question

Social Security Amendments Medicare Prospective Payment System -Diagnosis related groups State Regulations Elimination of Reductionistic model of practice NBCOT

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1980s

question

Leaders urging practice to return to Moral Treatment and occupation Yerxa, Shannon, Riely, Kielhofner MOHO

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Return to Occupation

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Information age Computer technology used as an intervention modality Americans With Disabilities Act Individuals with disabilities education act Balanced budget act of 1997

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1990s

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Research Evidence-based knowledge Continuing competency State licensure Occupation-based practice

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Ongoing Issues

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Activity in which one engages

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Occupation

question

Treatment of an illness or disability

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Therapy

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And toward which effort is directed

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Goal

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State or condition of being involved

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Activity

question

State or condition of being self-reliant

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Independence

question

Action for which a person is specifically fitted

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Function

question

A practice that uses goal-directed activity to promote independence in function Therapeutic use of everyday activities Participation in home, school, workplace, community Physical, cognitive, and psychosocial Promoting health and wellness Engagement in everyday life

answer

Occupational therapy

question

Various life activities, including ADLs, IADLs, education, work, play, leisure, and social participation

answer

Areas of occupation

question

The ability to carry out activities of daily life (including activities in the areas of occupation)

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Occupational performance

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An activity used during intervention that is goal-directed and may or may not be viewed as meaningful to the client. These activities typically involve an end product and are goal-directed.

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Purposeful activity

question

Master's degree Professional program

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Occupational therapist (OT)

question

Associate's degree Technical program Supervised by OT

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Occupational therapy assistant (OTA)

question

Work with clients of all ages and diagnosis Goal is to increase the ability of the client to participate in everyday activities Interact with a client to assess existing performance, set therapeutic goals, develop a plan, and implement intervention to enable the client to function better in his or her world Advocate for clients, make or modify equipment, and/or provide hands on experiences to help people reengage in life. Records progress and communicates intervention specific others

answer

OT practitioner

question

Refers to the basic units of action

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Task

question

Desire to help others Appreciation of diversity Respect for human's ability to change Empathy Flexibility Interest in life-long learning

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OT personality characteristics

question

All ages Physical, cognitive, psychological, psychosocial problems Trauma, disease, conflict, or stress, accident, social deprivation, genetics, congenital anomalies Developmental delays, congenital problems Range of problems including genetic, neurological, Orthopedic, musculoskeletal, immunological, and cardiac dysfunctions as well as psychological, social, behavioral, or emotional disorders

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People Served by Occupational Therapy

question

Hospitals Clinics Schools Homes Community centers Prisons

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Settings

question

Help get the client ready for purposeful activity Range of motion, exercise, strengthening, or stretching

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Preparatory activities

question

Made-up activities that may include some of the same skills required for the occupation. Used to help simulate the actual activity and may help get the client ready.

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Contrived activities

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Performed a natural setting (physical, social, and temporal) preparing lunch at home at noon using one's own kitchen supplies

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Occupation centered activities

question

Refers to the objects and materials the practitioner uses to facilitate change. It may include games, toys, activities, dressing or self-care activities, work activities, arts, crafts, computers, industrial activities, sports, music and dance, role-playing and theater, yoga, gardening, homemaking activities, magic, pet care, and creative writing. Activities may also include the use of assistive technology, aquatics, animal assisted therapy, ergonomics, and community integration

answer

Media

question

Science base Human development Occupational therapy foundation and theory Clinical skills Problem-solving Fieldwork

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OT/OTA Educational Programs

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Accreditation Council for Occupational Therapy Education (ACOTE) Standards Professionalism

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OT/OTA Curricula

question

All people are entitled to compassion Sought ways to make the existence of those confined more bearable, purposeful activity Moral treatment movement: Phillippe Pinel and William Tuke Benjamin Rush

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Moral Treatment

question

Work treatment for insane Used occupation to divert the patients' minds away from their emotional disturbances and toward improving their skills. Physical exercise, work, music, literature Introduced farming as an important element of institutional life

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Phillippe Pinel

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The society of friends (Quakers) Established the York Retreat Believed moral treatment methods were preferable to using restraint and drugs Environment was like that of a family in which the patients were approached with kindness and consideration

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William Tuke

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United States Quaker First physician to institute moral treatment practices in the US

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Benjamin Rush

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Using one's hands to make items connected people to their work, physically and mentally, and thus was healthier. Sought to restore the ties between beautiful work and the worker, by returning to high standards of design and craftsmanship not found in mass-produced items John Ruskin and William Morris Turn the 20th century, members of society became concerned for those were taken from the mainstream of life by injury or illness. These events influenced the development of occupational therapy profession

