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
Please take this assessment quiz, so that you know which study material you should focus on the most. You should study the areas you scored the poorest first and proceed to your best areas last. For paid members this test is a 100 questions or more.
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Module 1 OT Quiz
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Here are your results for Module 1 OT Quiz. If you do not receive above 75% or better on this exam. it is highly recommended that you sign up for a personal tutoring session immediately before taking the actual NBCOT® exam. A personal tutor can significantly help you better understand any problem areas, and do not want to take the actual exam if you have any problem areas. It will significantly jeopardize you from passing. If you need to meet a score criteria for your university or college, It is recommended that you take a screenshot of your score score once you receive it before moving on.
An OT practitioner is being audited by NBCOT® to verify the validity of the documentation that was submitted as part of the renewal process. Which statements are true in terms of the NBCOT® ‘s license renewal requirements? Select the 3 best answers.
A. A professional development unit (PDU) is the term NBCOT® utilizes with its renewal program.
E. NBCOT® certification requires at least 36 units accrued during a 3 year renewal cycle for both Registered Occupational Therapists and Certified Occupational Therapy Assistants.
F. All PDUs can be completed online via webinars or online training.
B. If the activity relates to occupational therapy and/or your practice area and it fits into one of the categories listed on our Certification Renewal Activities Chart, you can count the units toward your renewal requirements. NBCOT® does not preapprove or accredit any specific courses or providers.
D. A competency assessment unit (CAU) is awarded for activities completed through “NBCOT®’s Navigator Platform”.
NBCOT® conducts a random audit during the renewal season, and you would need to provide documentation if you were selected for audit.
Module 1 PTOT. Topic: CEUs
A. A professional development unit (PDU) is the term NBCOT® utilizes with its renewal program.
E. NBCOT® certification requires at least 36 units accrued during a 3 year renewal cycle for both Registered Occupational Therapists and Certified Occupational Therapy Assistants.
F. All PDUs can be completed online via webinars or online training.
B. If the activity relates to occupational therapy and/or your practice area and it fits into one of the categories listed on our Certification Renewal Activities Chart, you can count the units toward your renewal requirements. NBCOT® does not preapprove or accredit any specific courses or providers.
D. A competency assessment unit (CAU) is awarded for activities completed through “NBCOT®’s Navigator Platform”.
NBCOT® conducts a random audit during the renewal season, and you would need to provide documentation if you were selected for audit.
Module 1 PTOT. Topic: CEUs
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 using this assessment?
B. Yes, the ethical principle of Beneficence is being violated.
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, the ethical principle of Beneficence is being violated.
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 post-op. 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 entire presentation as it has all the relevant information and great diagrams to illustrate the specific hip precautions. By presenting this 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 OT is helping a patient apply for durable medical equipment (DME) which is covered by Medicare. Which of the following is considered to be medically necessary equipment by Medicare?
B. Hospital bed.
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.
Examples: 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 therefore not covered.
C. You may be eligible to receive Durable Medical Equipment that makes it easier for you to move around your home, such as a cane or walker, but most equipment designed to make your bathroom safer is not considered “primarily medical in nature” by the Centers for Medicare & Medicaid Services. Grab bars and raised toilet seats, for instance, are considered convenience items and you will have to pay out-of-pocket for these safety devices. Commodes will be covered under Part B’s Durable Medical Equipment benefits if the patient is confined to a room without bathroom facilities.
a href=”https://www.medicare.org/articles/does-medicare-cover-bathroom-safety-devices/” rel=”noopener” target=”_blank”>https://www.medicare.org/articles/does-medicare-cover-bathroom-safety-devices/
B. Hospital bed.
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.
Examples: 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 therefore not covered.
C. You may be eligible to receive Durable Medical Equipment that makes it easier for you to move around your home, such as a cane or walker, but most equipment designed to make your bathroom safer is not considered “primarily medical in nature” by the Centers for Medicare & Medicaid Services. Grab bars and raised toilet seats, for instance, are considered convenience items and you will have to pay out-of-pocket for these safety devices. Commodes will be covered under Part B’s Durable Medical Equipment benefits if the patient is confined to a room without bathroom facilities.
a href=”https://www.medicare.org/articles/does-medicare-cover-bathroom-safety-devices/” rel=”noopener” target=”_blank”>https://www.medicare.org/articles/does-medicare-cover-bathroom-safety-devices/
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?
C. Place cans of food in upper cabinets using the affected hand while wearing a hand mitt on the unaffected hand.
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.
A. Training the patient in the use of an adaptive cutting board and a roller knife to slice cheese 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 supporting the affected limb (eg., to prevent subluxation of the shoulder joint) and does not work on improving the underlying deficit.
D. Does not utilize/address 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. Place cans of food in upper cabinets using the affected hand while wearing a hand mitt on the unaffected hand.
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.
A. Training the patient in the use of an adaptive cutting board and a roller knife to slice cheese 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 supporting the affected limb (eg., to prevent subluxation of the shoulder joint) and does not work on improving the underlying deficit.
D. Does not utilize/address 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
In which of the following settings would Medicare cover OT services?
A. Hospice/Palliative Care.
Occupational therapy is covered by Medicare in hospice and palliative care facilities when provided to patients who have less than 6 months to live. Other examples: 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 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.
Re: Palliative care. Occupational therapy practitioners provide skilled intervention to improve quality of life by facilitating engagement in daily life occupations throughout the entire life course. Participation in meaningful life occupations continues to be as important at the end of life as it is at earlier stages. The term end of life care has replaced the term terminal care and encompasses both hospice and palliative care that can occur during the final stages of life.
The Role of Occupational Therapy in End-of-Life Care. http://www.cptopr.org/Documents/Role%20of%20Occupational%20Therapy%20in%20End%20of%20Life%20Care.pdf
A. Hospice/Palliative Care.
Occupational therapy is covered by Medicare in hospice and palliative care facilities when provided to patients who have less than 6 months to live. Other examples: 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 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.
Re: Palliative care. Occupational therapy practitioners provide skilled intervention to improve quality of life by facilitating engagement in daily life occupations throughout the entire life course. Participation in meaningful life occupations continues to be as important at the end of life as it is at earlier stages. The term end of life care has replaced the term terminal care and encompasses both hospice and palliative care that can occur during the final stages of life.
The Role of Occupational Therapy in End-of-Life Care. http://www.cptopr.org/Documents/Role%20of%20Occupational%20Therapy%20in%20End%20of%20Life%20Care.pdf
Which intervention is an example of tertiary prevention?
D. Teaching joint protection techniques and providing a pamphlet on joint protection techniques to a man with rheumatoid arthritis.
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. Teaching joint protection techniques and providing a pamphlet on joint protection techniques is an example of tertiary prevention which aims to reduce the effects of the disease once it has been established in an individual.
Other examples of tertiary prevention: A water exercise program for people with multiple sclerosis and teaching education in relaxation techniques for a patient with fibromyalgia. The goal in these examples is to improve the patients’ quality of life by reducing the severity of their diseases- it targets ways to reduce the effects of the disease once it has already been established.
A. 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.
B. 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.
C. 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.
D. Teaching joint protection techniques and providing a pamphlet on joint protection techniques to a man with rheumatoid arthritis.
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. Teaching joint protection techniques and providing a pamphlet on joint protection techniques is an example of tertiary prevention which aims to reduce the effects of the disease once it has been established in an individual.
Other examples of tertiary prevention: A water exercise program for people with multiple sclerosis and teaching education in relaxation techniques for a patient with fibromyalgia. The goal in these examples is to improve the patients’ quality of life by reducing the severity of their diseases- it targets ways to reduce the effects of the disease once it has already been established.
A. 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.
B. 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.
C. 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.
An inpatient who recently sustained a C8 SCI has been participating in OT for the past 2 weeks. His main goal is to regain his independence in upper body dressing. The patient has learnt to transfer from his bed into his wheelchair without assistance and he is able to don and doff a t-shirt independently while sitting in his wheelchair. He, however, continues to need assistance selecting his t-shirt from the closet as he has difficulty maintaining his balance while reaching for the t-shirt. Which statement is the BEST description for the assessment portion (A) of the SOAP progress note?
