This week focuses on: OT Process, NBCOT® Rules and Regulations, Professional Development, OT Roles, Medicare vs. Medicaid, Professional Standards & Ethics, OT and OTA, Research & Statistics, Frame of Reference and Models
This week focuses on: OT Process, NBCOT® Rules and Regulations, Professional Development, OT Roles, Medicare vs. Medicaid, Professional Standards & Ethics, OT and OTA, Research & Statistics, Frame of Reference and Models
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Ethics Clinical Simulation
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Scenario: An OTR® working in an outpatient clinic receives an order to evaluate and treat a 32-year-old woman who has been diagnosed with carpal tunnel syndrome. When the patient arrives for her initial evaluation, the OTR® discovers that the patient has also been diagnosed with an Autism spectrum disorder (ASD). Based on information gathered from interviewing the patient, the following has been ascertained: The patient is not married, and she lives with her sister and her sister’s family. She works at a local sheltered workshop that is run by a private, non-profit agency. She spends her leisure time playing video games and hand painting Christmas cards which she sells around Christmas time.
Section A: During the initial interview, the patient informs the OTR® that her hands become very painful when she is performing her job which consists of dipping metal blades into a liquid coating and then hanging these blades on a drying rack. Despite the patient’s sister “having had words” with the patient’s supervisor about her job placement at the workshop, the supervisor has refused to move the patient to another job. How should the OTR® proceed based on this information? Select the best 3 choices.
Rationale:
A. Gather more detailed information about the patient’s leisure activities, including how much time she spends playing her video games.
C. Include cognitive and mental health assessments as a part of the initial evaluation to determine if the patient’s ASD is having an impact on the cause of her carpal tunnel symptoms
E. Ask the patient and her sister for permission to contact the patient’s supervisor at the sheltered workshop to gather more information about the patient’s job.
Gathering more details about the patient’s cognitive and mental health status, video game habits, and job requirements all meet the criteria for following the Code of Ethics principle of Beneficence. This principle states that Occupational therapy personnel shall demonstrate a concern for the well-being and safety of the recipients of their services. Beneficence includes all forms of action intended to benefit other persons, and requires taking action by helping others, in other words, by promoting good, by preventing harm, and by removing harm. This includes: providing appropriate evaluation and a plan of intervention for recipients of occupational therapy services specific to their needs.
B. Asking the supervisor why the patient has not been assigned to another job violates the Code of Ethics principle of Veracity, as the OTR® is basing this question on subjective information that she received from the patient’s sister. Veracity is based on the virtues of truthfulness, candor, and honesty. The Principle of Veracity refers to comprehensive, accurate, and objective transmission of information. This includes refraining from using or participating in the use of any form of communication that contains false, fraudulent, deceptive, misleading, or unfair statements or claims.
D. Pressing the patient to stop playing video games even if she becomes distressed violates the Code of Ethics principle of Nonmaleficence, as the patient may need to play video games for stress relief. Nonmaleficence obligates OT personnel to abstain from causing harm to others.
F. Delaying contacting the patient’s supervisor violates the Code of Ethics principle of Beneficence by delaying an action that constitutes competent occupational therapy practice. However, asking the patient and her sister if it is alright to contact the supervisor follows the Code of Ethics principle of Autonomy by respecting the patient’s right to privacy regarding the disclosure of her supervisor’s actions related to her job placement at the workshop.
Rationale:
A. Gather more detailed information about the patient’s leisure activities, including how much time she spends playing her video games.
C. Include cognitive and mental health assessments as a part of the initial evaluation to determine if the patient’s ASD is having an impact on the cause of her carpal tunnel symptoms
E. Ask the patient and her sister for permission to contact the patient’s supervisor at the sheltered workshop to gather more information about the patient’s job.
Gathering more details about the patient’s cognitive and mental health status, video game habits, and job requirements all meet the criteria for following the Code of Ethics principle of Beneficence. This principle states that Occupational therapy personnel shall demonstrate a concern for the well-being and safety of the recipients of their services. Beneficence includes all forms of action intended to benefit other persons, and requires taking action by helping others, in other words, by promoting good, by preventing harm, and by removing harm. This includes: providing appropriate evaluation and a plan of intervention for recipients of occupational therapy services specific to their needs.
B. Asking the supervisor why the patient has not been assigned to another job violates the Code of Ethics principle of Veracity, as the OTR® is basing this question on subjective information that she received from the patient’s sister. Veracity is based on the virtues of truthfulness, candor, and honesty. The Principle of Veracity refers to comprehensive, accurate, and objective transmission of information. This includes refraining from using or participating in the use of any form of communication that contains false, fraudulent, deceptive, misleading, or unfair statements or claims.
D. Pressing the patient to stop playing video games even if she becomes distressed violates the Code of Ethics principle of Nonmaleficence, as the patient may need to play video games for stress relief. Nonmaleficence obligates OT personnel to abstain from causing harm to others.
F. Delaying contacting the patient’s supervisor violates the Code of Ethics principle of Beneficence by delaying an action that constitutes competent occupational therapy practice. However, asking the patient and her sister if it is alright to contact the supervisor follows the Code of Ethics principle of Autonomy by respecting the patient’s right to privacy regarding the disclosure of her supervisor’s actions related to her job placement at the workshop.
Scenario: An OTR® working in an outpatient clinic receives an order to evaluate and treat a 32-year-old woman who has been diagnosed with carpal tunnel syndrome. When the patient arrives for her initial evaluation, the OTR® discovers that the patient has also been diagnosed with an Autism spectrum disorder (ASD). Based on information gathered from interviewing the patient, the following has been ascertained: The patient is not married, and she lives with her sister and her sister’s family. She works at a local sheltered workshop that is run by a private, non-profit agency. She spends her leisure time playing video games and hand painting Christmas cards which she sells around Christmas time.
Section B: When the OTR® speaks to the patient’s supervisor about her job, the supervisor tells her that he believes the patient’s carpal tunnel syndrome is the direct result of her obsessive playing of video games when she is at home. He does not believe that the patient’s job has caused her condition and he feels that the patient is trying to get out of work. How should the OTR® respond to this information? Select the best 3 choices.
A. Ask the supervisor if she can schedule a work site evaluation to assess the patient’s job tasks and how the patient performs her job.
D. Discuss the effects of video game playing with the patient and her sister in a non-threatening way.
E. Inform the supervisor that there are many ways that repetitive motion injuries can develop and a full assessment of the patient’s daily living tasks, including her job, will help to develop a plan to alleviate her symptoms.
Performing a work site evaluation and discussing the effects of video game playing with the patient and her sister follow the Code of Ethics principle of Beneficence, by following appropriate occupational therapy evaluation and treatment procedures.
Conducting the work site evaluation over the phone rather than in person would violate this code, as the OTR® will not know if the supervisor is reporting the specifics of the patient’s job accurately or considering factors about the job that may be contributing to the patient’s symptoms. The supervisor may require justification for the work site evaluation, so informing him that the evaluation is necessary to develop an appropriate treatment plan follows the Code of Ethics principle of Fidelity by interacting with the supervisor with the same respect due to another professional. Questioning the supervisor about his knowledge of repetitive motion injuries implies that the supervisor is negligent in his duties toward the patient, violating the Code of Ethics principles of Veracity and Fidelity. Threatening to report the supervisor also violates these two principles.
A. Ask the supervisor if she can schedule a work site evaluation to assess the patient’s job tasks and how the patient performs her job.
D. Discuss the effects of video game playing with the patient and her sister in a non-threatening way.
E. Inform the supervisor that there are many ways that repetitive motion injuries can develop and a full assessment of the patient’s daily living tasks, including her job, will help to develop a plan to alleviate her symptoms.
Performing a work site evaluation and discussing the effects of video game playing with the patient and her sister follow the Code of Ethics principle of Beneficence, by following appropriate occupational therapy evaluation and treatment procedures.
Conducting the work site evaluation over the phone rather than in person would violate this code, as the OTR® will not know if the supervisor is reporting the specifics of the patient’s job accurately or considering factors about the job that may be contributing to the patient’s symptoms. The supervisor may require justification for the work site evaluation, so informing him that the evaluation is necessary to develop an appropriate treatment plan follows the Code of Ethics principle of Fidelity by interacting with the supervisor with the same respect due to another professional. Questioning the supervisor about his knowledge of repetitive motion injuries implies that the supervisor is negligent in his duties toward the patient, violating the Code of Ethics principles of Veracity and Fidelity. Threatening to report the supervisor also violates these two principles.
Scenario: An OTR® working in an outpatient clinic receives an order to evaluate and treat a 32-year-old woman who has been diagnosed with carpal tunnel syndrome. When the patient arrives for her initial evaluation, the OTR® discovers that the patient has also been diagnosed with an Autism spectrum disorder (ASD). Based on information gathered from interviewing the patient, the following has been ascertained: The patient is not married, and she lives with her sister and her sister’s family. She works at a local sheltered workshop that is run by a private, non-profit agency. She spends her leisure time playing video games and hand painting Christmas cards which she sells around Christmas time.
Section C: The OTR® completes the work site evaluation at the sheltered workshop. During the evaluation, she observes that the patient’s job consists of the following steps: Tightly pinching and maintaining a grasp on a small wire hook which is attached to a metal blade in order to pick a blade up from the table. Then, dipping the blade into a liquid coating for approximately 20 seconds. Finally, lifting the blade up to hang it on a drying rack. Each metal blade weighs about 3 pounds and this process is repeated until the patient has completed her quota for the day. The patient’s supervisor reports that the patient participates in the job for the full 6-hour work day. When asked why the patient has not been switched to another job, the supervisor states that there are only 4 people physical capable of completing the job, and the patient is one of them. He also appears surprised when the OTR® mentions that the physical actions of the job put stress on the carpal tunnel area. What conclusions can the OTR® make based on the work site evaluation? Select the best 3 choices.
A. The supervisor may think that the patient’s symptoms are only caused by her activities outside of work
B. The supervisor is not familiar with the causes and symptoms of carpal tunnel syndrome
E. The patient’s ASD has caused her to experience more difficulty dealing with her carpal tunnel symptoms on the job because she does not know how to communicate with the supervisor.
Concluding that the supervisor is not familiar with the causes of carpal tunnel syndrome and that the patient has had difficulty communicating her symptoms to the supervisor due to her ASD are fair conclusions based on the work-site evaluation and follow the Code of Ethics principle of Justice. The fact that the supervisor seems surprised that the physical actions of the job put stress on the carpal tunnel area could also lead the OTR® to conclude that the supervisor may think the patient’s symptoms are caused only by her activities outside of work, but the OTR® should not hold a biased attitude against the supervisor because of this conclusion. Instead, the OTR® should clarify with the supervisor what he thinks the causes of the patient’s symptoms are and educate him on how the patient’s job could contribute to her symptoms. Making assumptions about the supervisor’s personal feelings toward the patient and his attitude toward the patient’s symptoms or concern over her wellbeing violates the Code of Ethics principle of Fidelity, as the supervisor should be treated with respect and fairness during the evaluation process. Concluding that the patient has been faking her symptoms also violates the Code of Ethics principle of Fidelity as well as the principle of Justice, since the assumption does not allow for fair and objective treatment of the patient at her workplace.
A. The supervisor may think that the patient’s symptoms are only caused by her activities outside of work
B. The supervisor is not familiar with the causes and symptoms of carpal tunnel syndrome
E. The patient’s ASD has caused her to experience more difficulty dealing with her carpal tunnel symptoms on the job because she does not know how to communicate with the supervisor.
Concluding that the supervisor is not familiar with the causes of carpal tunnel syndrome and that the patient has had difficulty communicating her symptoms to the supervisor due to her ASD are fair conclusions based on the work-site evaluation and follow the Code of Ethics principle of Justice. The fact that the supervisor seems surprised that the physical actions of the job put stress on the carpal tunnel area could also lead the OTR® to conclude that the supervisor may think the patient’s symptoms are caused only by her activities outside of work, but the OTR® should not hold a biased attitude against the supervisor because of this conclusion. Instead, the OTR® should clarify with the supervisor what he thinks the causes of the patient’s symptoms are and educate him on how the patient’s job could contribute to her symptoms. Making assumptions about the supervisor’s personal feelings toward the patient and his attitude toward the patient’s symptoms or concern over her wellbeing violates the Code of Ethics principle of Fidelity, as the supervisor should be treated with respect and fairness during the evaluation process. Concluding that the patient has been faking her symptoms also violates the Code of Ethics principle of Fidelity as well as the principle of Justice, since the assumption does not allow for fair and objective treatment of the patient at her workplace.
Scenario: An OTR® working in an outpatient clinic receives an order to evaluate and treat a 32-year-old woman who has been diagnosed with carpal tunnel syndrome. When the patient arrives for her initial evaluation, the OTR® discovers that the patient has also been diagnosed with an Autism spectrum disorder (ASD). Based on information gathered from interviewing the patient, the following has been ascertained: The patient is not married, and she lives with her sister and her sister’s family. She works at a local sheltered workshop that is run by a private, non-profit agency. She spends her leisure time playing video games and hand painting Christmas cards which she sells around Christmas time.
Section D: After 6 weeks of occupational therapy intervention, the patient’s carpal tunnel symptoms have improved, but she is still having problems at work. Despite the OTR® providing written recommendations to the patient’s supervisor and education in the causes and symptoms of carpal tunnel syndrome, he has refused to provide any adaptations to the patient’s job or place her on another job. The only accommodation he has allowed is rest breaks every hour to allow the patient to ice her wrists. The patient and her sister are both very upset with the supervisor and the sheltered workshop. The supervisor will not return the OTR®’s phone calls. How should the OTR® proceed? Select the best 3 choices.
