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Midterm Flashcards

1
Q

Six elements of Vision 2020

A

Autonomous practice, direct access, DPT, Evidence Based Practice, Practitioner of Choice, Professionalism

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2
Q

Five Roles of a PT

A

Clinical Practitioner, Consultant, Administrator/manager, researcher, educator

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3
Q

Core Values of Professionalism in PT

A

Accountability, altruism, compassion/caring, excellence, integrity, professional duty, social responsibility

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4
Q

Altruism

A

place patient’s needs before your own

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5
Q

Accountability

A

Acceptance of responsibility for diverse roles, obligations, and actions

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6
Q

Excellence

A

Evidence based practice

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7
Q

Integrity

A

adherence to ethical principles or professional standards

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8
Q

How do PTs know what they can do?

A

Scope of Practice, Standards of Practice, Laws/Regulatory Authorities, Code of Ethics

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9
Q

Scope of Practice

A

Examining
Alleviating impairment thru intervention
Prevention/wellness
Consultation/education/research

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10
Q

Standards of Practice

A 
Criteria, performance standards an assessments for the practice of PT
Ethical/legal considerations
Revised Code of Ethics effective 7/1/10
Administration of PT service
Patient/Client management model
Education
Research
Commitment to society
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11
Q

Patient Client Management Model

A

Patient management sequence- how we systematically approach patient care
Structure of documentation of initial episode/interaction with patient/clients
Terminology must be understood within the context of PCMM

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12
Q

PCMM Cycle

A 
Examination
Evaluation
Diagnosis
Prognosis
Intervention
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13
Q

Examination

A

Beginning to understand what is going on with your patient
History, systems review, test&measurement
Comprehensive screening and testing process
Purpose: to establish the nature and status of condition

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14
Q

Evaluation

A

PT makes clinical judgments using data collected during examination
Purpose: to interpret the findings

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15
Q

Diagnosis

A

Label assigned based on the information collected and clinical experience

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16
Q

Prognosis

A

(Plan of Care)- Guide to PT practice is used to help determine these
What are we trying to achieve- GOALS (short term/long term)
Predict the level of improvement- OUTCOMES
How long will it take- FREQ & DURATION

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17
Q

Intervention

A

Treatments/Coordination of care

Administered and modified based on response

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18
Q

Medical Model

A 
Medical doctors (MDs, Dos)
Treat the ailment/disease (we don't do this)
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19
Q

Disablement Model

A

DPT’s
Addresses the functional impairments that result from a medical condition
Looks how health changes and progresses towards disability

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20
Q

ICF- International Classification of Functioning, Health, and Disability

A

This links nicely with our coding system here in the U.S.

Addresses activity and participation

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21
Q

Nagi’s Framework

A

Healthy -> Disease -> physiological impairment -> Functional Limitations -> Disability

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22
Q

Disease (Nagi)

A

Signs and symptoms (joint swelling)

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23
Q

Physiological impairment (Nagi)

A

MS, NM, CP, Integumentary (decreased AROM)

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24
Q

Functional Limitations (Nagi)

A

physical, psychological, social (difficulty walking)

