PTA 120 Unit 2 Patient / Client Model – Flashcards
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2/Objective: List the five elements of patient/client management: List the elements that may be directed to the PTA
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2/Objective: List the components of the PT's plan of care
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2/Objective: Describe the relationship between the physical therapist's examination and evaluation, and the implementation of the physical therapist's plan of care
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2/Objective: Discuss the role of intervention as related to achievement of the goals in the plan of care
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2/Objective: discuss the purpose, significance and elements of the Guide to Physical Therapist Practice
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2/Objective: Describe the decision making process of the PTA within the intervention element of the patient/client management model
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3/How does PT work?!?!: T/F Physical Therapy varies greatly from PT/PTA to PT/PTA.
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False: Shouldn't be much different from PT/PTA to PT/PTA
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3/How does PT work?!?!: The PT framework assists medical personnel how? (4)
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Framework assists medical personnel: 1 - Road map (systematic patient treatment). 2 - Covers all bases. 3 - Easily transferable to new personnel. 4 - Easily described to 3rd parties (insurance companies, e.g.)
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4/Guide to Physical Therapist Practice: What is the purpose of the Guide to Physical Therapist Practice (GPTP)? (4)
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Purpose: 1 -Reference for PTs, PTAs, and others. 2 -Describe accepted physical therapist practice. 3 -Standardize terminology. 4 - Improve the delivery of PT services
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4/Guide to Physical Therapist Practice: Who uses the GPTP?
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Used by physical therapy education programs
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4/Guide to Physical Therapist Practice: Who reviews the GPTP?
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Reviewed by physical therapy community, (Revisions occurring now)
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4/Guide to Physical Therapist Practice: How do you access it?
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Now free online to members: http://guidetopractice.apta.org
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5/Guide to Physical Therapist Practice: What are the 4 GPTP preferred practice patterns?
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Preferred Practice Patterns: 1 - Musculoskeletal. 2 - Neuromuscular. 3 - Cardiovascular/Pulmonary. 4 - Integumentary
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5/Guide to Physical Therapist Practice: What are the 4 areas of PT the GPTP provides information?
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Provides information about: 1 - Examination. 2 - Evaluation. 3 - Diagnosis. 3 - Prognosis 4. - Intervention
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6/Guide to Physical Therapist Practice: What are the 6 areas associated with Impaired Posture?
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Impaired Posture (Musculoskeletal - Pattern B): 1- Medical diagnoses the patient may present with. 2 - What to include in the patient history (i.e., occupation). 3 - What to include in the examination (i.e., musculoskeletal symmetry). 4 - Which tests and measures to consider (i.e., functional capacity). 5 - Framework for developing the plan of care (i.e., expected number of visits). 6 - Interventions to consider (i.e., therapeutic exercise)
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7/Guide to Physical Therapist Practice: How does an experienced clinician use the GPTP?
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Experienced clinicians: confirms choices
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7/Guide to Physical Therapist Practice: How does the less experienced clinician use the GPTP
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Less experienced clinicians: offers additional options
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7/Guide to Physical Therapist Practice: What framework does it provide, give an example.
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Framework for clinical decision making (i.e., plan of care)
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7/Guide to Physical Therapist Practice: What does it interpret?
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Interprets physical therapy services
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7/Guide to Physical Therapist Practice: What major non-medical group uses the GPTP as a reference?
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Reference for insurance companies
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8/Terminology Used in the Guide: Define Patient according to GPTP.
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Patient: received physical therapy direct interventions
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8/Terminology Used in the Guide: Define Client according to GPTP.
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Client: individual that can benefit from PT services
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8/Terminology Used in the Guide: Define Examination according to GPTP.
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Examination: gathering objective & subjective patient/client data
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8/Terminology Used in the Guide: Define Evaluation according to GPTP.
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Evaluation: PT's clinical judgments based on examination data
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8/Terminology Used in the Guide: Define Interventions according to GPTP.
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Interventions: skilled techniques and activities in the treatment plan
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8/Terminology Used in the Guide: Define Discharge according to GPTP.
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Discharge: discontinuing interventions in a single episode of care
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9/Patient/Client Management Model: What are the 6 main steps for Patient/Client model?
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Examination - Evaluation - Diagnosis - Prognosis - Intervention - Outcomes
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10/Examination: What 3 areas occur during the pt/ct examination?
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Patient/client history. Systems Review. Tests and measures.
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10/Examination: What does the Patient/client history include and what are the sources.
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Patient/client history: 1 - Past and current health status. 2 - Systematically gathering data. 3 - Sources: interviews, medical chart, prescription
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10/Examination: What is the systems review for the pt/ct?
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Systems review: 1- Short examination that provides additional information. 2 -Hands-on. 3 - Anatomical and physiological status plus communication/cognitive ability
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10/Examination: How are tests and measures selected for the examination?
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Tests and measures: 1 -Selected by the PT based on above information - test hypotheses. 2 - Helps PT acquire more information about pt/ct status
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11/Evaluation: What basis does the PT make clinical judgments?
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PT makes clinical judgments based on data gathered during the examination
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11/Evaluation: The evaluation results impact what 3 areas?
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Results in determination of: 1 -Diagnosis. 2 - Prognosis. 3 - Interventions
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12/Evaluation: What factors does the PT consider for the evaluation?