A. Write a letter to the supervisor expressing concern over the lack of follow through with the recommendations for adapting the patient’s job. The letter should explain how the patient’s rights are violated at work by not providing adaptations.
C. Give the patient and her sister information on what further action they can take if the supervisor does not respond to the letter from the OTR® or make changes to the patient’s job.
E. Discuss with the patient and her sister how she feels about her job and if she should consider taking a leave of absence to recover from her symptoms. Allow the patient and her sister to come to their own decision regarding the leave of absence.
Writing the letter to the supervisor expressing concern over the lack of follow through follows the Code of Ethics principles of Justice and Fidelity by allowing the supervisor to directly respond to the OTR®’s concerns before any further action is taken. Bypassing the supervisor and reporting the situation to the management of the sheltered workshop or the county would violate these principles. However, providing the woman and her sister with information on how to proceed if the supervisor does not respond to the letter or make changes to the woman’s job follows the principle of Justice by empowering the woman and her sister with the ability to follow up regarding the woman’s rights at the sheltered workshop. Since the woman is not capable of advocating for herself, telling the woman’s sister to file a complaint with the management of the sheltered workshop without the participation of the woman herself violates the Code of Ethics principle of Justice. Discussing a possible leave of absence from the job, however, follows the Code of Ethics principle of Autonomy, as it allows the woman to take part in making her own decision regarding whether she should continue working.
A. Write a letter to the supervisor expressing concern over the lack of follow through with the recommendations for adapting the patient’s job. The letter should explain how the patient’s rights are violated at work by not providing adaptations.
C. Give the patient and her sister information on what further action they can take if the supervisor does not respond to the letter from the OTR® or make changes to the patient’s job.
E. Discuss with the patient and her sister how she feels about her job and if she should consider taking a leave of absence to recover from her symptoms. Allow the patient and her sister to come to their own decision regarding the leave of absence.
Writing the letter to the supervisor expressing concern over the lack of follow through follows the Code of Ethics principles of Justice and Fidelity by allowing the supervisor to directly respond to the OTR®’s concerns before any further action is taken. Bypassing the supervisor and reporting the situation to the management of the sheltered workshop or the county would violate these principles. However, providing the woman and her sister with information on how to proceed if the supervisor does not respond to the letter or make changes to the woman’s job follows the principle of Justice by empowering the woman and her sister with the ability to follow up regarding the woman’s rights at the sheltered workshop. Since the woman is not capable of advocating for herself, telling the woman’s sister to file a complaint with the management of the sheltered workshop without the participation of the woman herself violates the Code of Ethics principle of Justice. Discussing a possible leave of absence from the job, however, follows the Code of Ethics principle of Autonomy, as it allows the woman to take part in making her own decision regarding whether she should continue working.
Clinical Simulation, setting 2: Scenario: An OTR® and a COTA® work in a small rural school district. The school is one continuous building, with an elementary school at one end and a middle/high school at the other end. The therapy room is in a sectioned off portion of a larger room that is part of the four-year-old kindergarten program. The dividers for the therapy space do not go up to the ceiling and do not block sound. The school district is in an impoverished area with high unemployment. About half of the student who attend school in the district are members of a local Native American tribe.
Section A: The OTR® and the COTA® work together in three school districts total. To comply with supervision regulations, they meet once per month to discuss all the students on their caseloads. They usually meet at this school because it fits into the schedule. The OTR® and the COTA® discuss all their students during the meeting, including the students from other schools. During the meeting, the four-year-old kindergarten class enters the other side of the partitioned room for play time. What should the OTR® and COTA® do? Select the best 3 choices.
Discussing students in front of other students or teachers violates the Code of Ethics principle of Autonomy for all the occupational therapy students by violating their privacy, even if others present will not understand the conversation. Confidential information might be overheard and identified even if students are not named. Asking the teacher to reschedule playtime violates the Code of Ethics principle of Fidelity by not showing the teacher respect in the scheduling of her class time. Moving or rescheduling the meeting follows the Code of Ethics principle of Autonomy for the occupational therapy students. Meeting via Skype is acceptable as long as both the OTR® and COTA® are in private areas when the meeting takes place.
Discussing students in front of other students or teachers violates the Code of Ethics principle of Autonomy for all the occupational therapy students by violating their privacy, even if others present will not understand the conversation. Confidential information might be overheard and identified even if students are not named. Asking the teacher to reschedule playtime violates the Code of Ethics principle of Fidelity by not showing the teacher respect in the scheduling of her class time. Moving or rescheduling the meeting follows the Code of Ethics principle of Autonomy for the occupational therapy students. Meeting via Skype is acceptable as long as both the OTR® and COTA® are in private areas when the meeting takes place.
Clinical Simulation, setting 2: Scenario: An OTR® and a COTA® work in a small rural school district. The school is one continuous building, with an elementary school at one end and a middle/high school at the other end. The therapy room is in a sectioned off portion of a larger room that is part of the four-year-old kindergarten program. The dividers for the therapy space do not go up to the ceiling and do not block sound. The school district is in an impoverished area with high unemployment. About half of the student who attend school in the district are members of a local Native American tribe.
Section B: The occupational therapy caseload at the school has been high due to a large number of referrals from the county birth to three agency. The special education director approaches the OTR® about the high caseload numbers and asks if any of the students can be dismissed, as the school budget will not support the level of occupational therapy services currently being provided. How should the OTR® respond? Select the best 3 choices..
The response to this request must be carefully considered to observe the Code of Ethics principles of Beneficence, Nonmaleficence, Justice and Fidelity, as the OTR® must respond to the special education director in a professional manner that is beneficial to the school while at the same time looking out for the best interests of her students. Giving estimated dates of dismissal for those students who are ready to be dismissed or requesting that their IEP annual reviews be moved up follows these principles. Telling the special education director that the OTR® will decide when students are dismissed violates the Code of Ethics principles of Autonomy and Fidelity, as it is the IEP team that makes the final decision regarding dismissal from occupational therapy services, not the OTR® alone. Putting the special education director off violates the Code of Ethics principle of Fidelity. Discussing the possible decrease in hours with the COTA® follows the Code of Ethics principle of Veracity as the OTR® and COTA®’s are collaborating in preparation for a decrease in hours at the school.
The response to this request must be carefully considered to observe the Code of Ethics principles of Beneficence, Nonmaleficence, Justice and Fidelity, as the OTR® must respond to the special education director in a professional manner that is beneficial to the school while at the same time looking out for the best interests of her students. Giving estimated dates of dismissal for those students who are ready to be dismissed or requesting that their IEP annual reviews be moved up follows these principles. Telling the special education director that the OTR® will decide when students are dismissed violates the Code of Ethics principles of Autonomy and Fidelity, as it is the IEP team that makes the final decision regarding dismissal from occupational therapy services, not the OTR® alone. Putting the special education director off violates the Code of Ethics principle of Fidelity. Discussing the possible decrease in hours with the COTA® follows the Code of Ethics principle of Veracity as the OTR® and COTA®’s are collaborating in preparation for a decrease in hours at the school.
Clinical Simulation, setting 2: An OTR® and a COTA® work in a small rural school district. The school is one continuous building, with an elementary school at one end and a middle/high school at the other end. The therapy room is in a sectioned off portion of a larger room that is part of the four-year-old kindergarten program. The dividers for the therapy space do not go up to the ceiling and do not block sound. The school district is in an impoverished area with high unemployment. About half of the student who attend school in the district are members of a local Native American tribe.
Section C: One of the students receiving occupational therapy services at the school is a 10-year-old girl with an educational diagnosis of Intellectual Disability. While the COTA® is conducting a session with the girl, the girl tells the COTA® that her uncle touched her private parts. The girl has a history of making comments that are not always true. How should the COTA® respond? Select the best 3 choices.
Reporting suspected abuse is mandatory for all school personnel, but it must be handled discreetly through proper channels. Since the COTA® reports directly to the OTR®, the COTA® should report the comment directly to the OTR® or follow any pre-arranged instructions given in the case of such an event. These two actions follow the Code of Ethics principles of Nonmaleficence and Fidelity. Letting the OTR® handle the situation violates the principle of Nonmaleficence because the COTA® is not doing all she can to prevent further harm to the student. Ignoring the girl’s comment also violates the principle of Nonmaleficence as the comment must be taken seriously until disproved, but taking the girl’s comment seriously supports this principle. OTs are not trained to ask questions in order to clarify the situation. Bypassing the OTR® or the student’s case manager violates the principle of Fidelity.
Reporting suspected abuse is mandatory for all school personnel, but it must be handled discreetly through proper channels. Since the COTA® reports directly to the OTR®, the COTA® should report the comment directly to the OTR® or follow any pre-arranged instructions given in the case of such an event. These two actions follow the Code of Ethics principles of Nonmaleficence and Fidelity. Letting the OTR® handle the situation violates the principle of Nonmaleficence because the COTA® is not doing all she can to prevent further harm to the student. Ignoring the girl’s comment also violates the principle of Nonmaleficence as the comment must be taken seriously until disproved, but taking the girl’s comment seriously supports this principle. OTs are not trained to ask questions in order to clarify the situation. Bypassing the OTR® or the student’s case manager violates the principle of Fidelity.
Clinical Simulation, setting 2: Scenario: An OTR® and a COTA® work in a small rural school district. The school is one continuous building, with an elementary school at one end and a middle/high school at the other end. The therapy room is in a sectioned off portion of a larger room that is part of the four-year-old kindergarten program. The dividers for the therapy space do not go up to the ceiling and do not block sound. The school district is in an impoverished area with high unemployment. About half of the student who attend school in the district are members of a local Native American tribe.
Section D:The OTR® and the COTA® are each conducting sessions with students at the same time in the therapy space. The COTA® begins telling the OTR® that one of the kindergarten teachers is getting a divorce. How should the OTR® respond? Select the best 3 choices..
1) Yes: This action observes the Code of Ethics principle of Fidelity because it protects the kindergarten teacher’s privacy while at the same time respecting the professional relationship between the OTR® and the COTA®.
2) No: This action violates the Code of Ethics principle of Fidelity because the therapists are discussing private information about a school employee in front of students.
3) No: The comment cannot be ignored because the COTA® has violated an ethical principle.
4) Yes: This action protects the kindergarten teacher’s privacy but does not explain to the COTA® why the OTR® refuses to discuss the subject.
5) No:This action violates the Code of Ethics principle of Fidelity. While the OTR® is correct, her COTA® will probably feel chastised by this remark.
6) Yes: The COTA® may have forgotten about the need to respect the privacy of other employees and requires a review of procedures to insure the situation does not happen again.
1) Yes: This action observes the Code of Ethics principle of Fidelity because it protects the kindergarten teacher’s privacy while at the same time respecting the professional relationship between the OTR® and the COTA®.
2) No: This action violates the Code of Ethics principle of Fidelity because the therapists are discussing private information about a school employee in front of students.
3) No: The comment cannot be ignored because the COTA® has violated an ethical principle.
4) Yes: This action protects the kindergarten teacher’s privacy but does not explain to the COTA® why the OTR® refuses to discuss the subject.
5) No:This action violates the Code of Ethics principle of Fidelity. While the OTR® is correct, her COTA® will probably feel chastised by this remark.
6) Yes: The COTA® may have forgotten about the need to respect the privacy of other employees and requires a review of procedures to insure the situation does not happen again.
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Module 1 OT Quiz
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An OT is planning on assessing the gross motor skills of a 15-year-old boy who presents with a global developmental delay and decides to save time by using an assessment that is quick to administer. The assessment is however, out of date (first edition) and not standardized for children older than 12 years of age. Is the OT violating any ethical principles by administering this assessment?
B. Yes, Beneficence.
Beneficence. Principle 1. Occupational therapy personnel shall demonstrate a concern for the well-being and safety of the recipients of their services. Beneficence includes all forms of action intended to benefit other persons. 1A- Provide appropriate evaluation and a plan of intervention for recipients of occupational therapy services specific to their needs.
1C- Use, to the extent possible, evaluation, planning, intervention techniques, assessments, and therapeutic equipment that are evidence based, current, and within the recognized scope of occupational therapy practice.
D. Autonomy- Principle 3. Occupational therapy personnel shall respect the right of the individual to self-determination, privacy, confidentiality, and consent.
The Principle of Autonomy expresses the concept that practitioners have a duty to treat the client according to the client’s desires, within the bounds of accepted standards of care, and to protect the client’s confidential information.
B. Yes, Beneficence.
Beneficence. Principle 1. Occupational therapy personnel shall demonstrate a concern for the well-being and safety of the recipients of their services. Beneficence includes all forms of action intended to benefit other persons. 1A- Provide appropriate evaluation and a plan of intervention for recipients of occupational therapy services specific to their needs.
1C- Use, to the extent possible, evaluation, planning, intervention techniques, assessments, and therapeutic equipment that are evidence based, current, and within the recognized scope of occupational therapy practice.
D. Autonomy- Principle 3. Occupational therapy personnel shall respect the right of the individual to self-determination, privacy, confidentiality, and consent.
The Principle of Autonomy expresses the concept that practitioners have a duty to treat the client according to the client’s desires, within the bounds of accepted standards of care, and to protect the client’s confidential information.
