Standards of practice

Question 1

COTA roles: initiation of treatment

Answer 1

• 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

Question 2

COTA roles: evaluation

Answer 2

• 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.

Question 3

COTA and evaluation documentation

Answer 3

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

Question 4

COTA and discharge

Answer 4

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

Question 5

Domain (OTPF)

Answer 5

Domain describes the occupation areas where OT process is applied.
-includes context, environment, performance skills, and performance patterns (habits, routines, rituals and roles).

Question 6

Process (OTPF)

Answer 6

Evaluation and intervention to achieve client centered outcomes.

Question 7

Steps of developing a professional development plan:

Answer 7

1. Self-assessment/ reflect on current performance
2. Review progress towards previously set goals
3. Determine what resources exist to meet goals
4. Modify previous goals and set new goals
5. Take action to meet goals
6. Document completed professional development activities

Question 8

Parts of Medicare

Answer 8

• 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

Question 9

SOAP notes

Answer 9

• 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

Question 10

COAST goal

Answer 10

• 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)

Question 11

RUMBA goal

Answer 11

Reasonable, Understandable, Measurable, Behavioral, Achievable

Question 12

Ethics in practice (Beneficence, nonmaleficence and Autonomy)

Answer 12

• 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.”

Question 13

Ethics in practice (Social justice, procedural justice, veracity and fidelity)

Answer 13

• 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.”

Question 14

Purpose of screening before evaluation

Answer 14

Screening determines whether a client would benefit from an occupational therapy evaluation

Question 15

TRICARE

Answer 15

TRICARE provides health coverage for the military

Question 16

CPT Codes

Answer 16

CPT codes are used to denote procedures and services completed in the outpatient setting

Question 17

OT Approach: Create and promote

Answer 17

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

Question 18

OT Approach: Establish and restore

Answer 18

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

Question 19

OT Approach: Maintain

Answer 19

Keeps skills consistent; preserves performance

-Increasing lighting in home hallway to maintain safety for low vision client

Question 20

OT Approach: Modify, adapt/compensate

Answer 20

Revise the context or activity demands to support performance in natural setting
-Modify the clutter in a room to decrease a clients distractibility

Question 21

OT Approach: Prevent

Answer 21

Addresses those at risk for occupational performance problems either with or without disabilities
-Prevent social isolation of employees by promoting after-work activities

Question 22

Reliability vs. Validity

Answer 22

• 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

Question 23

Resident Assessment Instrument

Answer 23

Part of the Minimum Data Set required by Medicare regulations for skilled nursing facilities

Question 24

Levels of evidence

Answer 24

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