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Arts and Crafts Movement

question

Provided medical supervision of crafts for the purpose of improving health and financial independence Established a facility in Massachusetts where patients neurasthenia worked on arts and crafts as part of treatment Neurasthenia is a disorder that was commonly seen in women, caused severe weakness during the performance of work activities "Work cure"- getting women with neurasthenia out of bed and working through crafts

answer

Herbert Hall

question

Personally experienced tuberculosis, foot amputation, and paralysis Used occupation as method of treatment Opened Consolation House for convalescent patients in New York where occupation was used as a method of treatment

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George Barton

question

Father of occupational therapy Arts and Crafts program at Sheppard Asylum Wrote on value of occupation 1915 Occupational Therapy: A Manual for Nurses President and treasurer of the foundation

answer

William Rush Dunton, Jr.

question

Mother of occupational therapy Social worker Worked at state hospitals Habit training Organized first OT school Held many offices in organization Eleanor Clarke Slagle Award

answer

Eleanor Clarke Slagle

question

a re-education program designed to overcome disorganized habits, to modify other habits, and to construct new ones, with the goal of restoring and maintaining health

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Habit Training

question

Training of nurses Wrote: Studies in Invalid Occupations (first book on occupational therapy) Believed only nurses were qualified to practice occupations

answer

Susan Tracy

question

Director of Occupations at the New York State Department of Public Charities Occupation could be morally uplifting Occupation could improve mental and physical state Individuals could contribute to self support. Taught occupational therapy Advocate for high educational standards and training competent practitioners

answer

Susan Cox Johnson

question

Vocational Secretary Canadian Military Hospitals Commission Included occupational therapy in architectural drawings for institutions for physically disabled Active in National Tuberculosis Association Promoted movement to hospitalize individuals with tuberculosis and designed hospitals in both Canada and US for the treatment of tuberculosis Encouraged OTs to capitalize on the opportunity of the Vocational Rehabilitation Act

answer

Thomas Kidner

question

March 15, 1917 George Barton, William Dunton, Eleanor Clark Slagle, Susan Cox Johnson, Thomas Kidner, Isabel Newton Object was to study and advance curative occupations for invalids and convalescents; to gather news of progress in occupational therapy and to use of such knowledge to the common good; to encourage original research, to promote cooperation among occupational therapy societies, and with other agencies of rehabilitation

answer

National Society for the Promotion of Occupational Therapy

question

National Society for the Promotion of Occupational Therapy decided to change the name to this in 1921

answer

American Occupational Therapy Association

question

Psychobiological approach Adolf Meyer Involvement in meaningful activity Rhythms and balance Work, play, rest, and sleep Each individual should be seen as a complete and unified whole, not merely a series of parts or problems to be managed Involvement in meaningful activity was a distinct human characteristic Providing an individual with the opportunity to participate in purposeful activity promoted health

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Holistic Perspective

question

Expressed point of view that eventually formed the philosophical base of the OT profession Committed to a holistic perspective and developed the psychobiological approach to mental illness

answer

Adolf Meyer

question

Reconstruction aides trained to take care of the veterans Validation of activity as therapy Link between occupational therapy and physical disability

answer

World War I

question

Orthopedic professionals OT Aides Physiotherapy aides Validation of activity as therapy

answer

reconstruction aids

question

Soldier's Rehabilitation Act Civilian Vocational Act OTs treating tuberculosis OT became valued as a provider of some of these prevocational and rehabilitation services Great Depression (1930-39)- slowed development of OT

answer

Post WWI through 1930s

question

New demand for occupational therapy eliminated the need for Accredited schools Emergency courses popped up again and the number of OTs shot up again

answer

World War II (1940-1947)

question

Continued shift away from a generalist approach to one of specialization and physical rehabilitation New drugs and technology: neuroleptic drugs National deinstitutionalization plan Splinting materials, wheelchairs, and more advanced prosthetics and orthotics. Rehabilitation Movement 1942 to 1960 VA hospitals developed physical medicine and rehabilitation departments to serve veterans with disabilities, OTs were employed Women's medical specialist corps Hill-Burton Act Medicare 1988 legislation granted OTs the right to Medicare provider numbers AOTF Promote research and OT through financial support Reductionistic model and specialization Occupational Therapy Assistant (1958) Began in psychiatry

answer

Post-WWII (1950-1960)

question

Personal computers Increase in drug and alcohol abuse AIDS Lack of services to support individuals coming out of the deinstitutionalization plan into smaller community facilities Community practice Legislation: Rehabilitation act of 1973, education for all handicapped children act of 1975, handicapped infants and toddlers act of 1986, technology-related assistance for individuals with disabilities act of 1988

answer

1970s-1980s

question

1918 Established a program of vocational rehabilitation for soldiers disabled on active duty. OT practitioners had a role helping soldiers adjust to their industrial responsibilities and civilian life. OT practitioners focused on rehabilitating the soldiers so they could return to productive living

answer

Soldier's Rehabilitation Act

question

1920 Provided federal funds to states on a 50-50 matching basis to provide vocational rehabilitation services to civilians with physical disabilities. To be eligible for benefits, applicants for the program had to be unable, because of their disability, to engage successfully in gainful employment. Funds provided for vocational guidance, training, occupational adjustment, prosthetics, and placement services