An OTR® is preparing a presentation on hip precautions post total hip replacement, anterior approach. While looking for information on the internet, the OTR® comes across a slide presentation which was published by an orthopedic surgeon, 3 years ago. To save time, the OTR® decides to copy the presentation as it has all the relevant information and great diagrams to illustrate the specific hip precautions. By presenting the information, which was copied directly from the doctor’s presentation, is the OTR® violating any ethical principles?
D. Yes, Veracity.
Veracity. Principle 5. Occupational therapy personnel shall provide comprehensive, accurate, and objective information when representing the profession. Veracity is based on the virtues of truthfulness, candor, and honesty. The Principle of Veracity refers to comprehensive, accurate, and objective transmission of information and is based on respect owed to others, including but not limited to recipients of service, colleagues, students, researchers, and research participants. This includes avoiding plagiarism of others’ work (AOTA, 2010b). 5H- Give credit and recognition when using the ideas and work of others in written, oral, or electronic media (i.e., do not plagiarize).
C. Justice- Principle 4. Occupational therapy personnel shall promote fairness and objectivity in the provision of occupational therapy services.
https://www.pacificu.edu/sites/default/files/documents/Code%20of%20Ethics%202015.pdf
D. Yes, Veracity.
Veracity. Principle 5. Occupational therapy personnel shall provide comprehensive, accurate, and objective information when representing the profession. Veracity is based on the virtues of truthfulness, candor, and honesty. The Principle of Veracity refers to comprehensive, accurate, and objective transmission of information and is based on respect owed to others, including but not limited to recipients of service, colleagues, students, researchers, and research participants. This includes avoiding plagiarism of others’ work (AOTA, 2010b). 5H- Give credit and recognition when using the ideas and work of others in written, oral, or electronic media (i.e., do not plagiarize).
C. Justice- Principle 4. Occupational therapy personnel shall promote fairness and objectivity in the provision of occupational therapy services.
https://www.pacificu.edu/sites/default/files/documents/Code%20of%20Ethics%202015.pdf
An inpatient who has a complete C8 SCI has been participating in OT for 2 weeks to improve his performance in upper body dressing. The patient is now able to transfer into his wheelchair and don a t-shirt, but he is still unable to reach for the t-shirt, from the closet. Which statement indicates the BEST description for the assessment portion of the SOAP progress note?
B. “The patient is learning techniques and is progressing towards the long-term dressing goal for dressing”.
Low-Cervical Nerves (C5 – C8). The “A” portion of the SOAP note represents the assessment which reflects the patient’s progress, functional limitations, and expected benefits from skilled OT interventions and to justify continuation in rehabilitation. The assessment describes the clinician’s interpretation of the “S” and “O” of the SOAP note and reflects the clinician’s clinical judgement.
B. “The patient is learning techniques and is progressing towards the long-term dressing goal for dressing”.
Low-Cervical Nerves (C5 – C8). The “A” portion of the SOAP note represents the assessment which reflects the patient’s progress, functional limitations, and expected benefits from skilled OT interventions and to justify continuation in rehabilitation. The assessment describes the clinician’s interpretation of the “S” and “O” of the SOAP note and reflects the clinician’s clinical judgement.
In which 3 situations is a patient’s confidentiality MOST at risk of being compromised? Select the 3 best answers.
A. If a patient is being treated by an OT practitioner who is a family member.
C. During a telehealth consultation.
D. If an OT practitioner treats a friend that they know through social media.
A. As a relative’s OT practitioner, you might have access to information that as a family member the patient did not want to share with you or any family member.
C. One of the risks related to providing services via telecommunication include the potential for loss of client privacy or confidentiality. Practitioners should consider all these risks as well as benefits when determining whether to provide occupation therapy services via telehealth technology. When it comes to telehealth, patients have the right to know that, despite efforts to protect their privacy and confidentiality, breaches may occur. In these instances, practitioners should understand and adhere to appropriate procedures addressing the compromise of the patient’s privacy and confidentiality of protected health information (AOTA, 2013). To maximize privacy and confidentiality, organizations and practitioners should use authentication or encryption technology. Authentication technology ensures that people accessing the technology are whom they claim to be, and encryption ensures that no one can copy information transported via the Internet.
D. As stated in the AOTA Advisory Opinion on social networking, those who “engage in online friendships with clients can jeopardize professional boundaries by involvement in a dual relationship with service recipients” (AOTA, 2011, p. 2). It is best to avoid this type of relationship, when possible, because of perceived conflict of interest and concerns about privacy and confidentiality. Although it may not be unlawful to have a client who is a friend, it may provoke ethical challenges and is not recommended.
B. To be considered “de-identified”, ALL of the 18 HIPAA Identifiers must be removed from the data set.
The HIPAA Privacy Rule sets forth policies to protect 18 identifiers that are considered Personally Identifiable Information (PII). These are data points that can be used to identify, contact, or locate an individual. When one of these identifiers is used in conjunction with a person’s healthcare information, or a payment method used for that healthcare, it becomes Protected Health Information (PHI).
These are the 18 identifiers designated under HIPAA:
1. Name
2. Geographical element – street address, city, county, or zip code (smaller than state)
3. Dates – birthdate, admission date, discharge date, date of death, and exact age if over 89
4. Telephone number
5. Fax number
6. Email address
7. Social Security Number
8. Medical record number
9. Health plan beneficiary number
10. Account number
11. Certificate or license number
12. Vehicle license plate and other identifiers
13. Device serial number
14. Website URL
15. Internet Protocol (IP) Address
16. Finger or voiceprint
17. Photographic image (any body part)
18. Any other characteristic that could uniquely identify the individual (like a tattoo)
E. For digital documents that need to be sent to a third party, you can either email or use a file sharing program. If you use a file sharing program, then it’s very important to encrypt the documents and make sure you use a trusted service provider.
F. For any information that’s stored digitally it’s incredibly important that you control access to it by using passwords, firewalls and encryption. This is especially important when the information is contained on smaller storage devices such as USB drives that are easily misplaced.
A. If a patient is being treated by an OT practitioner who is a family member.
C. During a telehealth consultation.
D. If an OT practitioner treats a friend that they know through social media.
A. As a relative’s OT practitioner, you might have access to information that as a family member the patient did not want to share with you or any family member.
C. One of the risks related to providing services via telecommunication include the potential for loss of client privacy or confidentiality. Practitioners should consider all these risks as well as benefits when determining whether to provide occupation therapy services via telehealth technology. When it comes to telehealth, patients have the right to know that, despite efforts to protect their privacy and confidentiality, breaches may occur. In these instances, practitioners should understand and adhere to appropriate procedures addressing the compromise of the patient’s privacy and confidentiality of protected health information (AOTA, 2013). To maximize privacy and confidentiality, organizations and practitioners should use authentication or encryption technology. Authentication technology ensures that people accessing the technology are whom they claim to be, and encryption ensures that no one can copy information transported via the Internet.
D. As stated in the AOTA Advisory Opinion on social networking, those who “engage in online friendships with clients can jeopardize professional boundaries by involvement in a dual relationship with service recipients” (AOTA, 2011, p. 2). It is best to avoid this type of relationship, when possible, because of perceived conflict of interest and concerns about privacy and confidentiality. Although it may not be unlawful to have a client who is a friend, it may provoke ethical challenges and is not recommended.
B. To be considered “de-identified”, ALL of the 18 HIPAA Identifiers must be removed from the data set.
The HIPAA Privacy Rule sets forth policies to protect 18 identifiers that are considered Personally Identifiable Information (PII). These are data points that can be used to identify, contact, or locate an individual. When one of these identifiers is used in conjunction with a person’s healthcare information, or a payment method used for that healthcare, it becomes Protected Health Information (PHI).
These are the 18 identifiers designated under HIPAA:
1. Name
2. Geographical element – street address, city, county, or zip code (smaller than state)
3. Dates – birthdate, admission date, discharge date, date of death, and exact age if over 89
4. Telephone number
5. Fax number
6. Email address
7. Social Security Number
8. Medical record number
9. Health plan beneficiary number
10. Account number
11. Certificate or license number
12. Vehicle license plate and other identifiers
13. Device serial number
14. Website URL
15. Internet Protocol (IP) Address
16. Finger or voiceprint
17. Photographic image (any body part)
18. Any other characteristic that could uniquely identify the individual (like a tattoo)
E. For digital documents that need to be sent to a third party, you can either email or use a file sharing program. If you use a file sharing program, then it’s very important to encrypt the documents and make sure you use a trusted service provider.
F. For any information that’s stored digitally it’s incredibly important that you control access to it by using passwords, firewalls and encryption. This is especially important when the information is contained on smaller storage devices such as USB drives that are easily misplaced.
Reginald, a 68-year-old patient who presents with mild flexor spasticity of his dominant upper extremity, is working with the OTR® on selecting activities to incorporate into his intervention plan. Functionally, Reginald has good stability and balance to perform standing tasks. He discusses his hobbies with the OTR® and expresses his joy in cooking simple meals and entertaining his friends at home. Using a bottom-up approach, which of the following activities addresses Reginald’s underlying deficit and also gives him the opportunity to continue participating in his preferred occupations?
Choose 3 best answers.
C. Integrate bimanual activities such as waxing the hood of the car with a large towel.
D. Place cans of food in upper cabinets using the affected hand while wearing a hand mitt on the unaffected hand.
E. Organize coins onto a collectors coin mat while stabilizing the mat vertically against a wall with scheduled rest periods.
A bottom -up approach aims to recover underlying skills.
The goal in this scenario, is to reduce the underlying deficit of spasticity and increase functional use of the affected arm through remediation by engaging the patient in voluntary practice with the impaired side. Bilateral integration including weight bearing and stabilization of the affected upper extremity reduces spasticity and improves motor function necessary to perform cooking skills.
A. Uses a compensatory approach to maximize skills by using tools that take the place of the patient’s ability to safely stabilize and cut food.
B. Focuses on support and not improving underlying deficit.
F. Does not utilize the dominant upper extremity.
Pass the OT Study Materials – Module 1: “Bottom-Up and Top-Down Approaches”
Siebers, A., Oberg, U., & Skargren, E. (2010). The effect of modified constraint-induced movement therapy on spasticity and motor function of the affected arm in patients with chronic stroke. Physiotherapy Canada. Physiotherapie Canada, 62(4), 388–396. doi:10.3138/physio.62.4.388
C. Integrate bimanual activities such as waxing the hood of the car with a large towel.
D. Place cans of food in upper cabinets using the affected hand while wearing a hand mitt on the unaffected hand.
E. Organize coins onto a collectors coin mat while stabilizing the mat vertically against a wall with scheduled rest periods.
A bottom -up approach aims to recover underlying skills.
The goal in this scenario, is to reduce the underlying deficit of spasticity and increase functional use of the affected arm through remediation by engaging the patient in voluntary practice with the impaired side. Bilateral integration including weight bearing and stabilization of the affected upper extremity reduces spasticity and improves motor function necessary to perform cooking skills.
A. Uses a compensatory approach to maximize skills by using tools that take the place of the patient’s ability to safely stabilize and cut food.
B. Focuses on support and not improving underlying deficit.
F. Does not utilize the dominant upper extremity.
Pass the OT Study Materials – Module 1: “Bottom-Up and Top-Down Approaches”
Siebers, A., Oberg, U., & Skargren, E. (2010). The effect of modified constraint-induced movement therapy on spasticity and motor function of the affected arm in patients with chronic stroke. Physiotherapy Canada. Physiotherapie Canada, 62(4), 388–396. doi:10.3138/physio.62.4.388
OTs collaborate with patients to identify both strengths and barriers to health, well-being, and participation. As part of this process, the OT considers a variety of environmental and contextual factors to direct the clinical reasoning process that guides patient evaluation, intervention, and targeting of outcomes. Partaking in a tradition of cooking a Christmas ham is an example of considering which context?
B. Cultural context
This is an example of a cultural tradition for the patient’s family.
B. Cultural context
This is an example of a cultural tradition for the patient’s family.
Sally, a program supervisor at an outpatient rehabilitation facility has identified the need to introduce a system that continuously monitors patients’ outcomes as she wants to monitor how many patients achieve their therapy goals before being discharged. What measures should this approach be based on for it to be successful?
D. The relationship between the presenting occupational performance deficits and the intervention goals.
Continuous quality improvement is a system-oriented approach that views limitations and problems proactively as opportunities to increase quality. The program director can use the data regarding performance deficits and intervention goals to provide inservice training to the therapy staff on goal writing.
D. The relationship between the presenting occupational performance deficits and the intervention goals.
Continuous quality improvement is a system-oriented approach that views limitations and problems proactively as opportunities to increase quality. The program director can use the data regarding performance deficits and intervention goals to provide inservice training to the therapy staff on goal writing.
In an outpatient clinic, an OT is working with a 43-year-old patient who is recovering from a right CVA. The patient has been working as a school bus driver for the past ten years and would like to return to work. In the last two treatment sessions, the OT has seen a decline in the patient’s reaction time and visual acuity. What action should the OT take next?
B. Report the information to the physician.
It is important to report this information to the physician so that the physician can do further testing. The physician needs to be made aware of the patient’s deficits, so that he/she can assess further assess the patient and discuss the matter with the patient. Besides the patient possibly needing further testing, it is typically the physician’s legal responsibility to report impaired drivers. It is not within the scope of practice, for an OT to make recommendations for driver training in this scenario, or to report the driver to the authorities.
