Chapter 3 Physical Therapy Clinical Practice Flashcards

Question

Clinical Practice Guidelines (CPGs) include what systems:

Answer 1

1•Musculoskeletal 2•Neuromuscular 3•Cardiovascular/pulmonary 4•Integumentary

Answer 2

1.Acute Care •Setting where patient is only admitted for a short time (usually less than 30 days), like hospitals •Treatment includes varied pathologies, diseases and surgeries •Technology can be intensive •Treatment (tx) & progression pace can be fast and intense •Patient/Caregiver education is very important due to the short treatment time available prior to discharge from the facility

Answer 3

Outpatient physical therapy provided in a home healthcare practice of a primary care physician ( PCP)

Answer 4

1•Intermediate level healthcare in a transitional skilled nursing facility 2•Must have 24 hour nursing care with PT, OT, and SLP (speech language pathologists) 3•Skilled nursing facilities include 3 types: ◦Subacute care- patients needing lots of rehab and will be returning home ◦Providing transitional care- hospital based ◦Extended care- longer term care provided

Answer 5

Outpatient clinics whose costs are less than inpatient centers

Answer 6

◦Facility that offers rehabilitation, social, and vocational services to patients with disabilities who need extensive rehab to return to a maximal functional capacity.

Answer 7

◦Long-term care facilities for patients staying >60 days (nursing homes) ◦Includes rehab as needed

Answer 8

1◦Care for patients who are terminally ill/dying. 2◦Can be offered in the hospital or home setting 3◦Rehab is optional

Answer 9

1◦PTs and PTAs work with students in school setting 2◦Child’s team and parents develop an individual educational plan (IEP) for the child to promote function in the classroom

Answer 10

1◦Privately owned PT facility offering outpatient services or contract services to SNFs, schools, or homecare agencies 2◦Documentation required every visit and re-evaluations due every 30 days

Answer 11

1◦Eligibility: 2◦patient must be “homebound”- needs physical assistance to leave home 3◦require skilled intervention from at least one of the following services- Nursing, PT, OT or ST 4◦Physician has to certify that skilled interventions are necessary 5◦PT needs to reevaluate every 3-6 weeks 6◦Safety at home- utmost importance-must report any abuse 7◦Some states require PTAs have 1 year experience prior, ***PT must be available by telecommunications, PT/PTA conferences 1-2x/week required***

Answer 12

``` 1◦Cardiovascular/pulmonary 2◦clinical electrophysiology 3◦Geriatrics 4◦Neurology 5◦Oncology 6◦Orthopedics 7◦Pediatrics 8◦Sports 9◦women’s Health ```

Answer 13

consists of musculoskeletal injuries and pathologies •Examples: shoulder rotator cuff, knee replacments, ACL tears, Tennis elbow, etc. •Goals include 1•Maximizing function 2•Alleviating pain 3•Decrease stress on joint 4•Educate on proper posture 5•Promote tissue healing, range of motion, and flexibility

Answer 14

1•Neurologic PT works with conditions affecting the nervous system 2•Occurs in many settings •Examples: Stroke, Brain injury, Spinal Cord injury, Multiple sclerosis, Cerebral palsy, etc •Treatment Goals: - focus on pathology signs and symptoms: pain, impaired balance, postural stability, postural control, coordination, delayed motor development, abnormal tone

Answer 15

•Cardiovascular and Pulmonary PT specializes in condition of the heart and lungs, such as heart attacks, COPD, Asthma, Coronary Artery Disease, Congestive Heart Failure, etc •Goals are 1-to achieve and maintain maximal level of independence and function

Answer 16

Pediatric PT: Involves working with children Pathologies and conditions include: Developmental disorders and delays, Cerebral Palsy, Autism, Muscular Dystrophy, -Settings: All settings, but especially in schools - Patients typically have: IEPs (Individual Educational Plans) that are mandated by law (IDEA- Individuals with Disabilities Education Act) - Healthcare team includes patient, patient’s family, physician, nurses, Social workers, psychologises, OTs, PTs/PTAs, SLP, teachers, PTAs, etc

Answer 17

Geriatric PT involves working with older individuals with a large variety that frequently affect that population, like arthritis. -Goals include focusing on functional goals, promoting optimal health, and maximizing independence and function Settings: all settings

Answer 18

Integumentary PT: involves working with patients with open wounds and burns -Goals: healing the wound, maintain functional movement & strength, prevent further skin damage Settings: Could be all settings, but often in acute care hospitals and wound care centers

Answer 19

Involves treatment of patients with cancer or with impairments due to cancer

Answer 20

Involves treatment of women

Answer 21

1•Policy and Procedure Manual: Should be present in all clinical settings, contains the rights & obligations of the employee & employer, guided by federal and state laws 2•Policy: a principle that guides decision making •Examples: Time off, leave of absence, dress code 3•Procedure: sequence of steps to be followed to accomplish policy intent •Examples: equipment management, cleaning and maintenance, safety inspections, training, safety and emergency procedures, & disciplinary procedures

Answer 22

1-All employees typically need to be CPR certified 2-Should have a safety manual that identifies all hazardous materials and how to deal with exposures 3-Have a “crash cart” available and checked daily

Answer 23