answer

Civilian Vocational Act

question

Included prerequisites for admission into training programs, length of courses, and content of courses Stipulated that courses of training for OT needed to be a minimum of one year, with eight or nine months of medical and craft training in three or four months of clinical work in hospitals. 1935 AMA at the request of AOTA assumed the inspection and accreditation of OT schools

answer

Minimum standards for courses of training in occupational therapy

question

Emphasized priority service for persons with the most severe disabilities and mandated that state agencies establish an order of selection that would place the most severely disabled persons first for service Every client accepted for services participates in the service planning process by completing an individualized written rehabilitation program (IWRP) that specifies their vocational goal and key supporting objectives, such as physical restoration, counseling, educational preparation, work adjustment, and vocational training Called for the development of a set of standards by which the impact of rehabilitation services could be assessed Emphasized the need for rehabilitation research Included civil rights provisions that gave equal opportunities for people with disabilities, prohibited discrimination in employment or in admissions criteria to academic programs solely on the basis of a disabling condition

answer

Rehabilitation Act of 1973

question

Establishes the right of all children to a free and appropriate education, regardless of handicapping condition Requires written IEP for each student that describes the student's specialized program and measurable goals

answer

Education for All Handicapped Children Act of 1975

question

Amendment extends the provision of the handicapped children's act to include children from 3 to 5 years of age and initiates new early intervention programs for children from birth to age 3 OT is considered a primary service

answer

Handicapped Infants and Toddlers Act 1986

question

Addresses the availability and assistive technology devices and services to individuals with disabilities. Many OT practitioners are involved in providing the services

answer

Technology-related assistance for individuals with disabilities act of 1988

question

Nationwide schedule was established that Dilip delineated what the government would pay for each inpatient stay the Medicare beneficiary. Level of payment was set by DRGs

answer

Prospective payment system

question

In the system of fixed payment for DRGs, massive changes in hospital organization and care delivery occurred. Most notably, patient length of stay in acute-care hospitals was shortened, and there was an increase of use of long-term-care facilities and home health services

answer

Diagnosis related groupings

question

Return to occupation Developed the model of human occupation Develop a model that would allow OT practitioners at all levels to better address the important issues concerning their clients Provided the profession with evidence to support occupation-based practice and tools to evaluate clients MOHO is the most evidence-based model of practice and occupational therapy The scholarship of practice Helped people with HIV/AIDS

answer

Gary Kielhofner

question

In 1986 AOTA separated professional membership and certification procedures by declaring the association no longer responsible for board certification

answer

National Board for certification in occupational therapy

question

Provides a civil rights to all individuals with disabilities Guarantees equal access to and opportunity in employment, transportation, public accommodations, state and local government, and telecommunications for individuals with disabilities

answer

Americans with disabilities act of 1990

question

Formally the education for all handicapped children act Requires school districts to educate students with disabilities in the least restrictive environment Requires states to establish procedures assuring that students with disabilities are educated, to the maximum extent appropriate, with students without disabilities Mandates that the local school district is responsible for providing assistive technology devices and related services as deemed appropriate to the child's education Amendment signed in 1997 Further improved the educational opportunities for children with disabilities Focus is improving on educational results for children with disabilities Law states that the assistive technology needs of children with disabilities must be considered along with other special factors by the IEP team in formulating the child's IEP Strengthens the role of parents and educational planning and decision-making on behalf of their children

answer

Individuals with disabilities education act

question

Intent was to reduce Medicare spending, create incentives for the development of managed-care plans, encourage enrollment in managed-care plans, and limit fee-for-service payment programs

answer

Balanced budget act of 1997

question

Refers to questions concerned with the nature of humankind

answer

Metaphysical

question

Related to the nature, origin, and limits of human knowledge and investigates questions such as "how do we know things?" and "how do we know what we know?"

answer

Epistemology

question

Concerned with the study of values Explores questions desirability and questions of ethics Aesthetics and ethics

answer

Axiology

question

Holistic Active being Engaged in occupation

answer

Occupational Therapy View of Human Being

question

Humans are actively involved in controlling and determining their own behavior and they're capable of changing behavior as desired. Humans are viewed as open systems in which there is continuous interaction between the person and the environment. The person's behaviors influence the physical and social environment; in turn, the person is affected by changes in the environment

answer

Active beings

question

Performance in areas of occupation Performance skills Performance patterns Cultural personal physical social temporal and virtual Organs and limbs

answer

Aspects of occupations in practice

question

The range of occupations and activities that make up peoples lives

answer

Performance in areas of occupation

question

The skills used by people to perform occupations and activities

answer

Performance skills

question

The habits, routines, and roles that are assumed by individuals in carrying out occupations for activities

answer

Performance patterns

question

The internal or external context, or conditions, in which occupation occurs and influences performance