B. Report the information to the physician.
It is important to report this information to the physician so that the physician can do further testing. The physician needs to be made aware of the patient’s deficits, so that he/she can assess further assess the patient and discuss the matter with the patient. Besides the patient possibly needing further testing, it is typically the physician’s legal responsibility to report impaired drivers. It is not within the scope of practice, for an OT to make recommendations for driver training in this scenario, or to report the driver to the authorities.
Name the research method that starts with the collection and analysis of data and does not begin with a hypothesis.
B. Grounded theory.
Grounded Theory Method involves the discovery of theory through the analysis of data. Grounded theory method is a research method which operates almost in a reverse fashion from traditional social science research. Rather than beginning with a hypothesis, the first step is data collection through a variety of methods. From the data collected, the key points are marked with a series of codes, which are extracted from the text. The codes are grouped into similar concepts in order to make the data more workable. From these concepts, categories are formed, which are the basis for the creation of a theory, or a reverse engineered hypothesis. This contradicts the traditional model of research, where the researcher chooses a theoretical framework, and only then applies this model to the phenomenon to be studied.
B. Grounded theory.
Grounded Theory Method involves the discovery of theory through the analysis of data. Grounded theory method is a research method which operates almost in a reverse fashion from traditional social science research. Rather than beginning with a hypothesis, the first step is data collection through a variety of methods. From the data collected, the key points are marked with a series of codes, which are extracted from the text. The codes are grouped into similar concepts in order to make the data more workable. From these concepts, categories are formed, which are the basis for the creation of a theory, or a reverse engineered hypothesis. This contradicts the traditional model of research, where the researcher chooses a theoretical framework, and only then applies this model to the phenomenon to be studied.
What is the value of prudence most associated with?
C. Using clinical and ethical reasoning skills.
Prudence—The concept of prudence means that occupational therapy personnel “use their clinical and ethical reasoning skills, sound judgment, and reflection to make decisions in professional and volunteer roles.
https://www.aota.org/~/media/Corporate/Files/Practice/Ethics/Advisory/state-licensure-professionalism-and-ethics.pdf
C. Using clinical and ethical reasoning skills.
Prudence—The concept of prudence means that occupational therapy personnel “use their clinical and ethical reasoning skills, sound judgment, and reflection to make decisions in professional and volunteer roles.
https://www.aota.org/~/media/Corporate/Files/Practice/Ethics/Advisory/state-licensure-professionalism-and-ethics.pdf
Which FOR would be best to use when working with a woman recovering from a traumatic brain injury?
Neurodevelopmental Treatment and Proprioceptive Neuromuscular Facilitation are frames of reference that were developed to address neurological conditions such as a traumatic brain injury (TBI). The Dynamic Interactional Approach was designed for people with cognitive dysfunction, which often occurs as a result of TBI. The Model of Human Occupation is a frame of reference that can be used with clients of any diagnosis. Psychodynamic Theory is a frame of reference that primarily pertains to people with mental health disorders, while Sensory Integration is a frame of reference developed for use with children and adults who have neuropsychological conditions that include sensory processing dysfunction.
Neurodevelopmental Treatment and Proprioceptive Neuromuscular Facilitation are frames of reference that were developed to address neurological conditions such as a traumatic brain injury (TBI). The Dynamic Interactional Approach was designed for people with cognitive dysfunction, which often occurs as a result of TBI. The Model of Human Occupation is a frame of reference that can be used with clients of any diagnosis. Psychodynamic Theory is a frame of reference that primarily pertains to people with mental health disorders, while Sensory Integration is a frame of reference developed for use with children and adults who have neuropsychological conditions that include sensory processing dysfunction.
A 24-year- old woman has been referred to the outpatient clinic for occupational therapy treatment, for carpal tunnel syndrome. The woman’s health insurance has very limited coverage of occupational therapy services and refuses to pay for additional treatment after 4 sessions. The woman could definitely benefit from additional treatment. What is the best action to take in this scenario?
B. Inform the woman of the coverage limitations and the costs for paying out of pocket.
If a patient’s insurance coverage runs out before a course of therapy has ended, the OT should inform the patient of their options regarding continued treatment. The patient can then decide whether to discontinue treatment or pay for treatment out of pocket.
B. Inform the woman of the coverage limitations and the costs for paying out of pocket.
If a patient’s insurance coverage runs out before a course of therapy has ended, the OT should inform the patient of their options regarding continued treatment. The patient can then decide whether to discontinue treatment or pay for treatment out of pocket.
A new OT is working in home health and sees seven pediatric patients a day. Her supervisor makes direct contact with her every two weeks on the phone to discuss her caseload. What type of supervision is she receiving?
Routine supervision is made with direct contact every two weeks
Routine supervision is made with direct contact every two weeks
There are 4 levels of intervention in the OT therapeutic process. Using theraband exercises is an example of which type of activity/intervention?
B. Enabling. Enabling Activities are exercises or ways to condition the body in order to get to the patient’s end goal. Strengthening exercises, such as those completed using an exercise band, prepare patients for purposeful activities such as dressing, so they are an enabling activity.
B. Enabling. Enabling Activities are exercises or ways to condition the body in order to get to the patient’s end goal. Strengthening exercises, such as those completed using an exercise band, prepare patients for purposeful activities such as dressing, so they are an enabling activity.
Kelly, a recent OTR® graduate, is trying to determine the level of significance of the data in a research article on sensory integration. Which p-value would determine that the research findings in this article are significant?
If the p-value is less than or equal to .05, then the data is significant. In this example the p-value is .04, therefore the data in this research article is considered statistically significant.
If the p-value is less than or equal to .05, then the data is significant. In this example the p-value is .04, therefore the data in this research article is considered statistically significant.
With which approach should an OT evaluation always begin?
B. Screening.
Occupational therapy evaluation should begin with a screening. This initial screening identifies aspects which could hinder future engagement in occupations if not addressed in the immediately. This initial screening is not a top-down, bottom-up or contextual approach, it is concerned with understanding the patient. Based on the findings from this screening, the OT can determine what the best course of action is. If the major concern is a health problem, the therapist would begin with a bottom-up approach. Examples include aspiration, a newly repaired tendon, or a patient with a fall risk. If the major concern is the ability to participate in a life activity, the therapist would begin with a top-down approach. Examples include taking care of one’s personal self-care, participating in a social group, or writing poetry.
C. The bottom-up approach considers foundational factors first to obtain an understanding of the patient’s limitations, real disabilities, and strengths. “A bottom-up approach to assessment and treatment focuses on the deficits of components of function, such as strength, range of motion, balance, and so on, which are believed to be prerequisites to successful occupational performance or functioning” (Trombly, 1993, p. 253). An assumption inherent in the bottom-up approach is that acquisition or reacquisition of motor, cognitive, and psychological skills will ultimately result in successful performance of activities of daily living.
D. Top-down assessments take a global perspective and focus on the patient’s participation in their living contexts to determine what is important and relevant to them. Top-down assessments should focus on critical roles as well as occupational performance issues, which include the ability to engage in activities of daily living, education, work, play, leisure, and social participation.
https://journals.sagepub.com/doi/pdf/10.4276/030802210X12682330090334
https://ajot.aota.org/pdfaccess.ashx?url=/aota/content_public/journal/ajot/930189/594.pdf
B. Screening.
Occupational therapy evaluation should begin with a screening. This initial screening identifies aspects which could hinder future engagement in occupations if not addressed in the immediately. This initial screening is not a top-down, bottom-up or contextual approach, it is concerned with understanding the patient. Based on the findings from this screening, the OT can determine what the best course of action is. If the major concern is a health problem, the therapist would begin with a bottom-up approach. Examples include aspiration, a newly repaired tendon, or a patient with a fall risk. If the major concern is the ability to participate in a life activity, the therapist would begin with a top-down approach. Examples include taking care of one’s personal self-care, participating in a social group, or writing poetry.
C. The bottom-up approach considers foundational factors first to obtain an understanding of the patient’s limitations, real disabilities, and strengths. “A bottom-up approach to assessment and treatment focuses on the deficits of components of function, such as strength, range of motion, balance, and so on, which are believed to be prerequisites to successful occupational performance or functioning” (Trombly, 1993, p. 253). An assumption inherent in the bottom-up approach is that acquisition or reacquisition of motor, cognitive, and psychological skills will ultimately result in successful performance of activities of daily living.
D. Top-down assessments take a global perspective and focus on the patient’s participation in their living contexts to determine what is important and relevant to them. Top-down assessments should focus on critical roles as well as occupational performance issues, which include the ability to engage in activities of daily living, education, work, play, leisure, and social participation.
https://journals.sagepub.com/doi/pdf/10.4276/030802210X12682330090334
https://ajot.aota.org/pdfaccess.ashx?url=/aota/content_public/journal/ajot/930189/594.pdf
A patient with Parkinson’s disease requires some help with bathing and grooming. Using the model of role acquisition, what can the OT provide in the intervention to help this patient?
A. Help the patient acquire specific skills needed to function in her environment.
It will be best to help the patient acquire specific skills needed to function in her environment.
Lifestyle performance model: Intervention focuses on enhancing the environment and the patient’s needs
Psychoanalytic and Psychodynamic theory: Intervention should help improve a patient’s self-identity and improve interpersonal relationships.
Biomechanical Frame of Reference: Intervention focuses on range of motion, strength, endurance, and restoring functional skills
A. Help the patient acquire specific skills needed to function in her environment.
It will be best to help the patient acquire specific skills needed to function in her environment.
Lifestyle performance model: Intervention focuses on enhancing the environment and the patient’s needs
Psychoanalytic and Psychodynamic theory: Intervention should help improve a patient’s self-identity and improve interpersonal relationships.
Biomechanical Frame of Reference: Intervention focuses on range of motion, strength, endurance, and restoring functional skills
An OTR® and COTA® are collaborating to improve the quality of patient services at an outpatient rehab facility. The process is based on reviewing outcomes to determine the success of interventions. Which of the following questions would be BEST to focus on during the review?
C. Did the intervention promote a positive change in a client’s engagement in occupation?
At the completion of intervention services, outcome measurements are reviewed to evaluate the effectiveness of the intervention. The outcomes measurement data can be used to improve or create cost-effective programs. A measure of quality is based on how patients’ expectations and needs are met, i.e. supports for patient engagement due to maximal functional level requiring minimal assist, change in functional performance and occupational participation due to carryover of use of breathing techniques.
A, B and D. Are a part of the process and design of patient services to improve the quality of patient care.
https://www.hrsa.gov/sites/default/files/quality/toolbox/508pdfs/qualityimprovement.pdf pp 3-7.
Law, M. C., & McColl, M. A. (2010). Interventions, effects, and outcomes in occupational therapy: adults and older adults. Thorofare, NJ: Slack Inc, pp 2-8.
C. Did the intervention promote a positive change in a client’s engagement in occupation?
At the completion of intervention services, outcome measurements are reviewed to evaluate the effectiveness of the intervention. The outcomes measurement data can be used to improve or create cost-effective programs. A measure of quality is based on how patients’ expectations and needs are met, i.e. supports for patient engagement due to maximal functional level requiring minimal assist, change in functional performance and occupational participation due to carryover of use of breathing techniques.
A, B and D. Are a part of the process and design of patient services to improve the quality of patient care.
https://www.hrsa.gov/sites/default/files/quality/toolbox/508pdfs/qualityimprovement.pdf pp 3-7.
Law, M. C., & McColl, M. A. (2010). Interventions, effects, and outcomes in occupational therapy: adults and older adults. Thorofare, NJ: Slack Inc, pp 2-8.
What method in research is based on the consensus of professionals and their judgments and not on actual evidence driven by scientific methods to gain data?
D. Expert Opinion.
An expert is a professional who has acquired knowledge and skills through study and practice over the years, in a particular field or subject, to the extent that his or her opinion may be helpful in fact finding, problem solving, or understanding of a situation. The expert opinion method provides validity and reliability of the research when it is necessary to obtain evidence of the research. Therefore, the results of the expertise, i.e., evaluation and opinion of competent and experienced experts on the subject matter becomes the basis for adopting serious decisions, including implementation of innovations recommended by a researcher in order to obtain the necessary results.The expert opinion method can be used both as a separate research and as a stage of a structured research.
http://llufb.llu.lv/conference/REEP/2018/Latvia_REEP_2018_proceedings_ISSN2255808X-74-80.pdf
D. Expert Opinion.
An expert is a professional who has acquired knowledge and skills through study and practice over the years, in a particular field or subject, to the extent that his or her opinion may be helpful in fact finding, problem solving, or understanding of a situation. The expert opinion method provides validity and reliability of the research when it is necessary to obtain evidence of the research. Therefore, the results of the expertise, i.e., evaluation and opinion of competent and experienced experts on the subject matter becomes the basis for adopting serious decisions, including implementation of innovations recommended by a researcher in order to obtain the necessary results.The expert opinion method can be used both as a separate research and as a stage of a structured research.
http://llufb.llu.lv/conference/REEP/2018/Latvia_REEP_2018_proceedings_ISSN2255808X-74-80.pdf
An OT with two years of experience submits her resume to an assisted living facility for an open position. She previously worked in a skilled nursing facility as a staff OT. On her resume, she has listed her experience as direct provision of occupational therapy services to patients, supervision of 1 OTA, and collection and compilation of outcomes data. In reality, the OT only assisted with gathering the outcomes data and her supervisor compiled it. What principle has the OT violated on her resume?
