and repeatable
Treatment
SOAP notes- analysis
A summary statement based on subjective and objective findings; clinician’s interpretation of the client’s functional status or condition
Five main components of an analysis statement
- Client profile/summary
- Present condition/diagnosis
- Any risks
- Prognosis and rationale
- Potential for kinesiology or referral to other services
Client profile/summary
- name
- date of birth
- sex
- pronouns
- significant presentation
Present condition/diagnosis
- current medial diagnosis
- working differential diagnoses
- physical diagnosis
- potential differential diagnoses
- present condition
Any risks
- conditions acuity/chronicity/stability
- primary concerns
- precautions
- contraindications
- assessment of primary concerns/goals
What does the prognosis and rationale attempt to answer?
What are the possible etilogies of the diagnosis/impairment and what potential ramifications are there for interventions or the future
What does a prognosis ask?
Do they have the necessary support to achieve their goals?
Do they express high or low self efficacy or motivation?
Potential for kinesiology or referral to other services
To determine the likelihood that the R.Kin has something to offer and that the client is or is not likely to benefit from the R.Kin
To determine if a referral to other services is warranted
What is a problem list?
A list of problems that can be addressed by kinesiology interventions and/or requires consultation or referral to another healthcare practitioner; forms basis of treatment plan
What can a problem be?
Impairment, activity or participation limitations
Actual or potential
Related to underlying cause or treatable issues
What is an example of a problem list?
Low cardiorespiratory fitness secondary to a sedentary lifestyle and time-consuming career.
Short term goals
Steps or milestones along the way to achieving outcomes (long-term goals); can address function, impairments or education
Long-term goals (outcomes)
- Linked to resolving the problem list
- May relate to returning to performing a meaningful activity/role or attaining a level of health and/or wellness
- Prioritize by importance
How many short and long term goals should you aim for?
2-3 SMART
SOAP notes- plan
A concise statement of the overall intervention plan and follow-up proposal for the next session
Components of a SOAP plan
- what is the treatment intervention plan?
- how do we achieve the patient and clinician goals?
- what will you do at the next appointment?
How does a kinesiologist demonstrate the standard of professional boundaries?
- showing sensitivity to the power imbalance and diversity
- establishing and managing the boundaries of the professional relationship
- refraining from inappropriate behaviour (abuse, neglect)
- refrain from excessive or inappropriate touching of patient
- engaging in appropriate and professional communication
- refraining from treating individuals who they have a close personal relationship with
How can a kinesiologist establish and manage the boundaries of a professional relationship?
- recognizing and understanding components
- appropriate distance
- refraining from accepting and giving gifts
- refraining from inappropriate self-disclosure
Can a kinesiologist have a sexual relationship with a patient/client?
A sexual relationship with a patient/client or their substitute decision maker (SDM) is
strictly prohibited and is considered sexual abuse unless the patient is the
Kinesiologist’s spouse .
Concerns of concurrent treatment
- treatments provided for same or related conditions counteract or interfere
- conflicting advice
- unable to determine impact of treatment intervention
- issues of confidentiality and privacy
- unethical or inefficient use of healthcare resources
How does a member demonstrate the standard of infection control?
- knowledge on current infection control protocols
- implement infection control policies in practice
- ongoing assessments of risks of infection
- adequate resources
- educate patients/clients, staff etc.
Can a kin treat a family member?
Yes but it is not advisable
When may a kin choose to treat a family member?
If another health care professional is not readily available, in an emergency situation, or for minor,
episodic care
What are some other questions you could ask the patient to put in to your SOAP note?
- sports/activities they like to do?
- level of pain 0/10?
- previous injury?
- night pain? day pain?
- goals?
How does an R.kin demonstrate the standard of record keeping?
- every patient has a reference which uniquely identifies them (health card #)
- sequential system in place
- every entry should be dates and include identity of who make entry
- every amendment or correction to a record should indicate what change was made without destroying the original record
- reasonable time