``` 1◦“Code Blue” cardiac care team 2◦“Code Red” fire 3◦“Code Violet” violent or combative persons 4◦“Code Pink” child abduction 5◦“Code Grey” weather emergency ```

Answer 24

1•Staff- held regularly to discuss departmental issues/changes 2•Team- held regularly to discuss aspects of individual patient’s care with other disciplines/caregivers (OT, SLP, Nursing, Physician, Case Manager) 3•Supervisory- such as PT-PTA meetings held regularly to discuss individual patient care issues 4•Strategic Planning- held occasionally and as needed to plan for future opportunities and challenges 5•Miscellaneous- Can be asked to be parts of committees or task forces as needed

Answer 25

1-Fiscal Management- Budgets 2-Budget- a financial projection of how available money will be spent to meet expenses over given time period 3-Explains anticipated income & expenses (personnel, buildings, equipment, supplies, space) 4-Helps to determine financial success of the department 5-Operating Expense Budget: daily operations- salaries, benefits (sick days, vacation), utilities, supplies, linen, housekeeping, maintenance, continuing education 6-Capital Expense Budget: for purchase of large items 7-Accounts Receivable Budget: Money owed to the company (such as Medicare) 8-Accounts Payable Budget: Money owed by the company (such as equipment maintenance company)

Answer 26

1-Direct costs: salaries, equipment, treatment supplies, continuing education 2-Indirect costs: housekeeping, utilities, laundry, marketing 3-Variable costs: costs that are not fixed, but change based on services: linens, utilities, supplies 4-Fixed costs: such as rent Therapists need to be aware of ◦Billing practices ◦Productivity ◦Supplies/Inventory

Answer 27

to promote delivery of high-quality patient care

Answer 28

evaluation of the necessity, quality, effectiveness, or efficiency ◦Does the cost = benefit of outcome

Answer 29

PTs and PTAs review each others documentation and/or work to help each other improve, Retrospective or Concurrent ◦Also performed by accrediting agencies or third-party payers (Medicare, Medicaid, Insurance) to assure quality of care, efficiency of providers

Answer 30

Rate treatment, therapists, facility, support staff, etc

Answer 31

It is ways to decrease liability and risk ◦Self-assessment, identification of problems, development of guidelines, anticipating future problems

Answer 32

1◦Maintaining equipment safety 2◦Staff education 3◦Identify potential injuries or damage 4◦Implement procedures to increase safety 5◦Adequate documentation and communication ~Risks include treatment mistakes, breaches of patient privacy, delegation of duties~

Answer 33

1◦Prevention of diabetes, obesity, arthritis, stroke, falls, | 2◦Promote regular physical activity and healthy diets and lifestyles

Answer 34

1◦Educating patients to identify risk factors & provide protective measures. -(most cost effective) primary prevention 2-Primary- before symptoms -secondary- early detection, -tertiary- minimizing effects of disease 3-Community Education 4◦PTs and PTAs can education people at senior centers, wellness centers, health groups 5◦Offer education on topics such as disease awareness/prevention, fall prevention strategies, chronic disease management

Chapter 3 Physical Therapy Clinical Practice Flashcards

(58 cards)