C. Principle 5: Veracity. The code of ethics principle of veracity (principle 5) states that occupational therapy personnel shall provide comprehensive, accurate, and objective information when representing the profession. The OT has misrepresented her skills on her resume by exaggerating her involvement with the outcomes process, so she has violated this principle.
C. Principle 5: Veracity. The code of ethics principle of veracity (principle 5) states that occupational therapy personnel shall provide comprehensive, accurate, and objective information when representing the profession. The OT has misrepresented her skills on her resume by exaggerating her involvement with the outcomes process, so she has violated this principle.
An OT would like to test the reliability of a study on a resting hand splint for patients with arthritis. What would the therapist need to do?
B. Find another study with exactly the same research design to see if the results are the same as the first study. Reliability in research refers to how well a study can be repeated by another researcher to obtain the same results.
B. Find another study with exactly the same research design to see if the results are the same as the first study. Reliability in research refers to how well a study can be repeated by another researcher to obtain the same results.
When does the discharge planning process begin for any patient who has been referred for OT services?
A. Day 1.
Planning for a successful discharge from therapy services begins at admission. In order to establish clear goals for your patient, you need to have a wholistic picture of your patient’s needs during their period of OT intervention, as well as their possible needs post-discharge. By starting to plan for your patient’s discharge right away, you will be ensuring that your patient will be able to transition smoothly to the next stage of their recovery.
A. Day 1.
Planning for a successful discharge from therapy services begins at admission. In order to establish clear goals for your patient, you need to have a wholistic picture of your patient’s needs during their period of OT intervention, as well as their possible needs post-discharge. By starting to plan for your patient’s discharge right away, you will be ensuring that your patient will be able to transition smoothly to the next stage of their recovery.
Which FOR uses a remedial approach and therefore assumes patients are able to acquire the voluntary motor skills necessary to perform their desired human occupation. The main goals of this FOR are preventing deterioration and maintaining existing movements for occupational performance, restoring movements for occupational performance, and compensating/adapting for loss of movements in occupational performance
D. Biomechanical.
The theoretical base of biomechanical frame of reference (FOR) is considered as a remedial approach focusing on impairments that limit occupational performance. This FOR assumes clients are able to acquire the voluntary motor skills necessary to perform the desired human occupation, meaning that the underlying impairment is amenable to remediation. It also assumes that engaging in occupation and therapeutic activities has the potential to remediate the underlying impairment, and results in improvement in occupational performance. The goals are to prevent deterioration and maintain existing movements for occupational performance, to restore movements for occupational performance, and to compensate/adapt for loss of movements in occupational performance. Individuals who have limitations in performing occupations due to limitations in movements, inadequate muscle strength, loss of endurance, or other biomedical conditions are suitable to use this FOR. The goals are to prevent limitation of range of motion, to move the target body part through full range of motion, either passively or actively appropriately, and to position the body to prevent contractures and edema. Assessment includes assessing the performance components on movements, strength and endurance. Some assessments associated with this FOR include standardized objective tests of occupational performance, pain scales, examination of skin/wounds, sensory testing, etc. Interventions associated with this FOR include ADL retraining, work hardening, static and dynamic orthoses, active, active assistive, passive range of motion exercises, nerve gliding, etc. The variety of interventions aims to amend underlying impairment and result in enhanced occupational performance in desired occupations.
https://ottheory.com/therapy-model/biomechanical-frame-reference
D. Biomechanical.
The theoretical base of biomechanical frame of reference (FOR) is considered as a remedial approach focusing on impairments that limit occupational performance. This FOR assumes clients are able to acquire the voluntary motor skills necessary to perform the desired human occupation, meaning that the underlying impairment is amenable to remediation. It also assumes that engaging in occupation and therapeutic activities has the potential to remediate the underlying impairment, and results in improvement in occupational performance. The goals are to prevent deterioration and maintain existing movements for occupational performance, to restore movements for occupational performance, and to compensate/adapt for loss of movements in occupational performance. Individuals who have limitations in performing occupations due to limitations in movements, inadequate muscle strength, loss of endurance, or other biomedical conditions are suitable to use this FOR. The goals are to prevent limitation of range of motion, to move the target body part through full range of motion, either passively or actively appropriately, and to position the body to prevent contractures and edema. Assessment includes assessing the performance components on movements, strength and endurance. Some assessments associated with this FOR include standardized objective tests of occupational performance, pain scales, examination of skin/wounds, sensory testing, etc. Interventions associated with this FOR include ADL retraining, work hardening, static and dynamic orthoses, active, active assistive, passive range of motion exercises, nerve gliding, etc. The variety of interventions aims to amend underlying impairment and result in enhanced occupational performance in desired occupations.
https://ottheory.com/therapy-model/biomechanical-frame-reference
A patient who resides in a SNF refuses to be treated by a Level ll fieldwork student. He states that he is tired of having to always work with different clinicians and he insists that he will only work with someone who is qualified and experienced. What action should the supervising OT take in this scenario?
B. The OT should treat the patient and allow the student to observe the session.
The Principle of Autonomy expresses the concept that practitioners have a duty to treat the client according to the client’s desires. This includes respecting and honoring the expressed wishes of recipients of our service. By allowing the student the opportunity to observe the session, the student’s needs are being met, although in a passive way.
B. The OT should treat the patient and allow the student to observe the session.
The Principle of Autonomy expresses the concept that practitioners have a duty to treat the client according to the client’s desires. This includes respecting and honoring the expressed wishes of recipients of our service. By allowing the student the opportunity to observe the session, the student’s needs are being met, although in a passive way.
What management system is being used when an OTR® supervisor performs chart audits on coworkers to maintain documentation standards?
A. Utilization review.
Utilization review (UR) is the process of making sure health care services are being used appropriately. The goal of utilization review is to make sure patients get the care they need, that it’s administered via proven methods, provided by an appropriate health care provider, and delivered in an appropriate setting. This should result in high-quality care administered as economically as possible and in accordance with current evidence-based care guidelines.Occupational therapy utilization review focuses on reviewing clinical records and documentation to ensure that patients of occupational therapists receive required services and an appropriate level of clinical care. Utilization review can be done while the care is being given, known as concurrent UR, or after the care has been completed, known as retrospective UR.
B. Prospective review is conducted at the onset of a service or treatment and is also referred to as precertification or prior authorization.
C. Peer reviewers primarily focus on ensuring that an article is factually accurate, provides new information in a specified field and meets the proofreading and editorial guidelines of the publication.
A. Utilization review.
Utilization review (UR) is the process of making sure health care services are being used appropriately. The goal of utilization review is to make sure patients get the care they need, that it’s administered via proven methods, provided by an appropriate health care provider, and delivered in an appropriate setting. This should result in high-quality care administered as economically as possible and in accordance with current evidence-based care guidelines.Occupational therapy utilization review focuses on reviewing clinical records and documentation to ensure that patients of occupational therapists receive required services and an appropriate level of clinical care. Utilization review can be done while the care is being given, known as concurrent UR, or after the care has been completed, known as retrospective UR.
B. Prospective review is conducted at the onset of a service or treatment and is also referred to as precertification or prior authorization.
C. Peer reviewers primarily focus on ensuring that an article is factually accurate, provides new information in a specified field and meets the proofreading and editorial guidelines of the publication.
An OT is helping a patient apply for medically necessary equipment which is covered by Medicare. Which three of the following DMEs would be covered? Select the best 3 answers.
A. Commode chair.
B. Hospital beds.
F. Patient lifts.
Durable medical equipment (DME) is equipment that helps you complete your daily activities. It includes a variety of items, such as walkers, wheelchairs, and oxygen tanks. Medicare usually covers DME if the equipment:
– Is durable, meaning it is able to withstand repeated use
– Serves a medical purpose
– Is appropriate for use in the home, although you can also use it outside the home
– And, is likely to last for three years or more
To be covered by Part B, DME must be prescribed by your primary care provider (PCP). If you are in a skilled nursing facility (SNF) or are a hospital inpatient, DME is covered by Part A.
Commode chairs, hospital beds, and patient lifts are all covered under Medicare as durable medical equipment. Reachers, universal cuffs, and raised toilet seats are not viewed as durable medical equipment by Medicare and are not covered.
A. Commode chair.
B. Hospital beds.
F. Patient lifts.
Durable medical equipment (DME) is equipment that helps you complete your daily activities. It includes a variety of items, such as walkers, wheelchairs, and oxygen tanks. Medicare usually covers DME if the equipment:
– Is durable, meaning it is able to withstand repeated use
– Serves a medical purpose
– Is appropriate for use in the home, although you can also use it outside the home
– And, is likely to last for three years or more
To be covered by Part B, DME must be prescribed by your primary care provider (PCP). If you are in a skilled nursing facility (SNF) or are a hospital inpatient, DME is covered by Part A.
Commode chairs, hospital beds, and patient lifts are all covered under Medicare as durable medical equipment. Reachers, universal cuffs, and raised toilet seats are not viewed as durable medical equipment by Medicare and are not covered.
Occupational therapy is covered under the terms of Medicare in which of the following facilities that provide services to aging individuals? Select the best 3 choices.
B. Skilled nursing facilities.
D. Hospice/Palliative Care.
E. Home Health Care.
Occupational therapy services are covered in skilled nursing facilities under Medicare Part A when a patient requires occupational therapy services for a minimum of 5 days per week. It is also covered as an outpatient service under Medicare Part B when provided in a Medicare certified facility. Occupational therapy is covered by Medicare in hospice and palliative care facilities when provided to patients who have less than 6 months to live. Occupational therapy is also covered by Medicare when provided through home health care agencies, as long as the patient is homebound and is receiving skilled nursing care, physical therapy, or speech therapy prior to initiating occupational therapy services. Continued occupational therapy services are also covered if any of the other services are discontinued. Occupational therapy services in group homes, assisted living facilities, and adult day care centers are not covered under the terms of Medicare, but may be covered under the terms of Medicaid or private insurance.
B. Skilled nursing facilities.
D. Hospice/Palliative Care.
E. Home Health Care.
Occupational therapy services are covered in skilled nursing facilities under Medicare Part A when a patient requires occupational therapy services for a minimum of 5 days per week. It is also covered as an outpatient service under Medicare Part B when provided in a Medicare certified facility. Occupational therapy is covered by Medicare in hospice and palliative care facilities when provided to patients who have less than 6 months to live. Occupational therapy is also covered by Medicare when provided through home health care agencies, as long as the patient is homebound and is receiving skilled nursing care, physical therapy, or speech therapy prior to initiating occupational therapy services. Continued occupational therapy services are also covered if any of the other services are discontinued. Occupational therapy services in group homes, assisted living facilities, and adult day care centers are not covered under the terms of Medicare, but may be covered under the terms of Medicaid or private insurance.
Which method of gathering data would be the the most objective source of information about the current dressing skills of a 10-year-old child with moderate developmental and cognitive delays secondary to ASD?
C. Observation is the most objective way to gather information about dressing skills.
C. Observation is the most objective way to gather information about dressing skills.
Which intervention techniques are examples of tertiary prevention? Select the best 3 answers.
A. A water exercise program for people with multiple sclerosis.
C. Education in relaxation techniques for a woman with fibromyalgia.
E. Teaching joint protection techniques and providing a pamphlet on joint protection techniques to a man with rheumatoid arthritis.
A. A water exercise program for people with multiple sclerosis. This is a tertiary prevention. The patients have been diagnosed with MS, a disease that is progressive. Tertiary prevention focuses on people who are already affected by a disease. The goal is to improve their quality of life by reducing disability, limiting or delaying complications, and restoring function, if possible.
C. Education in relaxation techniques for a woman with fibromyalgia. This is a tertiary prevention. The woman has been diagnosed with Fibromyalgia which is a chronic disease. The goal is to improve her quality of life. Tertiary prevention aims to reduce the severity of the disease. It targets ways to reduce the effects of the disease once it has already been established.
E. Teaching joint protection techniques and providing a pamphlet on joint protection techniques to a man with rheumatoid arthritis. This is an example of tertiary prevention which aims to reduce the effects of the disease once it has been established in an individual.
B. An educational program on safety at home for senior citizens. This is a primary prevention. The goal is to prevent injury from occurring. Educational and fall prevention programs are examples of primary prevention.
D. Screening oral motor skills of a 2-year-old who was born prematurely. Secondary prevention often occurs in the form of screenings. The goal is early detection of problems in a population which is at risk, to reduce/ minimize developmental delays.
F. Recommending a patient wear wrist brace while typing to prevent repetitive stress injury. This an example of primary prevention which aims to prevent the onset injury before the disease process begins.
3 Levels of Prevention
1. Primary prevention—those preventive measures that prevent the onset of illness or injury before the disease process begins. Trying to prevent the patient from getting a disease.
2. Secondary prevention—those preventive measures that lead to early diagnosis and prompt treatment of a disease, illness or injury to prevent more severe problems developing. Trying to detect a disease early and prevent it from getting worse. Secondary prevention often occurs in the form of screenings.
3. Tertiary prevention—those preventive measures aimed at rehabilitation following significant illness. At this level health services workers can work to retrain, re-educate and rehabilitate people who have already developed an impairment or disability. Trying to improve the patient’s quality of life and reduce the symptoms of a disease they already have. Tertiary prevention focuses on people who are already affected by a disease. The goal is to improve quality of life by reducing disability, limiting or delaying complications, and restoring function. This is done by treating the disease and providing rehabilitation. Tertiary prevention targets both the clinical and outcome stages of a disease. It is implemented in symptomatic patients and aims to reduce the severity of the disease as well as of any associated sequelae. While secondary prevention seeks to prevent the onset of illness, tertiary prevention seeks to reduce the effects of the disease once established in an individual.