answer

Cultural, personal, physical, social, temporal, and virtual

question

A pattern of behavior that involves certain rights and duties that an individual is expected, trained, and often encouraged to perform in a particular social situation A culturally defined pattern of occupation that reflects particular routines and habits

answer

Role

question

Describes a general class of human actions that are goal directed

answer

activity

question

Considered the basic units of behavior and are the simplest form of an action

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Tasks

question

The use of a specific occupation to bring about a change in the clients performance Maybe equivalent to activity

answer

Occupation as a means

question

The desired outcome or product of intervention (i.e., the performance of activities or tasks that the person deems as important to life), and it is derived from the person's values, experiences, and culture

answer

Occupation as an end

question

A change in function that promotes survival and self actualization Takes place as part of the normal developmental process, in the process of adjusting to stress or change

answer

Adaptation

question

The ability to adapt, to cope with the problems of everyday living, and to fulfill life roles requires a rich reservoir of experiences gathered from direct engagement with both human and nonhuman objects in one's environment. It is through such action with feedback from both human and nonhuman objects that an individual comes to know the potential and limitations of self and the environment and achieves a sense of competence and intrinsic worth.

answer

Competency

question

What is meaningful and which provides satisfaction to an individual is determined by the experience of that individual

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Phenomenological

question

OT practitioner involves the client, family, and significant others in OT process. Central to the aid to practice since the clients can determine his or her quality of life, and, consequently, they must help the practitioner understand their experience

answer

Client-centered approach

question

They believe that the client should be treated as a person, not an object

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Humanism

question

The unselfish concern for the welfare of others

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Altruism

question

Refers to treating all individuals equally with the attitude of fairness and impartiality and respecting each individuals beliefs, values, and lifestyles in the day today interactions

answer

Equality

question

An individuals right to exercise choice and to demonstrate independence, initiative, and self-direction. Demonstrated through nurturing, which is very different from controlling or directing

answer

Freedom

question

The need for all your teeth practice is to abide by the laws that govern the practice into respect the legal rights of the client

answer

Justice

question

Encourages the development of independence in the client, rather than retaining all direction and control in the hands of the practitioner. Provide support and encouragement, enabling the client to develop his or her potential.

answer

Nurture

question

Altruism, equality, freedom, nurturing, justice, dignity, truthfulness, prudence

answer

OT practitioners value...

question

The ability to demonstrate sound judgment, care, and discretion

answer

Prudence

question

Aging in Place, driver assessments and training programs, community health and wellness, needs of children and youth, ergonomics consulting, technology and assistive device developing and consulting

answer

Six emerging areas of practice

question

basing practice on the best available research evidence

answer

Evidence-based practice

question

American occupational therapy Association 1923 Mission: To advance the quality, availability, use and support of occupational therapy through standard-setting, advocacy, education, and research on behalf of its members and the public Assure the quality of occupational therapy services Improvement consumer access to Healthcare Services Promote to be professional development of its members

answer

AOTA

question

World Federation of occupational therapists 1952

answer

WFOT

question

Coordinated online opportunities for leadership Developed to promote active participation and membership

answer

COOL

question

American student committee of the occupational therapy Association

answer

ASCOTA

question

Accreditation Council for occupational therapy education

answer

ACOTE

question

The commission on continuing competence and professional development

answer

CCCPD

question

American Journal of occupational therapy

answer

AJOT

question

American occupational therapy political action committee

answer

AOTPAC

question

American occupational therapy foundation Designed to advance the science of occupational therapy and increase public understanding of the value of OT 1965

answer

AOTF

question

Provides quality occupational therapy services, including evaluation, intervention, program planning and implementation, discharge planning - related documentation, and communication. Service provision may include direct, monitored, and consultative approaches

answer

Practitioner - OT

question

Provides quality occupational therapy services to assigned individuals under the supervision of an OT

answer

Practitioner - OTA

question

Develops and provides educational offering or training related to occupational therapy to consumer, peer, and community individuals or groups

answer

Educator (consumer/peer)

question

Manages level one or two field work in a practice setting. Provides OT students with opportunities to practice and carry out practitioner competencies

answer

Fieldwork educator (practice setting)

question

Manages the overall daily operation of occupational therapy services in defined practice areas

answer

Supervisor

question

Manages department, program, services, or agency providing occupational therapy services

answer

Administrator (practice setting)

question

Provides occupational therapy consultation to individuals, groups, organizations

answer

Consultant

question

Manages student fieldwork program within academic setting

answer

Academic fieldwork coordinator

question

Provides formal academic education for OT or OTA students

answer

Faculty

question

Manages the educational program for OT or OTA students

answer

Academic program director

question

Performs scholarly work of the profession, including examining, developing, refining, and evaluating the profession's body of knowledge, theoretical base, and philosophical foundations

answer

Research/scholar

question

Partially or fully self-employed individuals who provide occupational therapy services

answer

Entrepreneur

question

Three ways to occur: Vertical movement within a setting, lateral movement across settings, maturation within a role