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PT considers a number of factors: 1 - Level of impairment. 2- Degree of functional loss. 3 - Degree of disability. 4 - Patient's overall health and activity level. 5 - Availability of social support systems. 6 - Living environment. 7 - Potential discharge destination. 8 - Multisystem involvement. 9 - Chronicity. 10 - Comorbid conditions. 11 - Medical stability of the patient
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13/Diagnosis: Who determines the Medical Diagnosis? What does it identify? How achieved? (2)
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Medical diagnosis: Determined by a physician who Identifies a disease, illness or disorder. 1 - Determined by interview, physical exam, medical tests and other procedures. 2 - Cell, tissue, organ or system level
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13/Diagnosis: Who determines the PT diagnosis? What is it the end result of? What is determined and at what function level?
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Physical therapy diagnosis: -Determined by a physical therapist, the end result of evaluating information from examination. 1 - Determines the most appropriate intervention strategies. 2 - System level (especially movement system) or organism level
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14/Diagnosis: Give 3 PT Diagnosis examples.
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PT Diagnosis Examples: 1 - Impaired posture. 2 - Impaired muscle performance. 3 - Impaired joint mobility, motor function, muscle performance and range of motion associated with spinal disorders.
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14/Diagnosis: Who is the famous PT Diagnostician?
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Shirley Sahrmann, PT, PhD, FAPTA Diagnosis and Treatment of Movement Impairment Syndromes, Ex: Glenohumeral Hypomobility Syndrome
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15/Prognosis: Describe the Prognosis. (3)
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1 - Determination of the predicted level of optimal improvement in function. 2 - Amount of time needed to reach improvement. 3 - Prognosis included in plan of care
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16/Plan of Care: What are the 6 areas that make up the plan of care?
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1- Anticipated goals and expected outcomes. 2 - Predicted level of optimal improvement. 3 - Specific interventions to be used. 4 - Proposed duration and frequency of interventions required to reach stated goals and outcomes. 5 - Describes patient/client managemen. 6 - Includes prognosis and interventions
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17/Plan of Care - Anticipated Goals: What are the 2 types of goals? What do they need to include (4)
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STGs and LTGs. 1 - Measurable and time limited. 2 - Take into consideration the expectations of the pt/ct and others. 3 - Express changes expected as a result of pt/ct management. 4 - Indicate changes
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17/Plan of Care - Anticipated Goals: How are changes indicated? (3)
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Change descriptions include: 1) Impairments, functional limitations and disabilities. 2) Health, wellness and fitness. 3) Risk reduction, prevention and pt/ct satisfaction
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18/Intervention: Define intervention
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Purposeful interaction of PT/PTA with the pt/ct
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18/Intervention: What is an intervention?
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Using various physical therapy procedures and techniques
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18/Intervention: What type of intervention is best?
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Evidence-based is best
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18/Intervention: What should an intervention produce?
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Produce changes in the condition c/w diagnosis & prognosis
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18/Intervention: What should an intervention serve to help?
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Should serve to help patient/client achieve goals
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19/Considerations for the PTA: T/F The PTA is at liberty to perform interventions they deem necessary.
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False: Do not perform interventions that are not part of the POC
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19/Considerations for the PTA: What interventions should the PTA NOT perform?
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Do not perform interventions that do not have an associated goal. Ensure the PT has written a goal for any intervention requested of the PTA
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20/Considerations for the PTA: What should the PTA ensure for a written goal?
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If a goal is written, the PT should have assessed the skill; if not request that the PT evaluate that skill
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21/Outcomes: The results of pt/ct management of PT interventions impact the what domains? (6)
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Results of pt/ct management, which include the impact of PT interventions in the following domains: 1 - Pathology/pathophysiology. 2 - Impairments, functional limitations and disabilities. 3 - Risk reduction/prevention. 4 - Health, wellness and fitness. 5 - Societal resources. 6 - Patient/client satisfaction
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22/Role of PTA in Patient/Client Management Model: PTS assists the PT with what selected interventions? (3)
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PTA assists the PT with selected interventions: 1 - Provision of physical therapy interventions. 2 - Appropriate data collection related to those interventions. 3 - Communication with the PT, health care team, and in the medical record
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22/Role of PTA in Patient/Client Management Model: How is the Problem-solving Algorithm utilzed by PTAs?
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Problem-Solving Algorithm Utilized by PTAs in Patient/Client Intervention: Decision-making of the PTA within the intervention element
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24/Problem Solving Algorithm: What are the controlling assumptions for the problem solving algorithm (3)
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Controlling Assumptions: 1 - PT has implemented 5 pt/ct management model steps, including POC. 2 - PTA is directed and supervised by the PT. 3 - PT is responsible for care if POC includes selected interventions provided by the PTA.
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24/Problem Solving Algorithm: what do the selected interventions include as part of the problem solving algorithm? (4)
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Selected interventions include: 1 - Procedural intervention: 2 - Associated data collection. 3 - Communication (with the PT & in medical chart). 4 - Safe, effective & efficient completion of the task
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25/Problem Solving Algorithm: What does the entry point into the problem solving algorithm depend on?
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Entry into the algorithm will depend on the point at which the PTA is directed by the PT to perform the selected intervention
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25/Problem Solving Algorithm: T/F Communication between the PT and PTA is ongoing in the problem solving algorithm.
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True: Communication between the PT and PTA is ongoing
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26/Problem Solving Algorithm: Where is the start of the problem solving algorithm?
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Begin in the upper left corner - follow arrows
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26/Problem Solving Algorithm: How do you identify decision points?
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Decision points - boxes with diamonds
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26/Problem Solving Algorithm: How are action items identified in the problem solving algorithm?
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Action items - regular boxes