A. A water exercise program for people with multiple sclerosis.
C. Education in relaxation techniques for a woman with fibromyalgia.
E. Teaching joint protection techniques and providing a pamphlet on joint protection techniques to a man with rheumatoid arthritis.
A. A water exercise program for people with multiple sclerosis. This is a tertiary prevention. The patients have been diagnosed with MS, a disease that is progressive. Tertiary prevention focuses on people who are already affected by a disease. The goal is to improve their quality of life by reducing disability, limiting or delaying complications, and restoring function, if possible.
C. Education in relaxation techniques for a woman with fibromyalgia. This is a tertiary prevention. The woman has been diagnosed with Fibromyalgia which is a chronic disease. The goal is to improve her quality of life. Tertiary prevention aims to reduce the severity of the disease. It targets ways to reduce the effects of the disease once it has already been established.
E. Teaching joint protection techniques and providing a pamphlet on joint protection techniques to a man with rheumatoid arthritis. This is an example of tertiary prevention which aims to reduce the effects of the disease once it has been established in an individual.
B. An educational program on safety at home for senior citizens. This is a primary prevention. The goal is to prevent injury from occurring. Educational and fall prevention programs are examples of primary prevention.
D. Screening oral motor skills of a 2-year-old who was born prematurely. Secondary prevention often occurs in the form of screenings. The goal is early detection of problems in a population which is at risk, to reduce/ minimize developmental delays.
F. Recommending a patient wear wrist brace while typing to prevent repetitive stress injury. This an example of primary prevention which aims to prevent the onset injury before the disease process begins.
3 Levels of Prevention
1. Primary prevention—those preventive measures that prevent the onset of illness or injury before the disease process begins. Trying to prevent the patient from getting a disease.
2. Secondary prevention—those preventive measures that lead to early diagnosis and prompt treatment of a disease, illness or injury to prevent more severe problems developing. Trying to detect a disease early and prevent it from getting worse. Secondary prevention often occurs in the form of screenings.
3. Tertiary prevention—those preventive measures aimed at rehabilitation following significant illness. At this level health services workers can work to retrain, re-educate and rehabilitate people who have already developed an impairment or disability. Trying to improve the patient’s quality of life and reduce the symptoms of a disease they already have. Tertiary prevention focuses on people who are already affected by a disease. The goal is to improve quality of life by reducing disability, limiting or delaying complications, and restoring function. This is done by treating the disease and providing rehabilitation. Tertiary prevention targets both the clinical and outcome stages of a disease. It is implemented in symptomatic patients and aims to reduce the severity of the disease as well as of any associated sequelae. While secondary prevention seeks to prevent the onset of illness, tertiary prevention seeks to reduce the effects of the disease once established in an individual.
The OTA delivers occupational therapy services under the supervision of and in partnership with the OT. How can the OT determine the OTA’s service competency?
A. The demonstrated ability to use an identified intervention task in a safe and effective manner with a similar outcome as the OT.
Service competency does not mean that the OTA will perform the task in exactly the same manner as the OT, only that the outcomes will be similar. The supervising OT’s view of the OTA’s performance is subjective, whereas the OTA’s ability to achieve a similar outcome as the OT is objective. The amount of continuing education the OTA has had can influence service competency, but does not define it. Similarly, an OTA may only require general supervision but may not demonstrate the same types of outcomes as the OT in certain areas.
A. The demonstrated ability to use an identified intervention task in a safe and effective manner with a similar outcome as the OT.
Service competency does not mean that the OTA will perform the task in exactly the same manner as the OT, only that the outcomes will be similar. The supervising OT’s view of the OTA’s performance is subjective, whereas the OTA’s ability to achieve a similar outcome as the OT is objective. The amount of continuing education the OTA has had can influence service competency, but does not define it. Similarly, an OTA may only require general supervision but may not demonstrate the same types of outcomes as the OT in certain areas.
As part of a research project, several OTs are requested to administer the same assessment to many different students. The researchers determine that the inter-rater reliability of the assessment is 0.27. What does this score indicate?
Inter-rater reliability is poor.
Inter-rater reliability is a statistical measure ranging from 0 to 1.0. The larger the number, the better the reliability. Values that are closer to zero, such as 0.27, suggest that reliability is poor and scoring methods should be reviewed and revised.
Inter-rater reliability is poor.
Inter-rater reliability is a statistical measure ranging from 0 to 1.0. The larger the number, the better the reliability. Values that are closer to zero, such as 0.27, suggest that reliability is poor and scoring methods should be reviewed and revised.
An OT receives a notice from the business office of the rehabilitation center that payment for occupational therapy services for a specific patient has been denied. How should the OT proceed?
Answer: D. Find out from the business office if they received a notice stating the reason why payment has been denied.
Payment for services can be denied for a variety of reasons. Sometimes the denial is generated by a coding error during billing. Other times a procedure is not covered or the medical necessity of services is questioned. The OT should find out what the reason was for the denial before determining the best course of action.
Answer: D. Find out from the business office if they received a notice stating the reason why payment has been denied.
Payment for services can be denied for a variety of reasons. Sometimes the denial is generated by a coding error during billing. Other times a procedure is not covered or the medical necessity of services is questioned. The OT should find out what the reason was for the denial before determining the best course of action.
An OT is reviewing an OTA’s daily treatment notes and notices that the OTA has not written notes in one of her patient’s chart, for three days. The OTA reports that she was extremely busy on those days and forgot to document her treatment sessions for that patient. What should the OT instruct the OTA to do?
C. Write the missing notes in after the notes that are already written and mark each note as a “late entry”. If treatment notes are missed, they should be written as soon as the error is identified. Notes should not be falsified, but should be entered as the next entry in the notes sequence with the date of the treatment session. Each note should be marked “late entry” to identify that the notes were missed and written at a later time.
C. Write the missing notes in after the notes that are already written and mark each note as a “late entry”. If treatment notes are missed, they should be written as soon as the error is identified. Notes should not be falsified, but should be entered as the next entry in the notes sequence with the date of the treatment session. Each note should be marked “late entry” to identify that the notes were missed and written at a later time.
An OT reads an article that states the construct validity of her preferred standardized fine motor test is being questioned by researchers due to errors in its design. How should the OT respond to this information?
B. Stop using the test until the test design has been corrected. Construct validity determines how well a test measures what it is supposed to measure. If the construct validity of the fine motor test is called into question due to errors in test design, then the OT can no longer depend on the test measuring fine motor skills. The OT should stop using the test until the test design is fixed and construct validity is determined to be adequate.
B. Stop using the test until the test design has been corrected. Construct validity determines how well a test measures what it is supposed to measure. If the construct validity of the fine motor test is called into question due to errors in test design, then the OT can no longer depend on the test measuring fine motor skills. The OT should stop using the test until the test design is fixed and construct validity is determined to be adequate.
An Occupational Therapist has conducted a research study on the effect chewing sugar-free gum has on a child’s attention span, in the classroom. When the OT calculates the correlation coefficient of the results of the study, the Pearson’s r value is determined to be +1. What does this result indicate?
D. All test subjects who chewed sugar free gum experienced an increase in attention to task. A Pearson’s r value of +1 indicates a perfect straight line correlation between the independent variable and the dependent variable in a research study. To achieve a Pearson’s r value of +1, all subjects included in the study would have shown an improvement in attention to task while chewing sugar free gum.
D. All test subjects who chewed sugar free gum experienced an increase in attention to task. A Pearson’s r value of +1 indicates a perfect straight line correlation between the independent variable and the dependent variable in a research study. To achieve a Pearson’s r value of +1, all subjects included in the study would have shown an improvement in attention to task while chewing sugar free gum.
A level II fieldwork student is due to commence working at the outpatient department, of the hospital. Who is allowed to supervise this student?
B. An OTR® with at least one year of experience as a certified OT.
In order to supervise a level II fieldwork student, an OTR® must have at least one year of experience.
B. An OTR® with at least one year of experience as a certified OT.
In order to supervise a level II fieldwork student, an OTR® must have at least one year of experience.
An OT who works in the field of pediatrics is attending a 2-hour lecture on the importance of sleep for the infant’s developing brain. How many CEUs will she receive?
D. .2 CEUs.
CEUs are earned as continuing education units.
1 CEU = 10 hours of education. If the OT attends a 2-hour lecture, the OT will receive .2 CEUs. (2/10)
D. .2 CEUs.
CEUs are earned as continuing education units.
1 CEU = 10 hours of education. If the OT attends a 2-hour lecture, the OT will receive .2 CEUs. (2/10)
What is the next step in the OT process once the OT has received a referral, completed a medical chart review, and performed a screening on a patient who recently underwent a full knee replacement?
D. Select an evaluation based on the patient’s needs.
After screening comes evaluation in the OT process.
The OT Process follows the following steps, in sequential order:
1. Referral
2. Screening
3. Evaluation
4. Intervention Plan
5. Intervention Implementation
6. Re-evaluation/outcomes
7. Discharge
The evaluation process includes:
a. determining the need for service
b. defining the problems within the domain of occupational therapy that need to be addressed
c. determining the patient’s goals and priorities
d. establishing intervention priorities
e. determining specific further assessment needs
f. determining specific assessment tasks that can be delegated to the occupational therapy assistant
D. Select an evaluation based on the patient’s needs.
After screening comes evaluation in the OT process.
The OT Process follows the following steps, in sequential order:
1. Referral
2. Screening
3. Evaluation
4. Intervention Plan
5. Intervention Implementation
6. Re-evaluation/outcomes
7. Discharge
The evaluation process includes:
a. determining the need for service
b. defining the problems within the domain of occupational therapy that need to be addressed
c. determining the patient’s goals and priorities
d. establishing intervention priorities
e. determining specific further assessment needs
f. determining specific assessment tasks that can be delegated to the occupational therapy assistant
Audrey, a director of a rehabilitation facility, is conducting a research study on patient satisfaction. When distributing the questionnaire, she hands it to every fifth patient listed on the rehabilitation floor. What type of sampling method is she using?
D. Systematic Sample.
In a systematic sample, individuals are selected from a population list at specified intervals. Selecting every fifth name on a list is an example of systematic sampling.
D. Systematic Sample.
In a systematic sample, individuals are selected from a population list at specified intervals. Selecting every fifth name on a list is an example of systematic sampling.
A patient who recently had a CVA is presenting with cognitive and perceptual difficulties. Which frame of reference should be used to treat this patient?
A. Toglia’s Dynamic Interactional Approach
Toglia’s Dynamic Interactional Approach is typically used with patients who have an acquired brain injury. Ie: patients with damage to their CNS who experience perceptual and cognitive deficits (CVA,TBI, and MH).
A. Toglia’s Dynamic Interactional Approach
Toglia’s Dynamic Interactional Approach is typically used with patients who have an acquired brain injury. Ie: patients with damage to their CNS who experience perceptual and cognitive deficits (CVA,TBI, and MH).
In the occupational therapy realm, what is the term “prudence” often associated with?
C. Using clinical and ethical reasoning skills
The concept of prudence means that occupational therapy personnel “use their clinical and ethical reasoning skills, sound judgment, and reflection to make decisions in professional and volunteer roles”
C. Using clinical and ethical reasoning skills
The concept of prudence means that occupational therapy personnel “use their clinical and ethical reasoning skills, sound judgment, and reflection to make decisions in professional and volunteer roles”
While transferring a patient from a wheelchair to a raised toilet seat, an entry level OT is observed locking the wheelchair brakes before the transfer. Which ethical principle did the therapist abide by?
C. Nonmaleficence.
Nonmaleficence. Principle 2. Occupational therapy personnel shall refrain from actions that cause harm. Nonmaleficence “obligates us to abstain from causing harm to others” (Beauchamp & Childress, 2013, p.150). The Principle of Nonmaleficence also includes an obligation to not impose risks of harm even if the potential risk is without malicious or harmful intent.Nonmaleficence relates to avoiding actions that may cause harm.
C. Nonmaleficence.
Nonmaleficence. Principle 2. Occupational therapy personnel shall refrain from actions that cause harm. Nonmaleficence “obligates us to abstain from causing harm to others” (Beauchamp & Childress, 2013, p.150). The Principle of Nonmaleficence also includes an obligation to not impose risks of harm even if the potential risk is without malicious or harmful intent.Nonmaleficence relates to avoiding actions that may cause harm.
An OT is considering using constraint-induced therapy in her feeding group. What is the highest level of research (using the evidence-based approach) she will need to review in order to justify the use of this treatment technique?
A. Randomized control trials is the highest level of evidence-based practice.
Randomized Controlled Trials (RCT): a specific type of scientific experiment, and the gold standard for a clinical trial. RCTs are often used to test the efficacy or effectiveness of various types of therapy interventions within a patient population.
A. Randomized control trials is the highest level of evidence-based practice.
Randomized Controlled Trials (RCT): a specific type of scientific experiment, and the gold standard for a clinical trial. RCTs are often used to test the efficacy or effectiveness of various types of therapy interventions within a patient population.
An OT is conducting research on a patient who sustained a spinal cord injury in a motorcycle accident. The focus of her research is on the patient’s progress in performing his ADLs. What type of study is she doing?