answer

Career development

question

Development of skills Socialization and the expectations related to the organization, peer, and profession Acceptance of responsibilities and accountability for role relevant professional activities is expected

answer

Entry level practitioner

question

Increased independence Mastery of basic role functions Ability to respond to situations based on previous experience Participation in the education of personnel Specialization is frequently initiated, along with increased responsibility for collaboration with other disciplines and related organizations. Participation and role relevant professional activities is increased

answer

Intermediate level practitioner

question

Refinement of specialized skills Understanding of complex issues affecting role functions Contribution to the knowledge base and growth of the profession results in being considered an expert, resource person, or consultant with in a role. This expertise is recognized by others inside and outside of the profession through leadership, men touring, research, education, and volunteerism

answer

Advanced level practitioner

question

Role for which OTA is well-qualified and can function independently Employed in group homes, institutions for people with mental retardation, assisted living facilities, and long-term-care facilities for older persons Responsible for planning, implementing, and documenting an ongoing program of activities that meet the needs of the residents

answer

Activity director

question

Contributing to the evaluation process by implementing delegated assessments Providing verbal and written reports of observations and client capacities to the OT

answer

Role of OTA during evaluation

question

Collaborating with the client to develop the plan Being knowledgeable about evaluation results and for providing input into the intervention plan, based on client needs and priorities

answer

Role of the OTA duringIntervention planning

question

Being knowledgeable about the clients occupational therapy goals Selecting, implementing, and modifying therapeutic activities and interventions that are consistent with demonstrated competency levels, client goals, and the requirements of the practice setting

answer

Role of the OTA during intervention implementation

question

Contributing to this process by exchanging information with and providing documentation to the OT about the clients responses to and communications during the intervention

answer

Role of OTA during intervention review

question

Being knowledgeable about the clients targeted occupational therapy outcomes and providing information and documentation related to outcome achievement Implementing outcome measurements and providing needed client discharge resources

answer

Role of OTA during outcome evaluation

question

Supervising therapist is in the immediate area at all times; required for OT and OTA students, limited permit holders, OT Aides

answer

Direct or continuous supervision

question

Daily, direct contact at the site of work

answer

Close supervision

question

Face to face contact at least every two weeks at the site of work, with interim supervision through methods of telecommunication

answer

Routine supervision

question

Initial direction and face to face contact with the supervising therapist at least once a month, interim supervision as needed by telecommunication

answer

General supervision

question

Useful mechanism to ensure that services are provided with the same high level of confidence The determination, made by various methods, that two people performing the same or equivalent procedures will obtain the same or equivalent results

answer

Service competency

question

Variety of disciplines that work together in a common setting. However the relationship between the team members is not interactive

answer

Multidisciplinary team

question

Members cross over professional boundaries and share roles and functions. Blurring of traditional practitioner roles

answer

Transdisciplinary team

question

Commonly found in healthcare today. Members maintain their own professional roles while using a cooperative approach that is interactive and centered on a common problem to solve

answer

Interdisciplinary team

question

Related to character and behavior from the point of view of right and wrong

answer

Morals

question

The study and philosophy of human conduct

answer

Ethics

question

A binding custom or practice of a community: a rule of conduct or action prescribed formally recognized as binding or enforced by controlling authority

answer

Law

question

Understanding the client Used it to develop and provide interventions to address goals and make necessary adaptations Requires problem-solving and professional judgment

answer

Clinical reasoning

question

Provides direction to members of a profession for mandatory behavior and protects the rights of clients, subjects, and their significant others, and the general public

answer

Code of ethics

question

OT practitioner will contribute to be good health and welfare of the client Treat each client fairly and equitably Advocate for recipients to obtain needed services Promote public health and safety and well-being Charge fees that are reasonable and commensurate with the services provided

answer

Beneficence

question

The practitioner should not inflict harm on the client Ensures that the OT practitioners maintain therapeutic relationships that do not exploit rights physically, emotionally, psychologically, socially, sexually, financially OG practitioner is obligated to identify and address problems that may impact professional duties and bring concerns regarding professional skills of colleagues to the appropriate authority

answer

Nonmaleficence

question

Autonomy is the freedom to decide and the freedom to act Confidentiality refers to the expectation that information shared by the client with the OT practitioner either directly or through written or electronic forms will be kept private and shared only with those directly involved with the intervention (under conditions expected by the client). Stipulates that the client will be tournament how and to whom information may be shared The OT practitioner: Collaborates with clients and caregivers to determine goals Informs client of the nature, possible risks, and outcomes of services Receives informed consent for the services Respects a client decision to refuse treatment Maintains confidentiality concerning information Informed consent

answer

Autonomy and confidentiality

question

OT practitioners provide services and fair and equitable manner to all Fair treatment and same opportunities

answer

Social justice

question

OT practitioners are obligated to comply with the laws and regulations that guy the profession OT practitioner must be aware of and follow federal, state, and local laws as well as institutional policies Inform others of laws OT practitioners must accurately report and document information related to professional activities