B. “The patient has learnt to transfer independently from his bed to wheelchair and vice versa and he is progressing towards his long-term goal of regaining independence in his 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.
SOAP note:
S: Subjective
This section is for subjective reporting of your patient and their concerns or questions.
It can include:
Patient’s mood
How a patient is feeling that day
Questions your patient asked
Another person’s report of the patient’s mood, behavior, or progress (such as a teacher, parent, family member, or other medical professional).
Ask yourself:
• What is the patient reporting?
• What are the patient’s parents or caregivers reporting?
• Is the patient reporting pain?
• Are they complaining of fatigue?
O: Objective
The objective section should be made up of quantitative, factual, and measurable data. This includes your observations of the patient, any specific interventions or modalities used in the session, and your patient’s response to them.
Make sure to include:
Observations of how the patient is performing in a specific task.
How the patient is performing throughout their occupational therapy session.
Details about specific interventions or therapeutic activities the patient engaged in and their response.
Ask yourself:
• What level of assistance did the patient need?
• How many verbal and physical prompts were provided?
• What did you observe?
• How did you grade the activity or modify the environment?
• In what percentage of trials was the patient successful?
• What progress is the patient currently making on their goals?
A: Assessment
The assessment section is where you document your analysis and interpretation as an occupational therapist of both the subjective and objective information, specifically looking at:
How the patient did during their session.
The patient’s progress toward their occupational therapy goals.
Ask yourself:
• After examining the subjective and objective data, what does this mean about the patient’s progress?
• Have there been any significant changes in functioning?
P: Plan
This last section of your SOAP note should provide insight into your plan with the patient moving forward. The plan section is also where you can state anything you are changing in their future occupational therapy sessions, such as:
Therapeutic activities.
Objectives.
Therapy frequency.
Ask yourself:
• Should the treatment plan be changed? How?
• Does a new referral need to be made?
• Are any accommodations or modifications recommended?
B. “The patient has learnt to transfer independently from his bed to wheelchair and vice versa and he is progressing towards his long-term goal of regaining independence in his 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.
SOAP note:
S: Subjective
This section is for subjective reporting of your patient and their concerns or questions.
It can include:
Patient’s mood
How a patient is feeling that day
Questions your patient asked
Another person’s report of the patient’s mood, behavior, or progress (such as a teacher, parent, family member, or other medical professional).
Ask yourself:
• What is the patient reporting?
• What are the patient’s parents or caregivers reporting?
• Is the patient reporting pain?
• Are they complaining of fatigue?
O: Objective
The objective section should be made up of quantitative, factual, and measurable data. This includes your observations of the patient, any specific interventions or modalities used in the session, and your patient’s response to them.
Make sure to include:
Observations of how the patient is performing in a specific task.
How the patient is performing throughout their occupational therapy session.
Details about specific interventions or therapeutic activities the patient engaged in and their response.
Ask yourself:
• What level of assistance did the patient need?
• How many verbal and physical prompts were provided?
• What did you observe?
• How did you grade the activity or modify the environment?
• In what percentage of trials was the patient successful?
• What progress is the patient currently making on their goals?
A: Assessment
The assessment section is where you document your analysis and interpretation as an occupational therapist of both the subjective and objective information, specifically looking at:
How the patient did during their session.
The patient’s progress toward their occupational therapy goals.
Ask yourself:
• After examining the subjective and objective data, what does this mean about the patient’s progress?
• Have there been any significant changes in functioning?
P: Plan
This last section of your SOAP note should provide insight into your plan with the patient moving forward. The plan section is also where you can state anything you are changing in their future occupational therapy sessions, such as:
Therapeutic activities.
Objectives.
Therapy frequency.
Ask yourself:
• Should the treatment plan be changed? How?
• Does a new referral need to be made?
• Are any accommodations or modifications recommended?
OT practitioners collaborate with patients to identify both strengths and barriers to health, well-being, and participation. As part of this process, the OT practitioner 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
Ecology of Human Performance: The interaction between a person and the environment affects his or her behavior and performance. Human performance can be understood only through the “lens” of context, which includes temporal (age, development, health status), physical, cultural, and social features that operate external to a person. In essence, the inter-relationship between person and context determines which tasks fall within the individual’s performance range.
The term context refers to elements within and surrounding a patient that are often less tangible than physical and social environments but nonetheless exert a strong influence on performance. Contexts are cultural, personal, temporal, and virtual.
Cultural context – The cultural context includes customs, beliefs, activity patterns, behavioral standards, and expectations accepted by the society of which a patient is a member. The cultural context influences the patient’s identity and activity choices.
B. Cultural context
Ecology of Human Performance: The interaction between a person and the environment affects his or her behavior and performance. Human performance can be understood only through the “lens” of context, which includes temporal (age, development, health status), physical, cultural, and social features that operate external to a person. In essence, the inter-relationship between person and context determines which tasks fall within the individual’s performance range.
The term context refers to elements within and surrounding a patient that are often less tangible than physical and social environments but nonetheless exert a strong influence on performance. Contexts are cultural, personal, temporal, and virtual.
Cultural context – The cultural context includes customs, beliefs, activity patterns, behavioral standards, and expectations accepted by the society of which a patient is a member. The cultural context influences the patient’s identity and activity choices.
Sally, a program director at an outpatient rehabilitation facility has identified the need to introduce a system that continuously monitors patients’ outcomes as she wants to evaluate the quality of service provided by the occupational therapists. What data would be the MOST useful to gather in order to demonstrate the effectiveness of the OT services?
D. The improvements in the patients’ function or level of independence pre-discharge.
Continuous quality improvement is a system-oriented approach that views limitations and problems proactively as opportunities to increase quality. The use of accurate and appropriate measures to evaluate the quality of service provided by occupational therapists is essential to promote the implementation of evidence-based decisions that lead to desired health outcomes. Effective evidence-based decision-making in occupational therapy is dependent upon critical thinking and problem solving, awareness of end-user needs and priorities, as well as consideration of data gathered through objective measurement. Quality performance in occupational therapy relates to the degree to which services increase the likelihood of desired outcomes and are consistent with professional knowledge and evidence-based practice.
An initial assessment provides the baseline against which a later measurement can be compared when considering the outcome for the service user.
Examples of outcomes that can be measured include:
• Improvements in health or quality of life.
• Improvements in function or level of independence.
• Attainment of intervention goals.
• Service user satisfaction.
• System changes such as reduced hospital length of stay, waiting lists, and readmission rates.
D. The improvements in the patients’ function or level of independence pre-discharge.
Continuous quality improvement is a system-oriented approach that views limitations and problems proactively as opportunities to increase quality. The use of accurate and appropriate measures to evaluate the quality of service provided by occupational therapists is essential to promote the implementation of evidence-based decisions that lead to desired health outcomes. Effective evidence-based decision-making in occupational therapy is dependent upon critical thinking and problem solving, awareness of end-user needs and priorities, as well as consideration of data gathered through objective measurement. Quality performance in occupational therapy relates to the degree to which services increase the likelihood of desired outcomes and are consistent with professional knowledge and evidence-based practice.
An initial assessment provides the baseline against which a later measurement can be compared when considering the outcome for the service user.
Examples of outcomes that can be measured include:
• Improvements in health or quality of life.
• Improvements in function or level of independence.
• Attainment of intervention goals.
• Service user satisfaction.
• System changes such as reduced hospital length of stay, waiting lists, and readmission rates.
In an outpatient clinic, you are 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 his main goal is to return to work as soon as possible. However, you have observed that the patient’s reaction time and vision have been significantly affected by his CVA. What action should you take NEXT, in this scenario?
B. Report your observations 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 they 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 your observations 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 they 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 is an inductive method of research in which data is collected first. The data is analyzed and then the hypothesis is drawn from the results of the analysis. This is often misidentified as qualitative research.
B. Grounded theory.
Grounded Theory is an inductive method of research in which data is collected first. The data is analyzed and then the hypothesis is drawn from the results of the analysis. This is often misidentified as qualitative research.