A. Case study
Case Studies/Case Series are analyses of persons, events, decisions, periods, projects, policies, institutions, or other systems that are studied holistically by one or more methods.
A. Case study
Case Studies/Case Series are analyses of persons, events, decisions, periods, projects, policies, institutions, or other systems that are studied holistically by one or more methods.
In statistics, which method determines the extent to which two or more raters get the same result while using the same instrument to measure a particular concept?
A. Inter-rater reliability
Inter-rater reliability is the degree of agreement among raters. It gives a score of how much homogeneity or consensus. For example, by determining if a particular scale is appropriate for measuring a particular variable. If various raters do not agree, either the scale is defective or the raters need to be re-trained. A method of measuring reliability. Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
A. Inter-rater reliability
Inter-rater reliability is the degree of agreement among raters. It gives a score of how much homogeneity or consensus. For example, by determining if a particular scale is appropriate for measuring a particular variable. If various raters do not agree, either the scale is defective or the raters need to be re-trained. A method of measuring reliability. Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
Billy, an OTR® specializing in hand therapy, is working with a professional pianist who suffers from CTD (cumulative trauma disorders) due to the long hours of practice. Billy is not certified in physical agent modalities but he is considering applying an ice pack to the patient’s wrist as he has noticed that the patient’s wrist is red and warm. Is this the best course of action for Billy to take?
D. Billy should check with the state laws and regulations regarding PAM’s.
Each state has its own regulations on how to incorporate PAMs into practice. The content of these regulations, which varies widely from state to state, is in many cases set with input from occupational therapy boards that closely monitor OT practice-act changes.
AOTA stipulates that PAMs may be applied only by occupational therapists and occupational therapy assistants who have documented evidence of possessing the theoretical background and technical skills for safe and competent integration of the modality into an occupational therapy intervention plan (AOTA, 2003). The foundational knowledge necessary for proper
use of these modalities requires appropriate, documented professional education. Examples of professional education include continuing education courses, institutes at annual conferences, and accredited higher education courses or programs. In some states, applying a superficial PAM such as an ice -pack does not require Governing Board certification e.g. New Hampshire.
D. Billy should check with the state laws and regulations regarding PAM’s.
Each state has its own regulations on how to incorporate PAMs into practice. The content of these regulations, which varies widely from state to state, is in many cases set with input from occupational therapy boards that closely monitor OT practice-act changes.
AOTA stipulates that PAMs may be applied only by occupational therapists and occupational therapy assistants who have documented evidence of possessing the theoretical background and technical skills for safe and competent integration of the modality into an occupational therapy intervention plan (AOTA, 2003). The foundational knowledge necessary for proper
use of these modalities requires appropriate, documented professional education. Examples of professional education include continuing education courses, institutes at annual conferences, and accredited higher education courses or programs. In some states, applying a superficial PAM such as an ice -pack does not require Governing Board certification e.g. New Hampshire.
While under the supervision of an OT, a patient with a SCI, falls onto the ground as he attempts a stand pivot transfer. What should the OT do next, following the fall?
C. Stay with the patient and call for help.
After the Fall:
• Stay with the patient and call for help.
• Check the patient’s breathing, pulse, and blood pressure. If the patient is unconscious, not breathing, or does not have a pulse, call a hospital emergency code and start CPR.
• DO NOT raise the patient’s head as they may have a neck or back injury. Wait for medical staff to check for a spinal injury.
• Once medical staff decides the patient can be moved, you need to choose the best way.
• If the patient is not hurt or injured and does not appear ill, have another staff member help you. Both of you should help the patient into a wheelchair or into bed. DO NOT help the patient on your own.
• Document the fall according to your hospital’s policies.
https://medlineplus.gov/ency/patientinstructions/000441.htm.
C. Stay with the patient and call for help.
After the Fall:
• Stay with the patient and call for help.
• Check the patient’s breathing, pulse, and blood pressure. If the patient is unconscious, not breathing, or does not have a pulse, call a hospital emergency code and start CPR.
• DO NOT raise the patient’s head as they may have a neck or back injury. Wait for medical staff to check for a spinal injury.
• Once medical staff decides the patient can be moved, you need to choose the best way.
• If the patient is not hurt or injured and does not appear ill, have another staff member help you. Both of you should help the patient into a wheelchair or into bed. DO NOT help the patient on your own.
• Document the fall according to your hospital’s policies.
https://medlineplus.gov/ency/patientinstructions/000441.htm.
Name the research method which can be described as a process in which the theory is developed from the data, rather than the other way around. A pre-research literature review is not completed, as pre-conceptualizing the problem, has the potential to contaminate the emerging theory. This method also uses key points, which are marked with a series of codes, to generate a theory.
B. Grounded theory.
Grounded Theory Method involves the discovery of theory through the analysis of data. Grounded theory method is a research method which operates almost in a reverse fashion from traditional social science research. Rather than beginning with a hypothesis, the first step is data collection through a variety of methods. From the data collected, the key points are marked with a series of codes, which are extracted from the text. The codes are grouped into similar concepts in order to make the data more workable. From these concepts, categories are formed, which are the basis for the creation of a theory, or a reverse engineered hypothesis. This contradicts the traditional model of research, where the researcher chooses a theoretical framework, and only then applies this model to the phenomenon to be studied.
B. Grounded theory.
Grounded Theory Method involves the discovery of theory through the analysis of data. Grounded theory method is a research method which operates almost in a reverse fashion from traditional social science research. Rather than beginning with a hypothesis, the first step is data collection through a variety of methods. From the data collected, the key points are marked with a series of codes, which are extracted from the text. The codes are grouped into similar concepts in order to make the data more workable. From these concepts, categories are formed, which are the basis for the creation of a theory, or a reverse engineered hypothesis. This contradicts the traditional model of research, where the researcher chooses a theoretical framework, and only then applies this model to the phenomenon to be studied.
What is the best description of the Ecology of Human Performance framework?
B. The interrelationship of person and context and which tasks fall within the person’s performance range.
The Ecology of Human performance serves as a framework for considering the effect of context. Context is described as a lens from which people view their world. The interrelationship of person and context determines which tasks fall within the person’s performance range. The Ecology of Human Performance framework provides guidelines for encompassing context in occupational therapy theory, practice, and research.
B. The interrelationship of person and context and which tasks fall within the person’s performance range.
The Ecology of Human performance serves as a framework for considering the effect of context. Context is described as a lens from which people view their world. The interrelationship of person and context determines which tasks fall within the person’s performance range. The Ecology of Human Performance framework provides guidelines for encompassing context in occupational therapy theory, practice, and research.
Which of the following processes are OTAs permitted to perform, in collaboration with a registered occupational therapist?
C. Intervention planning and intervention implementation.
* Intervention planning- The OT and OTA collaborate with the patient to develop the intervention plan. The OTA is responsible for being knowledgeable about the patient’s evaluation results and for providing input into the intervention plan, based on the patient’s needs and priorities.
* Intervention implementation- The OTA selects, implements, and makes modifications to therapeutic activities and interventions that are consistent with demonstrated competency levels, patient goals, and the requirements of the practice setting.
Only OTs can evaluate (they can delegate selected assessments to the OTA based on competency and if permitted by state law, but the OT is responsible for developing the plan of care, goals, etc.), change the plan of care, make recommendations, and discharge the patient. OTAs always work under the supervision of an OT although they can treat and document independently and contribute to the progress note, evaluation (as noted above), re-evaluation, and discharge plan; again, if permitted by state law and other applicable regulations.
https://www.aota.org/Practice/Manage/Scope-of-Practice-QA/OTA.aspx
C. Intervention planning and intervention implementation.
* Intervention planning- The OT and OTA collaborate with the patient to develop the intervention plan. The OTA is responsible for being knowledgeable about the patient’s evaluation results and for providing input into the intervention plan, based on the patient’s needs and priorities.
* Intervention implementation- The OTA selects, implements, and makes modifications to therapeutic activities and interventions that are consistent with demonstrated competency levels, patient goals, and the requirements of the practice setting.
Only OTs can evaluate (they can delegate selected assessments to the OTA based on competency and if permitted by state law, but the OT is responsible for developing the plan of care, goals, etc.), change the plan of care, make recommendations, and discharge the patient. OTAs always work under the supervision of an OT although they can treat and document independently and contribute to the progress note, evaluation (as noted above), re-evaluation, and discharge plan; again, if permitted by state law and other applicable regulations.
https://www.aota.org/Practice/Manage/Scope-of-Practice-QA/OTA.aspx
An OTR® is in the process of screening premature infants for potential developmental delays. Which type of prevention is this OTR® using?
B. Secondary prevention. Early detection of problems in a population that is already at risk to reduce the duration of a disorder/disease and/or minimize its effects through early detection (screening of infants born prematurely for developmental delays).
Primary prevention- the reduction of the incidence or occurrence of disease or disorder within a population that is currently well or potentiality at risk.
Tertiary prevention- the elimination or reduction of the impact of dysfunction on an individual who already has an established disease or disorder.
Early intervention – providing therapy and support services to children from birth to 3 years old who have disabilities, or who are at risk for developing them, so that they can succeed later in life. The goal is to enhance development, minimize the potential for developmental delay, and help families to meet the special needs of their infants and toddlers.
B. Secondary prevention. Early detection of problems in a population that is already at risk to reduce the duration of a disorder/disease and/or minimize its effects through early detection (screening of infants born prematurely for developmental delays).
Primary prevention- the reduction of the incidence or occurrence of disease or disorder within a population that is currently well or potentiality at risk.
Tertiary prevention- the elimination or reduction of the impact of dysfunction on an individual who already has an established disease or disorder.
Early intervention – providing therapy and support services to children from birth to 3 years old who have disabilities, or who are at risk for developing them, so that they can succeed later in life. The goal is to enhance development, minimize the potential for developmental delay, and help families to meet the special needs of their infants and toddlers.
An OT has been requested to evaluate a 6-year-old patient who has a history of sensory processing difficulties. Which FOR should the OT incorporate into her treatment sessions?
B. Sensory integration.
Improved sensory processing provides a foundation for enhanced attention and academic ability. Responding adaptively to the environment enhances the intake and combining of sensory information
B. Sensory integration.
Improved sensory processing provides a foundation for enhanced attention and academic ability. Responding adaptively to the environment enhances the intake and combining of sensory information
An OT in private practice wants to provide evidence that she is maintaining a high standard, in the treatment she provides to her patients. What measure is the best for her to use in order to help support the quality assurance for her practice?
D. Patient outcomes data.
Measures of patient outcomes will show the overall improvement of patients who have received services from the OT, demonstrating quality assurance for her practice.
D. Patient outcomes data.
Measures of patient outcomes will show the overall improvement of patients who have received services from the OT, demonstrating quality assurance for her practice.
Which statistical approach systematically combines pertinent qualitative and quantitative study data from several selected studies in order to develop a single conclusion that has greater statistical power?
A. Meta analysis.
Meta analysis: methods that focus on contrasting and combining results from different studies, in the hope of identifying patterns among study results, sources of disagreement among those results, or other interesting relationships that may come to light in the context of multiple studies.
A. Meta analysis.
Meta analysis: methods that focus on contrasting and combining results from different studies, in the hope of identifying patterns among study results, sources of disagreement among those results, or other interesting relationships that may come to light in the context of multiple studies.
An entry level OT is looking at a standardized assessment to evaluate a child with cerebral palsy. What should the OT know about inter-rater reliability?
D. Extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
Inter-rater reliability: the degree of agreement among raters. It gives a score of how much homogeneity or consensus. For example, by determining if a particular scale is appropriate for measuring a particular variable. If various raters do not agree, either the scale is defective or the raters need to be re-trained. A method of measuring reliability. Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
D. Extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
Inter-rater reliability: the degree of agreement among raters. It gives a score of how much homogeneity or consensus. For example, by determining if a particular scale is appropriate for measuring a particular variable. If various raters do not agree, either the scale is defective or the raters need to be re-trained. A method of measuring reliability. Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
A 67-year-old female patient who suffered a CVA 4 weeks ago, has reached her maximum recovery and is now functioning at a MIN assist FIM level. The patient is due to be discharged from the hospital in two days and the patient and her family need to make plans for the continuation of her care. In terms of insurance, what will Medicare not cover for this patient after she leaves this in-patient facility?
B. Stay at a long term care facility.
According to Medicare: Long-term care is a range of services and support for your personal care needs which isn’t medical care. Instead, most long-term care is help with basic activities of daily living. Medicare doesn’t cover long-term care (also called custodial care), if that’s the only care you need. Most nursing home care is custodial care.
Types of care which Medicare do cover:
1. Skilled nursing care. Medicare helps to pay for your recovery in a skilled nursing care facility after a three-day hospital stay
2. Home health care. If you are homebound by an illness or injury, and your doctor says you need short-term skilled care, Medicare will pay for nurses and therapists to provide services in your home. This is not round-the-clock care. Generally, it’s for no more than 28 hours per week. With your doctor’s recommendation, you may qualify for more.
3. Hospice . Medicare covers hospice care. Hospice is care you get to make you more comfortable when you are in the last stage of life with a terminal illness. You’re eligible if you are not being treated for your terminal illness, and your doctor certifies that you probably will live no longer than six months. You can get care for longer than that, as long as your doctor says you are still terminally ill.
https://www.medicare.gov/coverage
https://www.webmd.com/health-insurance/medicare-and-long-term-care
B. Stay at a long term care facility.
According to Medicare: Long-term care is a range of services and support for your personal care needs which isn’t medical care. Instead, most long-term care is help with basic activities of daily living. Medicare doesn’t cover long-term care (also called custodial care), if that’s the only care you need. Most nursing home care is custodial care.