answer

Procedural justice

question

Refers to the duty of the healthcare professional to tell the truth OT practitioners must accurately represent their qualifications, education, training, and competence No false advertising or exaggerated claims Practitioner must disclose instances that pose actual or potential conflicts of interest

answer

Veracity

question

Faithfulness Describes the interactions between it and OT practitioner and his or her colleagues and other professionals Importance of maintaining confidentiality in the matters related to colleagues and staff; accurately representing qualifications, views, and findings of colleagues; reporting any misconduct to the appropriate entity Includes statements concerning taking measures to discourage, prevent, expose, or correct any breaches of the code

answer

Fidelity

question

1. Gather all of the relevant facts about the situation. Describe the clinical, contextual, individual, and personal preferences concerning the situation 2. Identify the type of ethical problem (e.g., distress, dilemma, locus of authority). Determine the ethical principles involved (e.g., beneficence, nonmaleficence, justice, veracity, autonomy, confidentiality, fidelity). 3. Clarify professional duties in this situation that may be outlined in the code of ethics (e.g., do no harm, tell the truth, keep promises, and be faithful to colleagues). 4. Explore alternatives, including the desired outcome and consequences of actions 5. Complete the action 6. Evaluate the action

answer

Solving ethical problems: 6 Steps

question

Challenges how a practitioner maintains his or her integrity or the integrity of the profession

answer

Ethical distress

question

A situation in which two or more ethical principles collide with one another, making it difficult to determine the best action

answer

Ethical dilemma

question

Require decisions about two should be the primary decision-maker

answer

Locus of authority

question

Laws that are enacted by the legislative branch of a government

answer

Statutes

question

Describe in specific terms how the intent of the law will be carried out

answer

Regulations

question

HIPPA IDEA (individuals with disabilities act) ADA The Social Security amendments of 1965

answer

Important federal statutes

question

The most stringent form of regulation The process by which an agency of government grants permission to an individual to engage in a given occupation upon finding that the applicant has attained the minimal degree of competence required to ensure that the public health, safety, and welfare will be reasonably protected

answer

Licensure

question

A formal expression of disapproval of conduct communicated privately by letter from the chairperson of the ethics committee that is nondisclosable and noncommunicative to other bodies

answer

Reprimand

question

A formal expression of disapproval that is public

answer

Censure

question

Failure to meet terms will subject a member to any of the disciplinary actions or sanctions

answer

Probation

question

Removal of membership for a specific period of time

answer

Suspension

question

Permanent denial of membership

answer

Revocation

question

Administration Levels of Care Areas of Practice

answer

Types of settings characterized by

question

the system's organization and management Public Agencies, Private not-for-profit agencies, Private for-profit agencies

answer

Administration of Setting

question

Operated by federal, state, or county governments. Federal agencies: veterans administration hospitals and clinics, public health services hospitals and clinics, and Indian health services. State run agencies: correctional facilities, mental health centers, and medical school hospital in their clinics County agencies: County hospitals, clinics, and rehabilitation facilities that deliver services to clients in the same way as federal and state facilities. However county administration must follow different rules and regulations and federal and state administrations which may affect employment or method of reimbursement.

answer

Public Agencies

question

Receive special tax exemptions and typically charge a fee for services and maintain a balanced budget to provide services. Include hospital and clinics with religious affiliation, private teaching hospitals, and organizations such as the Easter Seal Society and United cerebral palsy

answer

Private not-for-profit agencies

question

Owned and operated by individuals or groups of investors. In business to make a profit Multi-facility systems: May focus on a special level of care or an multiple facilities across the continuum of care

answer

Private for-profit agencies

question

Continuum of Care Acute Care Diagnosis-related groups Subacute Care Long-term Care

answer

Levels of Care

question

Healthcare is provided to the consumer along a continuum, as the client's needs dictate

answer

Continuum of Care

question

The first level on the continuum The client at this level has a sudden and short-term need for services and is typically seen in the hospital

answer

Acute-care

question

Depending on the client's diagnosis, hospitals are paid a predetermined, fixed fee, based on their diagnosis, regardless of the services provided. Started under the perspective payment system and public Law 98 - 21 Provides an incentive for hospitals and physicians to reduce costs and to discharge clients from the hospital as soon as possible Reduced number of OTs working in hospital-based settings

answer

Diagnosis-related groups

question

an interim level of care for shorter hospital stays At this level the client still needs care but does not require intensive level or specialized service, Thereby reducing hospital costs. Typically clients require one to four weeks more of rehabilitation Typical clients served for stroke or hip fracture, Cardiac condition, cancer Occupational therapy major component

answer

Subacute care

question

Hospitals (general, state and federal, specialty) Clinics Worksites (industry) Home health Skilled nursing facilities Medical problems caused by disease, disorder, or trauma OT addresses loss of capacity, loss of sense, limitation in development or growth, Limitation in movement, pain, damage to body systems, or neuromuscular disorders