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.
The profession is grounded in seven long-standing Core Values: (1) Altruism, (2) Equality, (3) Freedom, (4)Justice, (5)Dignity, (6) Truth, and (7) Prudence. Altruism involves demonstrating concern for the welfare of others. Equality refers to treating all people impartially and free of bias. Freedom and personal choice are paramount in a profession in which the values and desires of the client guide our interventions. Justice expresses a state in which diverse communities are inclusive; diverse communities are organized and structured such that all members can function, flourish, and live a satisfactory life. Occupational therapy personnel, by virtue of the specific nature of the practice of occupational therapy, have a vested interest in addressing unjust inequities that limit opportunities for participation in society. Inherent in the practice of occupational therapy is the promotion and preservation of the individuality and Dignity of the client by treating him or her with respect in all interactions. In all situations, occupational therapy personnel must provide accurate information in oral, written, and electronic forms (Truth). Occupational therapy personnel use their clinical and ethical reasoning skills, sound judgment, and reflection to make decisions in professional and volunteer roles (Prudence).
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.
The profession is grounded in seven long-standing Core Values: (1) Altruism, (2) Equality, (3) Freedom, (4)Justice, (5)Dignity, (6) Truth, and (7) Prudence. Altruism involves demonstrating concern for the welfare of others. Equality refers to treating all people impartially and free of bias. Freedom and personal choice are paramount in a profession in which the values and desires of the client guide our interventions. Justice expresses a state in which diverse communities are inclusive; diverse communities are organized and structured such that all members can function, flourish, and live a satisfactory life. Occupational therapy personnel, by virtue of the specific nature of the practice of occupational therapy, have a vested interest in addressing unjust inequities that limit opportunities for participation in society. Inherent in the practice of occupational therapy is the promotion and preservation of the individuality and Dignity of the client by treating him or her with respect in all interactions. In all situations, occupational therapy personnel must provide accurate information in oral, written, and electronic forms (Truth). Occupational therapy personnel use their clinical and ethical reasoning skills, sound judgment, and reflection to make decisions in professional and volunteer roles (Prudence).
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.
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?
A. .04.
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.
A. .04.
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.
In the OT process, how should an OT evaluation always begin?
D. Establishing an occupational profile.
Evaluation refers to the process of obtaining and interpreting data necessary for intervention. This includes planning for and documenting the evaluation process and results. Assessment refers to specific tools or instruments that are used during the evaluation process. Two parts of the evaluation process have been identified: the generation of an occupational profile and the analysis of occupational performance. The assessments chosen help in developing the occupational profile. The OT then analyzes the client’s occupational performance through synthesis of data collected using a variety of means. The evaluation portion begins with the OT and client developing an occupational profile that reviews the client’s occupational history and describes the client’s current needs and priorities.
B. A screening comes before an evaluation in the OT process. After the referral, the occupational therapist needs to screen the patient in order to determine if an evaluation is needed. A screening is used to obtain preliminary information of the patient’s situation.
Pendleton, Heidi McHugh; Schultz-Krohn, Winifred. Pedretti’s Occupational Therapy – E-Book (Occupational Therapy Skills for Physical Dysfunction (Pedretti)) (p. 30). Elsevier Health Sciences. Kindle Edition.
D. Establishing an occupational profile.
Evaluation refers to the process of obtaining and interpreting data necessary for intervention. This includes planning for and documenting the evaluation process and results. Assessment refers to specific tools or instruments that are used during the evaluation process. Two parts of the evaluation process have been identified: the generation of an occupational profile and the analysis of occupational performance. The assessments chosen help in developing the occupational profile. The OT then analyzes the client’s occupational performance through synthesis of data collected using a variety of means. The evaluation portion begins with the OT and client developing an occupational profile that reviews the client’s occupational history and describes the client’s current needs and priorities.
B. A screening comes before an evaluation in the OT process. After the referral, the occupational therapist needs to screen the patient in order to determine if an evaluation is needed. A screening is used to obtain preliminary information of the patient’s situation.
Pendleton, Heidi McHugh; Schultz-Krohn, Winifred. Pedretti’s Occupational Therapy – E-Book (Occupational Therapy Skills for Physical Dysfunction (Pedretti)) (p. 30). Elsevier Health Sciences. Kindle Edition.
When working with a patient who has Huntington’s disease, what model/FOR is the BEST to base your intervention on, if the patient’s goal is to continue to perform their desired occupations?
A. The Canadian Model of Occupational Performance and Engagement (CMOPE).
Engagement is one of the main concepts covered in this model because it offers a less restricted focus on occupational performance (Polatajko, Townsend, & Craik, 2007). Although a person may not be able to occupationally perform in their desired occupations, they can still engage in them through the help of modification, adaptation, and caregiver role (Polatajko, Townsend, & Craik, 2007).
Huntington’s disease (HD) is a neurodegenerative disease. Huntington’s disease is delineated by three stages in its progression: early, middle, and late stage. The early stage is marked by the onset of a triad of symptoms including physical, behavioral and cognitive impairments. The middle stage is marked by an increase in motor control problems as well as cognitive deficits that begin to have a greater impact on an individual’s abilities to carry out ADLs. The late stage is characterized as the loss of muscle, the presence of contractures, increased involuntary control of movement, even more severe cognitive deficit, and the need for increased safety precautions. As the disease progresses, independence in activities of daily living decrease and coping with these changes becomes more challenging.
B. Biomechanical Frame of Reference. This is a rehabilitative FOR which is best suited for patients with an intact central nervous system.
C. Dynamic Interactional Model of Cognitive Rehabilitation. This is a restorative cognitive rehabilitation approach, used to enhance the functional performance of patients who have a cognitive impairment.
D. Cognitive Behavioral Frame of Reference. The focus is on replacing behaviors that result from abnormal thought processes with more normal or adaptive thought processes and behaviors.
A. The Canadian Model of Occupational Performance and Engagement (CMOPE).
Engagement is one of the main concepts covered in this model because it offers a less restricted focus on occupational performance (Polatajko, Townsend, & Craik, 2007). Although a person may not be able to occupationally perform in their desired occupations, they can still engage in them through the help of modification, adaptation, and caregiver role (Polatajko, Townsend, & Craik, 2007).
Huntington’s disease (HD) is a neurodegenerative disease. Huntington’s disease is delineated by three stages in its progression: early, middle, and late stage. The early stage is marked by the onset of a triad of symptoms including physical, behavioral and cognitive impairments. The middle stage is marked by an increase in motor control problems as well as cognitive deficits that begin to have a greater impact on an individual’s abilities to carry out ADLs. The late stage is characterized as the loss of muscle, the presence of contractures, increased involuntary control of movement, even more severe cognitive deficit, and the need for increased safety precautions. As the disease progresses, independence in activities of daily living decrease and coping with these changes becomes more challenging.
B. Biomechanical Frame of Reference. This is a rehabilitative FOR which is best suited for patients with an intact central nervous system.
C. Dynamic Interactional Model of Cognitive Rehabilitation. This is a restorative cognitive rehabilitation approach, used to enhance the functional performance of patients who have a cognitive impairment.
D. Cognitive Behavioral Frame of Reference. The focus is on replacing behaviors that result from abnormal thought processes with more normal or adaptive thought processes and behaviors.
An OTR® and COTA® are collaborating to improve the quality of patient services at an outpatient rehab facility. This process incorporates reviewing outcomes to determine the success of OT interventions. Which of the following questions is BEST to ask during the review?
C. Did the intervention promote a positive change in a client’s engagement in occupation?
OT outcome measures are used to determine value and effectiveness of treatment in therapy. 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?
OT outcome measures are used to determine value and effectiveness of treatment in therapy. 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 in which the efficacy of using resting hand splint for patients with arthritis is discussed. What would the OT need to do in order to establish the reliability of this study?
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.
A new therapy aide is hired to work in the rehab department. Is an entry-level OTA allowed to supervise this aide?
A. Yes, once the entry-level OTA shows service competency to a supervising OT.
Entry-level OTAs are allowed to supervise aides, technicians, and volunteers once they show service competency in this area to a supervising OT.