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25
Disability (Nagi)
Environmental Role (can't work)
26
Qualities of a Profession
Autonomy, Ethical Standards, Accountability
27
Hierarchy of criteria of a profession
Autonomy of judgement Service to patient/clients Specialized education- CAPTE, arm of APTA Representative organization- APTA, develops standards, educational opportunities Life Time commitment
28
Autonomous Practice
direct and unrestricted access: entry point to health care system ability to refer to other healthcare providers ability to refer to other professionals ability to refer for diagnostic tests Collaborative, independent, self determined thoughts and actions
29
***Ethical Standards***
``` Standards of Practice for Physical Therapy Code of Ethics (PT) Guide for Professional Conduct (PT) Standards of ethical conduct for the PTA Guide for conduct of the PTA Professionalism in PT: core values ```
30
Levels of Care
Primary, Secondary, Tertiary
31
Primary Care
entry into health care system | no referral required
32
Secondary Care
care provided after receiving care at a primary level | referral is frequently required
33
Tertiary Care
care provided by a specialist
34
Team Approach
Intradisciplinary and Interdisciplinary
35
Intradisciplinary
within your departments/practices
36
Interdisciplinary
across departments across disciplines across professional levels- physicians and PT techs
37
Screenings
determine if an underlying condition might be present | to determine if further services might be needed
38
Health Promotion
prevention or minimize risk of injury
39
Coordination of Care
communication | documentation of episode of ‘care’
40
Discharging Patient/client
goals/outcomes met
41
Discontinuation of Services
patient/client terminates services PT/client unable to continue due to medical/psychosocial or financial reasons PT judgement is intervention will not improve the status of the individua
42
Utilization of the PTA
no-examination, evaluation, diagnosis, prognosis or plan of care- PT only Yes- Assessments- measurement or assigned value but not “assess” Yes- Interventions, some of them Yes-modify a plan of care only due to a patient’s status or response to an episode of care
43
Can a PTA progress a patient?
If it’s in the plan of care yes. The plan of care may say, progression resistant exercises for 2 weeks, the PTA can increase the resistance.
44
Delegation of clinical roles to PTA
``` Education- additional training Experience & skill level Current responsibilities Predictability of outcomes Acuteness of patient’s status, stability complexity and criticality Federal and State statutes Liability and Risk Management issues Mission of the practice setting Needed frequency of reexamination ```
45
Supervision of PTAs in FL- general
Delegation of duties without PT present- yes PTAs can work on pt. w/out PT present same rules apply-delegation criteria PT must be available by telecommunication access (2-way) at ALL times during the delivery of care in same geographical location
46
Supervision of PTAs in FL when employed by physicians
``` GENERAL supervisions by a PT Board certified physician orthopedic chiropractor physiatrist ONSITE supervision of a PT all other or non board certified as outlined in practice act ```
47
Ethical Compass
A set of internal ideas, concepts, values, and duties that keep us heading in the right direction as professionals. Guidance when there are alternative pathways or behaviors A tool that we can fall back on when we feel lost or unsure
48
Resources Available for Ethical Decision Making
Code of ethics Standards for ethical conduct These documents may not provide definitive answers to difficult ethical decisions
49
Ethics
A rational reflection Particularly important when there are competing realms or 2/more possible courses of action The reflection or analysis needed when confronted with conflicted ideas/values
50
Values
Standards for what is right and wrong, good or bad,etc Derived by individuals from personal, professional, organizational, societal, and cultural sources Different from ethics, but foundational to ethical decision making
51
Laws
May be local, state, or national | Include rules, admin codes, and regulations created by admin agencies to interpret, delineate or implement legislation
52
Justice
Determined by- Fairness, need, and/or entitlement
53
Types of Justice
Distributive, Criminal, Compensatory, Procedural
54
Distributive Justice
how benefits, burdens, rights, and responsibilities are distributed
55
Criminal Justice
a system of punishment through law
56
Compensatory Justice
compensation for wrongs
57
Procedural Justice
fair processes or due process
58
Informed Consent
The duty of informed consent requires the PT to respect the right of the patient to make a decision about his/her health care, based on understanding the necessary info (benefits, risks,etc). This includes the right to agree to or refuse the course of action
59
3 conditions of informed consent
Competence of the patient Information Voluntariness
60
Confidentiality
Duty to maintain privacy of info concerning patients by not divulging it to unauthorized persons
61
Paternalism
Generally considered the opposite of autonomy | 2 types: Weak and Strong
62
Strong Paternalism
a more active intervention to promote good
63
Weak Paternalism
intervention solely to protect a patient from harm
64
Fidelity
Put the patient first to meet REASONABLE expectations
65
Professional Boundaries
The idea of not becoming inappropriately involved, emotionally or behaviorally, with patients and others involved in one’s work. It does not mean emotional uninvolvement and indifference.
66
Conflict of interest
Exists when a professional has competing interests or obligations that prevent fulfillment or primary professional obligations Multiple obligations do not of themselves create a conflict of interest
67
Concepts of RIPS
Environmental Context (realm) Individual process involved (ethical sensitivity, judgment, or courage) Situation (ethical issue, dilemma, distress)
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RIPS process (4 steps)
Recognize and define Reflect Decide Implement, reassess, and evaluate
69
Realms of RIPS
Societal, institutional/organizational, individual
70
Societal realm
the primary concern at this level is the common good Ex- national and state systems, including legal, financial, cultural, and religious establishments. Issues at this level tend to have more complexity and higher importance than those in other realms
71
Institutional/organizational realm
The primary concern is the good of the organization Ex- mediating structures, such as professional organizations, families, agencies, and corporations The focus of this realm is on structures and systems that facilitate organizational/institutional goals
72
Individual realm
The primary concern is the good of the patient Ex- PT working directly with the patient The focus of this realm is on rights, duties, relationships, and behaviors between individuals. There is lower complexity of problems as compared to other realms
73
Individual Processes
Ethical sensitivity Ethical judgment Ethical courage/character
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Ethical Sensitivity
recognizing and interpreting ethical situations
75
Ethical Judgement
judging which action is right or wrong
76
Ethical courage/character
prioritizing ethical values over other ones, demonstrating courage, persisting , implementing, developing and negotiating a plan of action
77
Types of Ethical Situations
``` Issue/Problem Dilemma Distress Temptation Silence ```
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Issue/Problem
important values are present or may be challenged
79
Dilemma
2 alternative courses of action; each fulfills an important duty and it is not possible to fulfill both obligations
80
Distress
you know the right course of action but are not authorized to perform it
81
Temptation
involves a choice between right and wrong and in which you may stand to benefit from doing the wrong thing
82
Silence
ethical values are challenged, but no one is speaking about this challenge to values
83
5 Tests of Right vs Wrong
Legal test: is something illegal Stench test: does it feel wrong Front-page test: how would you like your actions on the front page for everyone to see Parent test: if I were my mother would I do this Professional ethics test: what do the documents say
84
3 ways to make an ethical decision
Rule based- rules, duties, or over-arching principles Ends based- focuses on consequences of the decision Care based- emphasizes concern for others and relationships (golden rule approach)
85
Types of Communication
verbal/nonverbal, reading, writing, listening (all equally important)

Foundations (6 decks)

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