answer

Biological/medical area of practice and setting

question

Institutions (psychiatric, mental retardation) Community mental health Teen centers Supervised living After school programs Emotional, cognitive, and affective or personality disorders Caused by an inability to cope with stress, biochemical imbalance, disease, or combination of developmental and environmental factors OT practitioners address psychological problems that affect thinking, memory, attention, emotional control, judgment, and self-concept

answer

Physiological areas of practice and setting

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Schools (public, special-visual impairment, hearing impairment, cerebral palsy) Day treatment Hippotherapy centers Workshops Special Olympics Special camp's(e.g., summer camps) Help clients meet the expectations of society Results from severe physical or cognitive disability that limits functioning, developmental delays, intellectual disability, long-term emotional problems, or a combination of problems OT practitioners address the absence of the ability to take care of one's own needs, lack or loss of life skills, poor interpersonal skills, failure to properly adapt to environmental changes, lack of capacity for independent functioning, and improper or detrimental behavior problems Generally require long-term life adjustments

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Sociological areas of practice and setting

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Industrial settings Therapeutic riding Officers Aqua therapy Senior citizen centers Migrant workers Victims of disasters Homeless people Correctional facilities Hospice National societies Role of practitioner varies according to the setting, Aim is to help individuals function more fully in their lives

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Nontraditional settings

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Include a long term care facilities that provide occupational. The services that address biological, psychological, and since theological functions

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All-inclusive settings

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Address a variety of aspects of client functioning and include clients of all ages and diagnosis

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Private practice and consulting settings

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Involves the interaction between the practitioner and the client the relationship between the practitioner and the client. The relationship between the practitioner and the client is a collaborative one that involves problem solving to support the clients occupational performance. The process is dynamic and the focus is on occupation and the client as an occupational being. Clients may be an individual, caregiver, group, or population Can be divided into the evaluation, intervention, and outcome

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Occupational therapy process

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Referral, screening, developing an occupational profile, and analyzing occupational performance Find out what the client wants and needs and to identify the factors support or hinder occupational performance Evaluation procedures based on client agent, diagnosis, developmental level, education, socioeconomic status, cultural background, and functional abilities

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Evaluation process

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First stage of occupational therapy process The request for service for a particular client OT is responsible for accepting and responding to referral May come from a physician, another professional, or the client May range from a specific prescription for dynamic orthosis or general suggestions to improve fine motor problems Federal, state, and local regulations and policies of third party payers determine the type of referral required and the role and OTA can have in the referral process

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Referral

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OT practitioner gathers preliminary information about the client and determines whether further evaluation and occupational therapy intervention are warranted Involves a review of the clients records, the use of a brief screening test, an interview with the client or caregiver, observation of the client, and/for a discussion of the client with referral source Practitioner investigates the clients prior and current level of occupational performance and determines the clients future occupational performance needs Practitioner communicates the screening results to the appropriate individuals OT initiates and directs the screening process, The OTA contributes to the screening process under direction of an OT Comprehensive evaluation arranged if screening suggests the client is in need of services

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Screening

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OT practitioner obtains initial information about the client, including the clients age, gender, and reason for referral; Diagnosis and medical history; prior living situation and level of function; and social, educational, and vocational background Information recorded in the clients occupational therapy chart and on the evaluation form Provides a practitioner with a history of the client's background and functional performance with which to design intervention Who is the client? Why is the client seeking service? What are the clients current concerns relative to engaging in occupations and daily life activities? What areas of occupation are successful, and what areas are causing problems or risks? What is the clients occupational history? What are the clients priorities and desired targeted outcomes?

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Occupational profile

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The practitioner makes decisions regarding the analysis of occupational performance from the information gathered during the occupational profile Information provides direction to the practitioner as to the areas that need to be further examined Practitioners select specific assessment instruments to collect further information Practitioner uses assessments to gather information on a client's occupational performance in regards to areas, skills, patterns, contexts, client factors, and activity demands Evaluation information forms the basis for the intervention plan Analyzing all aspects of the occupation to determine the client factors, patterns, contexts, skills, and behaviors required to be successful OT does final evaluation, OTA assist with the evaluation under OT supervision. Evaluation process: interview, skilled observation, and formal evaluation procedures

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Occupational Performance Analysis

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Primary mechanism for gathering information for the occupational profile Practitioner asks questions regarding the clients function in daily activities before the onset of the problem that resulted in the referral Used as a means of developing trust and rapport with the client Sometimes use a checklist or questionnaire for the interview to determine how the person spends his or her day and what types of activities he were she is involved Stages of interview: initial contact, information gathering, and closure

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Interview

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Put the subject at ease Introduce self and program Convey general information, not specific details Create a relaxed and unthreatening atmosphere, it is the first impression

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Initial Contact

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Guide conversation in a way to yield the desired data and keeps the flow easy and comfortable Explaine before beginning that you are taking notes Ask questions conversationally while making eye contact and do not read directly from notes Use interview outline