A. Yes, once the entry-level OTA shows service competency to a supervising OT.
Entry-level OTAs are allowed to supervise aides, technicians, and volunteers once they show service competency in this area to a supervising OT.
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.
Ensuring the privacy and protection of patients’ healthcare data is mandatory by law. Which statements are TRUE about patient confidentiality in healthcare? Select the 3 best answers.
A. Always safeguard private information about patients, employees, colleagues, and students.
D. Confidentiality may be breached when reporting suspected abuse.
E. Confidentiality may be breached when the safety of a patient is at risk.
Whether in written, verbal, electronic, or virtual communication, occupational therapy personnel uphold the highest standards of confidentiality, informed consent, autonomy, accuracy, timeliness, and record management. Based on the principles established in the Code, confidentiality is a duty of occupational therapy personnel and a right of the patient. Subject to federal mandates (HIPAA) and state laws (practice acts), confidentiality may be breached or overridden when the safety of a patient is at risk or there is an ethical obligation to prevent foreseeable harm to self or others. Other exceptions to confidentiality include mandatory reporting of suspected abuse, information required by law during court proceedings, and documentation of communicable diseases to public health agencies.
B. Posting photos of a patient on social media is only allowed if written consent is provided
C. OT practitioners shall not electronically post personal health information or anything, including photos, that may reveal a patient’s identity or personal or therapeutic relationship, without the patient’s written consent. All statements, regardless of intent, about a patient can potentially contain sufficient information for a member of a community to recognize the patient, thus violating the state and/or federal law i.e., Health Insurance Portability and Accountability Act (HIPAA). In the past, healthcare workers often collected patient data for research and usually only omitted the patients’ names. This is no longer permitted, now any protected health information (PHI) that can identify a patient or the patient’s relatives, employers, or household members, must be omitted before being used
F. Medical data of deceased patients should continue to be treated as confidential and therefore be protected by law.
A. Always safeguard private information about patients, employees, colleagues, and students.
D. Confidentiality may be breached when reporting suspected abuse.
E. Confidentiality may be breached when the safety of a patient is at risk.
Whether in written, verbal, electronic, or virtual communication, occupational therapy personnel uphold the highest standards of confidentiality, informed consent, autonomy, accuracy, timeliness, and record management. Based on the principles established in the Code, confidentiality is a duty of occupational therapy personnel and a right of the patient. Subject to federal mandates (HIPAA) and state laws (practice acts), confidentiality may be breached or overridden when the safety of a patient is at risk or there is an ethical obligation to prevent foreseeable harm to self or others. Other exceptions to confidentiality include mandatory reporting of suspected abuse, information required by law during court proceedings, and documentation of communicable diseases to public health agencies.
B. Posting photos of a patient on social media is only allowed if written consent is provided
C. OT practitioners shall not electronically post personal health information or anything, including photos, that may reveal a patient’s identity or personal or therapeutic relationship, without the patient’s written consent. All statements, regardless of intent, about a patient can potentially contain sufficient information for a member of a community to recognize the patient, thus violating the state and/or federal law i.e., Health Insurance Portability and Accountability Act (HIPAA). In the past, healthcare workers often collected patient data for research and usually only omitted the patients’ names. This is no longer permitted, now any protected health information (PHI) that can identify a patient or the patient’s relatives, employers, or household members, must be omitted before being used
F. Medical data of deceased patients should continue to be treated as confidential and therefore be protected by law.
An OT practitioner is working in a SNF as part of a multi-disciplinary team. A new patient with advanced dementia has been admitted to the facility and the physician has ordered a comprehensive evaluation to be performed on this patient. The speech therapist who is a close friend to the OT practitioner, asks the OT practitioner to perform the swallowing assessment on their behalf as they have an overwhelming caseload and they have confidence that the OT practitioner has the necessary knowledge . If the OT practitioner agrees to do this, which code of ethics will they be violating? Select the 3 best answers.
A. Veracity.
D. Nonmaleficence.
E. Beneficence.
Physical, speech, respiratory, and occupational therapies must be provided by individuals who have met specific qualifications by successfully completing their respective academic programs, fieldwork placements, and national certification requirements, and who hold active state licensure (or other required regulation) in their discipline. Professionals are individually licensed, and these licenses are not interchangeable.
– Veracity: Occupational therapy practitioners shall represent the profession in a thorough, objective and accurate manner. By fulfilling the role of the speech therapist, the OT practitioner is not representing the OT profession authentically.
– Nonmaleficence: Occupational therapy practitioners shall take reasonable precautions to avoid inflicting harm on others or their property. The OT practitioner may inflict harm on the patient during treatment as they do not have the same skill set or qualification as the speech therapist.
– Veracity: Occupational therapy practitioners shall represent the profession in a thorough, objective and accurate manner. By performing the duties of the speech therapist, the OT practitioner is not representing the OT profession authentically. This part of the patient’s evaluation was ordered by the physician for the speech therapist to perform.
B. Justice: Occupational therapy practitioners shall provide occupational therapy services in a fair and objective manner.
C. Autonomy: Occupational therapy practitioners shall treat patients according to their wishes and shall keep patient information confidential.
F. Fidelity: Occupational therapy practitioners shall treat patients and other healthcare professionals with respect.
A. Veracity.
D. Nonmaleficence.
E. Beneficence.
Physical, speech, respiratory, and occupational therapies must be provided by individuals who have met specific qualifications by successfully completing their respective academic programs, fieldwork placements, and national certification requirements, and who hold active state licensure (or other required regulation) in their discipline. Professionals are individually licensed, and these licenses are not interchangeable.
– Veracity: Occupational therapy practitioners shall represent the profession in a thorough, objective and accurate manner. By fulfilling the role of the speech therapist, the OT practitioner is not representing the OT profession authentically.
– Nonmaleficence: Occupational therapy practitioners shall take reasonable precautions to avoid inflicting harm on others or their property. The OT practitioner may inflict harm on the patient during treatment as they do not have the same skill set or qualification as the speech therapist.
– Veracity: Occupational therapy practitioners shall represent the profession in a thorough, objective and accurate manner. By performing the duties of the speech therapist, the OT practitioner is not representing the OT profession authentically. This part of the patient’s evaluation was ordered by the physician for the speech therapist to perform.
B. Justice: Occupational therapy practitioners shall provide occupational therapy services in a fair and objective manner.
C. Autonomy: Occupational therapy practitioners shall treat patients according to their wishes and shall keep patient information confidential.
F. Fidelity: Occupational therapy practitioners shall treat patients and other healthcare professionals with respect.
Which method of gathering data would be 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.
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.
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 practitioner 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 they receive?
D. .2 CEUs.
A CEU is a unit of credit equal to 10 hours of participation in an accredited program designed for professionals with certificates or licenses to practice various professions. A single hour of participation in a course is equal to 0.1 CEUs. If the OT practitioner attends a 2-hour lecture, the OT practitioner will receive .2 CEUs. (2 x 0.1)
D. .2 CEUs.
A CEU is a unit of credit equal to 10 hours of participation in an accredited program designed for professionals with certificates or licenses to practice various professions. A single hour of participation in a course is equal to 0.1 CEUs. If the OT practitioner attends a 2-hour lecture, the OT practitioner will receive .2 CEUs. (2 x 0.1)
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.
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.
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.
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 duties 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.
A screening is the process by which a person’s OT needs are assessed. Whether or not an OTA can complete a screening depends on the information required from the screening. An OTA can state or write observations but cannot make an evaluation or determine a need for occupational therapy services. This must be determined by an OT. The OTA may, if directed by the occupational therapist, and deemed competent, perform designated assessments to contribute to the evaluation, but may not interpret data. The interpretation of assessment results and the overall evaluation is the responsibility of the occupational therapist. In terms of intervention discontinuation, the OT is responsible for determining the need for continuing, modifying, or discontinuing occupational therapy services.
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.