Types of care which Medicare do cover:
1. Skilled nursing care. Medicare helps to pay for your recovery in a skilled nursing care facility after a three-day hospital stay
2. Home health care. If you are homebound by an illness or injury, and your doctor says you need short-term skilled care, Medicare will pay for nurses and therapists to provide services in your home. This is not round-the-clock care. Generally, it’s for no more than 28 hours per week. With your doctor’s recommendation, you may qualify for more.
3. Hospice . Medicare covers hospice care. Hospice is care you get to make you more comfortable when you are in the last stage of life with a terminal illness. You’re eligible if you are not being treated for your terminal illness, and your doctor certifies that you probably will live no longer than six months. You can get care for longer than that, as long as your doctor says you are still terminally ill.
https://www.medicare.gov/coverage
https://www.webmd.com/health-insurance/medicare-and-long-term-care
An OT is working at a rehab facility and is requested to conduct an evaluation on a patient who recently had a knee replacement. The patient does not understand the purpose of occupational therapy so the OT educates the patient. The patient then states that he does not want to participate and only wants to work with a physical therapist. What would be the best steps for the OT to take next?
Document the patient’s response and respect the patient’s wishes
The OT has done her due diligence in informing the patient of the purpose of OT. The patient has the right to refuse services even if the OT does not believe that it is in her best interests. The OT must document the refusal to show that the patient has refused a service that might help her to regain skills and return to home.
Document the patient’s response and respect the patient’s wishes
The OT has done her due diligence in informing the patient of the purpose of OT. The patient has the right to refuse services even if the OT does not believe that it is in her best interests. The OT must document the refusal to show that the patient has refused a service that might help her to regain skills and return to home.
Which model would an OTR® use when working with a patient who is motivated to explore the world and exhibit mastery in a new environment?
D. Occupational Adaptation. Occupational Adaptation is a complex series of steps and factors that occur when the person is faced with an occupational challenge that takes place within one’s environment and within one’s role capacity. It involves 1) the person, 2) the occupational environment, 3) the interaction or process that takes places between the person and environment. This process depicts how a person can respond adaptively and masterfully when engaged in occupations.
D. Occupational Adaptation. Occupational Adaptation is a complex series of steps and factors that occur when the person is faced with an occupational challenge that takes place within one’s environment and within one’s role capacity. It involves 1) the person, 2) the occupational environment, 3) the interaction or process that takes places between the person and environment. This process depicts how a person can respond adaptively and masterfully when engaged in occupations.
Several members of the nursing staff have questioned the program director of a senior nursing facility on the purpose of periodic OT evaluations. An OT has decided to provide the nursing staff at the senior nursing facility with an educational seminar. What would be the most important information to provide to the nursing staff?
A. Research behind the value of periodic OT evaluations. The nursing staff will gain a great knowledge of the reason for periodic OT evaluations if evidence and research is presented to them.
A. Research behind the value of periodic OT evaluations. The nursing staff will gain a great knowledge of the reason for periodic OT evaluations if evidence and research is presented to them.
When dealing with insurance companies, in order to maximize reimbursement for OT services rendered, what is the most important information the OTR® should include in their documentation?
C. Details of the skilled services that were provided during the patient’s treatment intervention. Insurance companies will not pay for services that are not skilled. Evidence must be shown that skilled services were provided by qualified personnel to ensure reimbursement. Procedure codes, intervention procedures and goal statements can be used to support the claim that skilled services were provided, but any one alone is not sufficient evidence. A key word in this question is “maximum” reimbursement.
C. Details of the skilled services that were provided during the patient’s treatment intervention. Insurance companies will not pay for services that are not skilled. Evidence must be shown that skilled services were provided by qualified personnel to ensure reimbursement. Procedure codes, intervention procedures and goal statements can be used to support the claim that skilled services were provided, but any one alone is not sufficient evidence. A key word in this question is “maximum” reimbursement.
Jill, an entry level OT, is looking at taking continuing education classes in order to renew her license. How many continuing education units (CEUs) does she need to take?
The number of continuing education units needed depends on the licensure requirements of the state where Jill lives. Each state sets its own license renewal requirements. While the state may receive input from the national certification board or the American Occupational Therapy Association, the state has the final say on license requirements.
The number of continuing education units needed depends on the licensure requirements of the state where Jill lives. Each state sets its own license renewal requirements. While the state may receive input from the national certification board or the American Occupational Therapy Association, the state has the final say on license requirements.
As part of an evaluation, an OT is completing an initial screening of a patient with a physical disability in a long-term care facility as part of an evaluation. The OT explains the purpose of occupational therapy and the benefits of participating in treatment sessions; however, the patient refuses to answer the OT’s questions, stating, “I don’t need your help.” What action should the OT take based on this patient’s response?
C. Respect the patient’s wishes and document the refusal in the medical record. The OT has done her due diligence in informing the patient of the purpose of OT. The patient has the right to refuse services even if the OT does not believe that it is in her best interests. The OT must document the refusal to show that the patient has refused a service that might help her to regain skills and return home.
C. Respect the patient’s wishes and document the refusal in the medical record. The OT has done her due diligence in informing the patient of the purpose of OT. The patient has the right to refuse services even if the OT does not believe that it is in her best interests. The OT must document the refusal to show that the patient has refused a service that might help her to regain skills and return home.
Which action listed below reflects the Occupational Therapy Code of Ethics principle of Autonomy?
C. Respecting a patient’s refusal of therapy services due to the patient feeling ill.
The Code of Ethics Principle of Autonomy reads as follows: “Occupational therapy personnel shall respect the right of the individual to self-determination, privacy, confidentiality, and consent.” (Occupational Therapy Code of Ethics, 2015). Actions taken that respect a patient’s right to privacy and decision making while receiving occupational therapy services reflect this principle.
C. Respecting a patient’s refusal of therapy services due to the patient feeling ill.
The Code of Ethics Principle of Autonomy reads as follows: “Occupational therapy personnel shall respect the right of the individual to self-determination, privacy, confidentiality, and consent.” (Occupational Therapy Code of Ethics, 2015). Actions taken that respect a patient’s right to privacy and decision making while receiving occupational therapy services reflect this principle.
Which of the following occupational therapy services may encounter problems receiving approval for payment?
B. Continued rehabilitation six months after a CVA for a Medicare Part B patient in a skilled nursing facility to focus on dressing.
Medicare Part B removed the therapy cap earlier this year (2019), and occupational therapy services now have unlimited coverage, if deemed medically necessary. 6 months after a CVA, the patient should have been taught and mastered compensatory methods for dressing. Thus OT services is not medically necessary.
Each payor has its own rules and guidelines for occupational therapy reimbursement, but in general therapists must show the medical necessity of the services provided. The hand therapy following a tendon transfer is clearly medically necessary. The inpatient therapy for an eating disorder must be covered under the current (2017) terms of the Affordable Care Act (ACA). Medicaid allows for maintenance therapy for conditions that require skilled services to provide the maintenance, such as management of contractures.
B. Continued rehabilitation six months after a CVA for a Medicare Part B patient in a skilled nursing facility to focus on dressing.
Medicare Part B removed the therapy cap earlier this year (2019), and occupational therapy services now have unlimited coverage, if deemed medically necessary. 6 months after a CVA, the patient should have been taught and mastered compensatory methods for dressing. Thus OT services is not medically necessary.
Each payor has its own rules and guidelines for occupational therapy reimbursement, but in general therapists must show the medical necessity of the services provided. The hand therapy following a tendon transfer is clearly medically necessary. The inpatient therapy for an eating disorder must be covered under the current (2017) terms of the Affordable Care Act (ACA). Medicaid allows for maintenance therapy for conditions that require skilled services to provide the maintenance, such as management of contractures.
Which intervention technique is an example of tertiary prevention?
A. A water exercise program for people with multiple sclerosis.
Tertiary prevention focuses on people who have already been affected by a disease. The goal is to improve their quality of life by reducing disability, limiting or delaying complications, and restoring function. This is done by treating the disease and providing rehabilitation. The objective of tertiary prevention is to maximize the remaining capabilities and functions of an already disabled patient.
3 levels of prevention:
1. Primary prevention—those preventive measures that prevent the onset of illness or injury before the disease process begins. An educational program for senior citizens on safety at home is an example of primary prevention.
2. Secondary prevention—those preventive measures that lead to early diagnosis and prompt treatment of a disease, illness or injury to prevent more severe problems developing. Treatment for oral motor skills for a 2-year-old through a birth-to-three program and adapting the home of a man recovering from a total hip replacement are examples of secondary prevention.
3. Tertiary prevention—those preventive measures aimed at rehabilitation following significant illness. At this level health services workers can work to retrain, re-educate and rehabilitate people who have already developed an impairment or disability.
A. A water exercise program for people with multiple sclerosis.
Tertiary prevention focuses on people who have already been affected by a disease. The goal is to improve their quality of life by reducing disability, limiting or delaying complications, and restoring function. This is done by treating the disease and providing rehabilitation. The objective of tertiary prevention is to maximize the remaining capabilities and functions of an already disabled patient.
3 levels of prevention:
1. Primary prevention—those preventive measures that prevent the onset of illness or injury before the disease process begins. An educational program for senior citizens on safety at home is an example of primary prevention.
2. Secondary prevention—those preventive measures that lead to early diagnosis and prompt treatment of a disease, illness or injury to prevent more severe problems developing. Treatment for oral motor skills for a 2-year-old through a birth-to-three program and adapting the home of a man recovering from a total hip replacement are examples of secondary prevention.
3. Tertiary prevention—those preventive measures aimed at rehabilitation following significant illness. At this level health services workers can work to retrain, re-educate and rehabilitate people who have already developed an impairment or disability.
An OTR® is preparing to deliver a presentation to the special education teaching staff of the local school district. The OTR® decides to use examples of quantitative research to support the use of weighted vests for children who have been diagnosed with ADHD. Which information should the OTR® include in their presentation?
A. A randomized controlled trial studying the use of weighted vests by children in a large metropolitan school district.
Quantitative research is research that uses two groups to compare the effects of a random variable. This type of research is structured so that an experimental group receives the experimental variable and the control group does not receive the experimental variable. The cause and effect relationship between the independent and dependent variables is examined. In occupational therapy research, quantitative research uses random selection to assign patients into an experimental group that receives the treatment being studied, and a control group that receives no treatment. Quantitative research is an appropriate model for validating clinical practice and providing evidence of treatment effectiveness.
B and D. A case study and case control study are Qualitative approaches.
A. A randomized controlled trial studying the use of weighted vests by children in a large metropolitan school district.
Quantitative research is research that uses two groups to compare the effects of a random variable. This type of research is structured so that an experimental group receives the experimental variable and the control group does not receive the experimental variable. The cause and effect relationship between the independent and dependent variables is examined. In occupational therapy research, quantitative research uses random selection to assign patients into an experimental group that receives the treatment being studied, and a control group that receives no treatment. Quantitative research is an appropriate model for validating clinical practice and providing evidence of treatment effectiveness.
B and D. A case study and case control study are Qualitative approaches.
A newly qualified OT is looking for her first job. From the list below, which place is considered to be a non-traditional OT setting?
D. Pre-Vocational Training setting.
Pre-Vocational Training prepares a client for placement in employment settings and addresses independent living skills with vocational skills. This is not considered a traditional OT practice setting but OTs are part of these programs.
An inpatient hospital unit and a community based rehabilitation center are both more traditional settings where OTs provide services. Large factories sometimes have their own medical facilities to help prevent workplace injuries or provide prompt treatment to facilitate recovery from injuries, so an OT could be hired to provide workplace rehabilitation. An OT can be employed in a forensic setting, and her role may be in the determining the competency to stand trial, and working on community living skills. OTs are also an integral part of the early intervention team.
D. Pre-Vocational Training setting.
Pre-Vocational Training prepares a client for placement in employment settings and addresses independent living skills with vocational skills. This is not considered a traditional OT practice setting but OTs are part of these programs.
An inpatient hospital unit and a community based rehabilitation center are both more traditional settings where OTs provide services. Large factories sometimes have their own medical facilities to help prevent workplace injuries or provide prompt treatment to facilitate recovery from injuries, so an OT could be hired to provide workplace rehabilitation. An OT can be employed in a forensic setting, and her role may be in the determining the competency to stand trial, and working on community living skills. OTs are also an integral part of the early intervention team.
An OT has just received a referral from a physician to work with a patient who recently had a knee replacement after sustaining an injury while on a ski trip. What is the FIRST step, the OT should take after receiving this referral?
C. Read the patient’s medical history record.
After the referral the OT will need to read the patient’s medical history report to gain background information about the patient
C. Read the patient’s medical history record.
After the referral the OT will need to read the patient’s medical history report to gain background information about the patient
What type of insurance covers people 65 years and over, who have been on social security for 24 months, and requires a minimum of 5 days/week of services?
Medicaid provides health coverage for children, pregnant women, parents, seniors, and individuals with disabilities. Blue Cross/Blue Shield PPO is private insurance. Medicare Part A covers patients that are in the acute care setting and need a minimum of 5d/wk of therapy. Medicare Part B covers patients in the outpatient setting that need therapy 3d/wk.