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Information Gathering

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Interviewer signals when the interview is about to end by summarizing the information gathered in reviewing the next step in the process Technique avoids abrupt time is up ending

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Closure

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Means of gathering information about a person or environment by watching and noticing Can occur through a structured series of steps introduced by the OT practitioner or maybe intentionally left unstructured to see what takes place Practitioner can observe the person's posture, dress, social skills, tone of voice, behavior, and physical abilities Structural observation is used to gain knowledge of what the person can or cannot do in relation to the demands of the task

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Observation

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Include tests, Instruments, or strategies that provide specific guidelines Informs practitioners about what is to be examined, how it is to be examined, how data are communicated, and how the information is applied in clinical problem-solving Have specific guidelines and are easily deep located and critically analyzed Test must have validity and reliability There are standardized tests and nonstandardized test

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Formal Assessment Procedures

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Research testing shows it to be a true measure of what it claims to measure

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Validity

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Measure of how accurately the scores obtained from the test reflects the true performance of the client Test - retest reliability Interrater reliability

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Reliability

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An indicator of the consistency of the results of a given test from one administration to another

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Test - retest reliability

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An indicator of the likelihood that test scores will be the same no matter who is the examiner

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Interrater reliability

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one that has gone through a rigorous process of scientific inquiry to determine its reliability and validity Carefully established protocol for administration Maybe based on normative data The Miller assessment for preschoolers(MAP) Sensory integration and Praxis test (SIPT)

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Standardized test

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Guidelines for administering and scoring but may not have established normative data or established reliability and validity Administration and scoring are more subjective and rely on clinical skill, judgment, and experience of the therapist

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Nonstandardized test

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Requires the practitioner to develop goals for the client, select activities, direct intervention to guide the client to learn ways of engaging in occupational performance, and monitor the results of the intervention

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Intervention process

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Based on an analysis of the information accumulated during the evaluation Problem identification Solution development Plan of action Outcome is a written report which addresses the strengths and weaknesses of the individual, interests of the client and caregivers, estimate of rehabilitation potential, and expected outcomes(short and long-term goals), along with frequency and duration of intervention, recommended methods and media, apparent environmental and time constraints, identification of a plan for reevaluation, and discharge planning

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Intervention plan

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OT reviews the results of the evaluation and identifies the client's strengths and deficits in occupational performance areas, performance skills, performance patterns, client factors, and contexts Includes developing a hypothesis about the cause of the problem

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Problem identification

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Process of identifying alternatives for intervention and forming goals and objectives Model of practice and frame of reference Each frame of reference is based on a body of knowledge that identifies principles and processes change Frame of reference provides the practitioner with guidelines for clinical reasoning and intervention planning

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Solution development

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Based on the problems and the identified frame of reference along with input received from the client First step is the creation of Long and short-term goals that address the problems identified Next intervention methods that will help the client achieve the goals are determined. Intervention methods are based on the selected frame of reference

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Plan of action

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Intervention: Involves working with the client through therapy to reach client goals Five intervention approaches: Create/promote Establish, restore Maintain Modify Prevent Implemented by: Consulting Education Central responsibility of the OTA

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Implementation of the plan

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The practitioner reevaluates by continually monitoring the clients needs, circumstances, and conditions to identify whether any permanent or temporary change in the intervention plan is required May result in changing activities, retesting, writing new plan, or making needed referrals The OT practitioner reevaluates the plan and how it is being carried out and achieving outcomes targeted for the client; modifies the plan as needed; And determines the need for continuation, discontinuation, or referral to another service

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Intervention review

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The coordination or facilitation of services for the purpose of preparing the client for a change May involve a change to a new functional level, life stage, program, or environment Practitioner is involved in identifying services and preparing an individualized transition plan to facilitate clients change from one place to another Transition plan needs to be individualized to meet the goals, needs, and environmental considerations of the individual client

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Transition services

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Last step of the intervention process Client is discharged when he or she has reached the goals delineated in the intervention plan, when he or she has realized the maximum benefit of occupational therapy services, or when he or she does not wish to continue services Discharge plan: developed and implemented to address the resources and supports that may be required upon discharge. Includes recommendations for continued services, Equipment recommendations, And any therapy the client is required to follow after discharge. May include training family members and caregivers OT writes a discharge summary of the clients functional level, changes that were made throughout the course of occupational therapy intervention, plans for discharge, equipment and services recommended, and follow-up

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Discontinuation of services

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Used to determine whether goals have been met and to make decisions regarding future intervention Provide objective feedback to the client and practitioner Important to select measures that are valid, reliable, and appropriately sensitive to change

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Outcome measure

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Include maintaining a safe and efficient workplace, documenting occupational therapy services, getting reimbursed for services, planning programs and evaluating them, integrating professional development activities and evidence-based practice into the workplace, and engaging in marketing and public relations

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Service management functions

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