A screening is the process by which a person’s OT needs are assessed. Whether or not an OTA can complete a screening depends on the information required from the screening. An OTA can state or write observations but cannot make an evaluation or determine a need for occupational therapy services. This must be determined by an OT. The OTA may, if directed by the occupational therapist, and deemed competent, perform designated assessments to contribute to the evaluation, but may not interpret data. The interpretation of assessment results and the overall evaluation is the responsibility of the occupational therapist. In terms of intervention discontinuation, the OT is responsible for determining the need for continuing, modifying, or discontinuing occupational therapy services.
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.
A 5-year-old child with a history of sensory processing difficulties has been referred to OT. Based on the child’s presenting difficulties, which FOR would the OT MOST likely incorporate into their intervention plan?
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 the treatment she is providing to her patients is effective. What can the OT use to help her achieve her goal?
D. Patient outcomes data.
In OT, outcome measures are used to determine the value and effectiveness of treatment in therapy. These measures are often completed at the start of therapy to determine baseline function and then again, at the end of therapy to assess progress and determine treatment efficacy.
D. Patient outcomes data.
In OT, outcome measures are used to determine the value and effectiveness of treatment in therapy. These measures are often completed at the start of therapy to determine baseline function and then again, at the end of therapy to assess progress and determine treatment efficacy.
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. Before using this assessment, the OT wants to find out about the inter-rater reliability of this assessment. Explain what inter-rater reliability means.
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
Which FOR focuses on the patient’s current abilities and incorporates using compensatory intervention strategies to enable the patient to return to performing their occupations through alternative means?
D. Rehabilitation.
The rehabilitation FOR focuses on the patient’s ability to return to the fullest physical, mental, social, vocational, and economic functioning as is possible. The emphasis is placed on the patient’s abilities and using the current abilities coupled with technology or equipment to accomplish occupational performance. Compensatory intervention strategies are often employed, and examples include teaching one-handed dressing techniques to an individual who, following a CVA, no longer has functional use of one hand. The focus of intervention is often engagement in occupation through alternative means.
Pedretti’s Occupational Therapy – E-Book (Occupational Therapy Skills for Physical Dysfunction p. 40).
D. Rehabilitation.
The rehabilitation FOR focuses on the patient’s ability to return to the fullest physical, mental, social, vocational, and economic functioning as is possible. The emphasis is placed on the patient’s abilities and using the current abilities coupled with technology or equipment to accomplish occupational performance. Compensatory intervention strategies are often employed, and examples include teaching one-handed dressing techniques to an individual who, following a CVA, no longer has functional use of one hand. The focus of intervention is often engagement in occupation through alternative means.
Pedretti’s Occupational Therapy – E-Book (Occupational Therapy Skills for Physical Dysfunction p. 40).
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 practitioner, is looking at taking continuing education classes in order to renew her license. How many continuing education units (CEUs) does she need to take?
A. It depends on the licensure requirements of the state where Jill lives.
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.
A. It depends on the licensure requirements of the state where Jill lives.
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.
An OT is completing an initial screening of a patient in a long-term care facility. 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 from their health insurance?
B. Under Medicare Part B, continued rehabilitation to focus on dressing 6-months post CVA for a patient in a skilled nursing facility .
Medicare Part B removed the therapy cap in 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 considered 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.
A. Medicaid allows for maintenance therapy for conditions that require skilled services such as management of contractures.
C. Hand therapy following a tendon transfer is considered medically necessary.
D. Inpatient therapy for an eating disorder is covered under the current (2017) terms of the Affordable Care Act (ACA).
B. Under Medicare Part B, continued rehabilitation to focus on dressing 6-months post CVA for a patient in a skilled nursing facility .
Medicare Part B removed the therapy cap in 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 considered 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.
A. Medicaid allows for maintenance therapy for conditions that require skilled services such as management of contractures.
C. Hand therapy following a tendon transfer is considered medically necessary.
D. Inpatient therapy for an eating disorder is covered under the current (2017) terms of the Affordable Care Act (ACA).
Which type of intervention 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.
B. 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.
C and D. 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.
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.
B. 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.
C and D. 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.
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 with ADHD in a large metropolitan school district.
A randomized control trial (RCT) is a trial in which subjects are randomly assigned to one of two groups: one (the experimental group) receiving the intervention that is being tested, and the other (the comparison group or control) receiving an alternative (conventional) treatment. The two groups are then followed up to see if there are any differences between them in their outcomes. The results and subsequent analysis of the trial are used to assess the effectiveness of the intervention, which is the extent to which a treatment, procedure, or service does patients more good than harm. RCTs are the most stringent way of determining whether a cause-effect relation exists between the intervention and the outcome. Randomized controlled trials are quantitative, comparative, controlled experiments in which investigators study interventions in a series of individuals who receive them in random order. The RCT is one of the simplest and most powerful tools in clinical research. 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. Case Study: An in-depth study of a single subject or group of subjects. Qualitative approach.
D. Case Control Study: An observational study where two groups of people, one with a specific medical condition and one without the condition, are compared to determine factors that may contribute to or affect the medical condition. Researchers look back in time (retrospective) to identify possible exposures. They often rely on medical records and patient recall for data collection.
A. A randomized controlled trial studying the use of weighted vests by children with ADHD in a large metropolitan school district.
A randomized control trial (RCT) is a trial in which subjects are randomly assigned to one of two groups: one (the experimental group) receiving the intervention that is being tested, and the other (the comparison group or control) receiving an alternative (conventional) treatment. The two groups are then followed up to see if there are any differences between them in their outcomes. The results and subsequent analysis of the trial are used to assess the effectiveness of the intervention, which is the extent to which a treatment, procedure, or service does patients more good than harm. RCTs are the most stringent way of determining whether a cause-effect relation exists between the intervention and the outcome. Randomized controlled trials are quantitative, comparative, controlled experiments in which investigators study interventions in a series of individuals who receive them in random order. The RCT is one of the simplest and most powerful tools in clinical research. 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. Case Study: An in-depth study of a single subject or group of subjects. Qualitative approach.
D. Case Control Study: An observational study where two groups of people, one with a specific medical condition and one without the condition, are compared to determine factors that may contribute to or affect the medical condition. Researchers look back in time (retrospective) to identify possible exposures. They often rely on medical records and patient recall for data collection.
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. Clubhouse.
Working in a Clubhouse is considered to be a non-traditional OT setting.
Assisted Living Facilities, School-based OT and Outpatient OT Clinics are all considered to be traditional OT settings.
Refer to Module 1. Worksheet on OT Settings
D. Clubhouse.
Working in a Clubhouse is considered to be a non-traditional OT setting.
Assisted Living Facilities, School-based OT and Outpatient OT Clinics are all considered to be traditional OT settings.
Refer to Module 1. Worksheet on OT Settings
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?
C. Medicare Part A.
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.
C. Medicare Part A.
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.
An OT has received a referral from the physician to complete a bathing evaluation with a patient who is due to be discharged. When the OT arrives at the patient’s room, the patient informs the OT that he just had a shower with the nurse’s help. What should the OT do NEXT, in this scenario?
B. Complete a simulated bathing task. In order to be discharged, the OT needs to see certain skills, even if the patient completed them in advance with the nursing staff.
B. Complete a simulated bathing task. In order to be discharged, the OT needs to see certain skills, even if the patient completed them in advance with the nursing staff.
Which frame of reference would be BEST to use when working with a woman who is recovering from a traumatic brain injury (TBI)?
C. Neurodevelopmental Treatment (NDT).
Neurodevelopmental Treatment and Proprioceptive Neuromuscular Facilitation are frames of reference that were developed to address neurological conditions such as a traumatic brain injury (TBI).
A. Psychodynamic Theory is a frame of reference that primarily relates to people with mental health disorders
B. Sensory Integration is a frame of reference developed for use with children and adults who have neuro-psychological conditions that include sensory processing dysfunction.
D. Psychoeducation is a frame of reference commonly used in psychiatric settings and although TBI can result in psychiatric symptoms, it is not necessarily considered a psychiatric diagnosis.
C. Neurodevelopmental Treatment (NDT).
Neurodevelopmental Treatment and Proprioceptive Neuromuscular Facilitation are frames of reference that were developed to address neurological conditions such as a traumatic brain injury (TBI).
A. Psychodynamic Theory is a frame of reference that primarily relates to people with mental health disorders
B. Sensory Integration is a frame of reference developed for use with children and adults who have neuro-psychological conditions that include sensory processing dysfunction.
D. Psychoeducation is a frame of reference commonly used in psychiatric settings and although TBI can result in psychiatric symptoms, it is not necessarily considered a psychiatric diagnosis.
An entry-level OT has just started working at a rehab facility. What type of supervision is required, at this stage of the OT’s career?
A. Supervision is not required.
Based on their education and training, occupational therapists, after initial certification, are autonomous practitioners who are able to deliver occupational therapy services independently. Occupational therapists are
responsible for all aspects of occupational therapy service delivery and are accountable for the safety and
effectiveness of the occupational therapy service delivery process. Although supervision is not mandatory, occupational therapists are encouraged to seek supervision and mentoring to develop best practice approaches and promote professional growth.
A. Supervision is not required.
Based on their education and training, occupational therapists, after initial certification, are autonomous practitioners who are able to deliver occupational therapy services independently. Occupational therapists are
responsible for all aspects of occupational therapy service delivery and are accountable for the safety and
effectiveness of the occupational therapy service delivery process. Although supervision is not mandatory, occupational therapists are encouraged to seek supervision and mentoring to develop best practice approaches and promote professional growth.
An OT has evaluated a 7-year-old child with cerebral palsy and makes several short and long-term goals. The OTA is tasked with implementing the intervention plan which includes keeping records of each session. What responsibility does the OT have in terms of the OTA’s record keeping?
B. Review the notes and co-sign if in agreement with all of its contents.
It is essential to document who provided the service, their qualifications and clinical expertise, and the purpose of the service. Documentation should be signed by the qualified professional (e.g., the COTA® with OTR® co-signature), as indicated by facility policy, third-party payer regulations, and state licensure laws.
https://www.nbcot.org/-/media/NBCOT/PDFs/Practice-Standards-COTA.ashx?la=en&hash=7D24D031D583DBE15E6585A707F2702A84B2DF21
B. Review the notes and co-sign if in agreement with all of its contents.
It is essential to document who provided the service, their qualifications and clinical expertise, and the purpose of the service. Documentation should be signed by the qualified professional (e.g., the COTA® with OTR® co-signature), as indicated by facility policy, third-party payer regulations, and state licensure laws.
https://www.nbcot.org/-/media/NBCOT/PDFs/Practice-Standards-COTA.ashx?la=en&hash=7D24D031D583DBE15E6585A707F2702A84B2DF21
An OT is giving a presentation on Medicare reimbursement guidelines for durable medical equipment (DME). From the list of examples below, in which scenario would reimbursement by Medicare be approved?
C. A walker for a person who cannot ambulate in the home without one.
A sock aid, grab bars, and a reacher are used for self-help and are not covered by Medicare. DME requires that the item must be medically necessary and reasonable to treat an illness or when the patient has a decline in function.
C. A walker for a person who cannot ambulate in the home without one.
A sock aid, grab bars, and a reacher are used for self-help and are not covered by Medicare. DME requires that the item must be medically necessary and reasonable to treat an illness or when the patient has a decline in function.
This model highlights occupational performance as its key feature, which is made up of three interacting components (person, environment, and occupation). Application of this model in practice requires a collaborative relationship with the patient and OT practitioner, and allows the patient to develop goals for themselves based on their individual desires and needs. This in turns leads to the development of a realistic and sequenced intervention plan. Which model is being described?
A. Person-Environment-Occupation-Performance (PEOP).
Person-Environment-Occupation-Performance model (PEOP). Occupational performance is emphasized in the PEOP model and involves three components: (1) characteristics of the person (including physiological, psychological, motor, sensory/perceptual, cognitive, or spiritual), (2) features of the environment (including cultural, social support, social determinants, and social capital, physical and natural environments, health education and public policy, assistive technology), and (3) characteristics of the activity, task, or role. When people perform occupations, they also interact with environment. Thus, there are reciprocal consequences; that is, a person’s goals and intentions influence his/her occupational performance, and the action changes his/her environment and his/her characteristics at the same time. The interaction between the person and environmental components positively or negatively influences occupational performance. When there is a person-environment fit in supporting the valued occupation, success in occupational performance eventually leads to participation and well-being. In addition, the PEOP model is a client-centered model; that is, client must actively set goals and participate in determining a plan that promotes occupational performance.
https://ottheory.com/therapy-model/person-environment-occupation-performance-model-peop
A. Person-Environment-Occupation-Performance (PEOP).
Person-Environment-Occupation-Performance model (PEOP). Occupational performance is emphasized in the PEOP model and involves three components: (1) characteristics of the person (including physiological, psychological, motor, sensory/perceptual, cognitive, or spiritual), (2) features of the environment (including cultural, social support, social determinants, and social capital, physical and natural environments, health education and public policy, assistive technology), and (3) characteristics of the activity, task, or role. When people perform occupations, they also interact with environment. Thus, there are reciprocal consequences; that is, a person’s goals and intentions influence his/her occupational performance, and the action changes his/her environment and his/her characteristics at the same time. The interaction between the person and environmental components positively or negatively influences occupational performance. When there is a person-environment fit in supporting the valued occupation, success in occupational performance eventually leads to participation and well-being. In addition, the PEOP model is a client-centered model; that is, client must actively set goals and participate in determining a plan that promotes occupational performance.
https://ottheory.com/therapy-model/person-environment-occupation-performance-model-peop
Which of the following is the best example of an OT intervention which is based on the ecology of human performance model?
A. Working within a person’s home to modify it for their needs.
Ecology of Human Performance: A focus on the person choosing appropriate tasks within the environment. The environment can be temporal, physical, social, and cultural. How does the context affect the person’s occupational performance. Examples include:
Working within a person’s home to modify it for their needs; In acute care teaching person to select correct self-care tools; ability to choose to sit and knit then gather and prepare a station with necessary tools, lighting, etc.
A. Working within a person’s home to modify it for their needs.
Ecology of Human Performance: A focus on the person choosing appropriate tasks within the environment. The environment can be temporal, physical, social, and cultural. How does the context affect the person’s occupational performance. Examples include:
Working within a person’s home to modify it for their needs; In acute care teaching person to select correct self-care tools; ability to choose to sit and knit then gather and prepare a station with necessary tools, lighting, etc.
What frame of reference is used when a patient uses a raised toilet seat during recovery from a hip replacement?
B. Rehabilitative frame of reference.
Rehabilitative frame of reference: The focus is on what the patient can do, rather than on what they cannot do, and it utilizes adaptation, compensation, and modification in order to facilitate the patient’s ability to participate in the desired activities. The rehabilitative approach looks at functional problems from a top-down approach and can be utilized regardless of the extent of the patient’s deficits because it does not require the restoration or development of missing skills, but instead focuses on maximizing independence where the patient is now in the recovery process.
B. Rehabilitative frame of reference.
Rehabilitative frame of reference: The focus is on what the patient can do, rather than on what they cannot do, and it utilizes adaptation, compensation, and modification in order to facilitate the patient’s ability to participate in the desired activities. The rehabilitative approach looks at functional problems from a top-down approach and can be utilized regardless of the extent of the patient’s deficits because it does not require the restoration or development of missing skills, but instead focuses on maximizing independence where the patient is now in the recovery process.
A new OTA is working in home health and sees seven pediatric patients per day. As the OTA’s supervisor, you make direct contact with her every two weeks on the phone to discuss her caseload. What type of supervision is this OTA receiving?
A. Routine supervision.
Routine supervision is made with direct contact every two weeks. General supervision is defined as direct, but only monthly, contact as well as indirect contact as needed. Close supervision includes daily, direct, on-site contact. Minimal supervision is not an existing term to describe a type of supervision between an OTA and a supervising OT.
A. Routine supervision.
Routine supervision is made with direct contact every two weeks. General supervision is defined as direct, but only monthly, contact as well as indirect contact as needed. Close supervision includes daily, direct, on-site contact. Minimal supervision is not an existing term to describe a type of supervision between an OTA and a supervising OT.
An OT practitioner is working with a patient who is recovering from a CVA. One of the patient’s goals, is to improve her cognitive skills. As Valentine’s day is the following day, the patient states that she would like to make a card for her husband. The OT practitioner structures the activity accordingly, to meet the therapeutic goals. During the session, the patient mentions that she always buys a card and a gift for her husband on Valentine’s Day. Later on during the day, the OT practitioner surprises the patient with candy that she had purchased for her, to give to her husband. What core value is this OT practitioner demonstrating in this scenario?
A. Altruism.
Altruism is the unselfish concern for the welfare of others. This concept is reflected in actions and attitudes of commitment, caring, dedication, responsiveness, and understanding. It is characterized by acts with no apparent benefits for the individual who performs them but that are beneficial to other individuals. Often, people behave altruistically when they feel empathy and a desire to help. For the patient participating in the card making activity will address certain OT intervention goals. Receiving candy from the OT practitioner , is however not relevant in terms of the patient’s intervention plan but it will help the patient feel less confined to the hospital and it’s restrictions.
A. Altruism.
Altruism is the unselfish concern for the welfare of others. This concept is reflected in actions and attitudes of commitment, caring, dedication, responsiveness, and understanding. It is characterized by acts with no apparent benefits for the individual who performs them but that are beneficial to other individuals. Often, people behave altruistically when they feel empathy and a desire to help. For the patient participating in the card making activity will address certain OT intervention goals. Receiving candy from the OT practitioner , is however not relevant in terms of the patient’s intervention plan but it will help the patient feel less confined to the hospital and it’s restrictions.
What type of qualitative research is the BEST to use in order to obtain detailed information about a patient’s medical history, background, and demographics?
B. Case Study.
Case studies are a type of qualitative research. This method does not involve statistical hypothesis testing. Case studies are analyses of persons, events, decisions, periods, projects, policies, institutions, or other systems that are studied holistically by one or more methods.
B. Case Study.
Case studies are a type of qualitative research. This method does not involve statistical hypothesis testing. Case studies are analyses of persons, events, decisions, periods, projects, policies, institutions, or other systems that are studied holistically by one or more methods.
An OT practitioner is working with a group of teen moms with the goal of educating them about ways to stimulate their babies in order to promote their babies’ development. Which level of prevention is being described in this scenario?
C. Primary prevention.
Primary Prevention is aimed at reducing the risk of disease or disability in a healthy population. It begins before the onset of a disease.
Secondary Prevention seeks to prevent the early stages of a disease advancing through early diagnosis and treatment. It attempts to prevent the disease from progressing by detecting it early.
Tertiary prevention focuses not only on restoring health after the occurrence of a disease or disability, but also on preventing any damaging after-effects and complications setting in. Attempts to reduce the damage caused by symptomatic disease by focusing on mental, physical, and social rehabilitation. Unlike secondary prevention, which aims to prevent disability, the objective of tertiary prevention is to maximize the remaining capabilities and functions of an already disabled patient. Goals of tertiary prevention include preventing pain and damage, halting progression and complications from disease, and restoring the health and functions of the individuals affected by disease.
C. Primary prevention.
Primary Prevention is aimed at reducing the risk of disease or disability in a healthy population. It begins before the onset of a disease.
Secondary Prevention seeks to prevent the early stages of a disease advancing through early diagnosis and treatment. It attempts to prevent the disease from progressing by detecting it early.
Tertiary prevention focuses not only on restoring health after the occurrence of a disease or disability, but also on preventing any damaging after-effects and complications setting in. Attempts to reduce the damage caused by symptomatic disease by focusing on mental, physical, and social rehabilitation. Unlike secondary prevention, which aims to prevent disability, the objective of tertiary prevention is to maximize the remaining capabilities and functions of an already disabled patient. Goals of tertiary prevention include preventing pain and damage, halting progression and complications from disease, and restoring the health and functions of the individuals affected by disease.
A patient has severe anxiety about being in public places. Using the cognitive behavioral frame of reference, what would be the best intervention to incorporate with this patient?
B. Role play. Since the patient has severe anxiety, going on an actual trip to a public place might make the patient’s symptoms worse rather than better. Role playing provides the patient with a safe environment in which to work through her abnormal thoughts and gives the patient and the OT the opportunity to replace those thoughts with normal thoughts toward public places. The patient might be ready for a trip to a public place after several successful role playing sessions.
B. Role play. Since the patient has severe anxiety, going on an actual trip to a public place might make the patient’s symptoms worse rather than better. Role playing provides the patient with a safe environment in which to work through her abnormal thoughts and gives the patient and the OT the opportunity to replace those thoughts with normal thoughts toward public places. The patient might be ready for a trip to a public place after several successful role playing sessions.
An OT has been invited to consult at a newly established adult day care facility. What type of data would be the MOST valuable for this OT to initially gather, in this scenario?
C. Any health issues of patients, activity needs, and the overall occupational performance.
When consulting at a facility, an OT needs to identify the overall needs of the population.
C. Any health issues of patients, activity needs, and the overall occupational performance.
When consulting at a facility, an OT needs to identify the overall needs of the population.
An OT and OTA who both work in orthopedics at a skilled nursing facility receive notice that they are due to renew their state licenses. The clinicians calculate that they are each 2 PDUs short of the continuing education requirements, for their state. What continuing education activity could the clinicians complete to each gain 2 additional PDUs?
D. Watch a 2-hour video course on total hip replacement surgery and rehabilitation. Since the OT and OTA need 2 PDUs and 1 PDU equals 1 contact hour spent in structured learning, a 2-hour video course would meet the 2 PDU requirement. The video course must be in the clinicians’ area of practice and must be directly related to occupational therapy treatment. While the required facility in-services contain essential information, they are not directly related to occupational therapy treatment.
D. Watch a 2-hour video course on total hip replacement surgery and rehabilitation. Since the OT and OTA need 2 PDUs and 1 PDU equals 1 contact hour spent in structured learning, a 2-hour video course would meet the 2 PDU requirement. The video course must be in the clinicians’ area of practice and must be directly related to occupational therapy treatment. While the required facility in-services contain essential information, they are not directly related to occupational therapy treatment.
What is a screening in Occupational Therapy?
D. A quick, easy procedure used to determine if formal evaluation is necessary. OTs often use screenings to determine what standardized tests are needed to complete an evaluation, such as screening active range of motion prior to completing goniometer measurements or screening cognitive skills using the Allen Cognitive Levels screening tool.
D. A quick, easy procedure used to determine if formal evaluation is necessary. OTs often use screenings to determine what standardized tests are needed to complete an evaluation, such as screening active range of motion prior to completing goniometer measurements or screening cognitive skills using the Allen Cognitive Levels screening tool.
NBCOT® license renewal requires both the OTR® and COTA® to accrue at least 36 Professional Development Units (PDUs) during a 3-year renewal cycle. Once you have certified that you have completed the required number of units on your renewal form, how long do you need to keep a record of your course completion certificates and documentation of other activities you completed?
D. 4-years.
You do not need to send your course completion to the board. You will be required to certify that you completed the required number of units on your renewal form and list the activities on the back of the renewal form. You must maintain copies of course completion certificates and documentation of other activities completed for a period of four (4) years following the renewal period. The Board will conduct periodic random audits. Failure to complete continuing competency requirements or provide documentation during an audit can result in your license being placed on inactive status, a citation and fine, or other disciplinary action.
Module 1. https://passtheot.com/ceus-2/
D. 4-years.
You do not need to send your course completion to the board. You will be required to certify that you completed the required number of units on your renewal form and list the activities on the back of the renewal form. You must maintain copies of course completion certificates and documentation of other activities completed for a period of four (4) years following the renewal period. The Board will conduct periodic random audits. Failure to complete continuing competency requirements or provide documentation during an audit can result in your license being placed on inactive status, a citation and fine, or other disciplinary action.
Module 1. https://passtheot.com/ceus-2/
After evaluating a student using a standardized assessment, the OT determines that the student achieved a percentile score of 18. What does this percentile score indicate?
B. Out of 100 students, this student scored better than 18 of them and the student is therefore eligible for services.
In statistics, percentiles are used to understand and interpret data. The percentile score shows how the child scored in relation to the entire normative sample. In this scenario, the student did better than 18% of the sample that participated in this test, and it also means that 82% percent scored the same or higher than the student. Since this child’s score is on the left of the bell curve, this child would most likely be eligible for OT services.
B. Out of 100 students, this student scored better than 18 of them and the student is therefore eligible for services.
In statistics, percentiles are used to understand and interpret data. The percentile score shows how the child scored in relation to the entire normative sample. In this scenario, the student did better than 18% of the sample that participated in this test, and it also means that 82% percent scored the same or higher than the student. Since this child’s score is on the left of the bell curve, this child would most likely be eligible for OT services.
An OT has completed an initial evaluation with a patient who has a diagnosis of a right rotator cuff tear. The business office of the clinic informs the OT that the patient’s insurance company requires precertification for treatment of rotator cuff tears. What should the OT do?
C. Obtain a precertification form from the insurance company and fill it out. Insurance companies have specific procedures that providers must follow to obtain precertification for services. This usually includes completing a precertification form and submitting it to the insurance company along with any pertinent documentation.
C. Obtain a precertification form from the insurance company and fill it out. Insurance companies have specific procedures that providers must follow to obtain precertification for services. This usually includes completing a precertification form and submitting it to the insurance company along with any pertinent documentation.
What is a utilization review?
D. A review of occupational therapy services conducted by an insurance company.
The process by which an insurance company reviews occupational therapy services and either approves or denies payment for those services is called utilization review.
A utilization review (UR) is the process of making sure healthcare services are being used appropriately and efficiently, which is a key component of a value-based approach to paying for health care. 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 healthcare provider, and delivered in an appropriate setting. The process should result in high-quality care administered as economically as possible and in accordance with current evidence-based care guidelines. UR is done by health insurance companies, but also by hospitals, home health companies, and other types of healthcare providers. The government requires hospitals to have an effective utilization review program in order to participate in Medicare and Medicaid.
D. A review of occupational therapy services conducted by an insurance company.
The process by which an insurance company reviews occupational therapy services and either approves or denies payment for those services is called utilization review.
A utilization review (UR) is the process of making sure healthcare services are being used appropriately and efficiently, which is a key component of a value-based approach to paying for health care. 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 healthcare provider, and delivered in an appropriate setting. The process should result in high-quality care administered as economically as possible and in accordance with current evidence-based care guidelines. UR is done by health insurance companies, but also by hospitals, home health companies, and other types of healthcare providers. The government requires hospitals to have an effective utilization review program in order to participate in Medicare and Medicaid.
A home health OT is working with an elderly patient who presents with generalized weakness. The goal of OT intervention is to ensure the patient’s safety within the home so that she can continue to live independently. Today’s session is focusing on cooking and the patient has chosen to make a simple meal of pasta and bolognaise sauce. As the patient is about to lift the pot of cooked pasta from the stove, to drain the water in the sink, the OT places a hot pad on the counter and instructs the patient to slide the pot to the sink. What is the OT’s action an example of?
C. A compensatory strategy. The OT helped the woman to compensate for her upper body weakness by having the woman perform the task in a different way. Nothing in the environment was modified and no special equipment was used to make the change, so this action is considered a compensatory strategy.
C. A compensatory strategy. The OT helped the woman to compensate for her upper body weakness by having the woman perform the task in a different way. Nothing in the environment was modified and no special equipment was used to make the change, so this action is considered a compensatory strategy.
An OT wants to know if there is evidence to support the use of listening therapy with children who have autism spectrum disorder. What is the BEST resource to locate this evidence?
B. Occupational therapy research journals.
These journals will contain research studies that contribute to the evidence base for occupational therapy interventions, including listening therapy. An occupational therapy research journal would be the best source for the OT to use to look for evidence on the effectiveness of listening as an intervention for autism spectrum disorder.
B. Occupational therapy research journals.
These journals will contain research studies that contribute to the evidence base for occupational therapy interventions, including listening therapy. An occupational therapy research journal would be the best source for the OT to use to look for evidence on the effectiveness of listening as an intervention for autism spectrum disorder.
A Level II fieldwork student arrives at her fieldwork site and finds out that her assigned supervisor will not be able to supervise her placement due to being on maternity leave. What should the student do?
D. Contact the fieldwork placement coordinator at her school. The fieldwork coordinator will assist the student in locating an alternate supervisor or an alternate placement if needed.
D. Contact the fieldwork placement coordinator at her school. The fieldwork coordinator will assist the student in locating an alternate supervisor or an alternate placement if needed.
An OT starts a new job at a skilled nursing facility. She is introduced to the facility staff, including an OTA who works in the Recreational Therapy department, providing recreational therapy services. Is the OT responsible for supervising this OTA?
D. No, because the OTA is providing therapeutic recreation in the facility, not skilled occupational therapy services. OTAs must be supervised by OTS if they are providing skilled occupational therapy services. If an OTA is working in a capacity other than providing occupational therapy services, he or she does not need to be supervised by an OT.
D. No, because the OTA is providing therapeutic recreation in the facility, not skilled occupational therapy services. OTAs must be supervised by OTS if they are providing skilled occupational therapy services. If an OTA is working in a capacity other than providing occupational therapy services, he or she does not need to be supervised by an OT.
An OTR® who graduated a year ago, has recently been employed as a home health service provider. Part of this OTR®’s job description is to supervise an OTA® who has many years of experience. The OTR® and OTA® often work at different sites and have to rely on communicating regularly via telephone or video conference. How can the OTR® ensure that the OTA® receives appropriate supervision?
A. Meet with the OTA in person every 30 days, review and co-sign the OTA’s treatment notes weekly, and provide direct care to the OTA’s patients at a frequency consistent with facility, state, and insurance requirements.
Since the OTA has more than one year of experience, she requires general supervision from the OT and does not require daily on-site or weekly in person supervision. The OT must make sure that she meets with the OTA a minimum of once per month, regularly reviews and co-signs the OTA’s notes (weekly is the usual frequency), and treats the OTA’s patients herself at the frequency dictated by the facility, state regulations, and insurance requirements. This frequency can vary between settings, states, and third party payers, so the OT should be familiar with the requirements.
AOTA Definitions of Supervision:
– General supervision means at least monthly direct contact, with interim supervision available as needed by other methods, and applies only to occupational therapists with increased skill development and mastery of basic role functions or occupational therapy assistants, as appropriate, for the delivery of occupational therapy services.
– Minimal supervision means supervision provided on a less-than-monthly basis to occupational therapy assistant when performing non-clinical administrative responsibilities.
Guidelines for Supervision, Roles, and Responsibilities During the Delivery of Occupational Therapy Services [pdf file]. (2014).” American Journal of Occupational Therapy 58.6 (2004)
A. Meet with the OTA in person every 30 days, review and co-sign the OTA’s treatment notes weekly, and provide direct care to the OTA’s patients at a frequency consistent with facility, state, and insurance requirements.
Since the OTA has more than one year of experience, she requires general supervision from the OT and does not require daily on-site or weekly in person supervision. The OT must make sure that she meets with the OTA a minimum of once per month, regularly reviews and co-signs the OTA’s notes (weekly is the usual frequency), and treats the OTA’s patients herself at the frequency dictated by the facility, state regulations, and insurance requirements. This frequency can vary between settings, states, and third party payers, so the OT should be familiar with the requirements.
AOTA Definitions of Supervision:
– General supervision means at least monthly direct contact, with interim supervision available as needed by other methods, and applies only to occupational therapists with increased skill development and mastery of basic role functions or occupational therapy assistants, as appropriate, for the delivery of occupational therapy services.
– Minimal supervision means supervision provided on a less-than-monthly basis to occupational therapy assistant when performing non-clinical administrative responsibilities.
Guidelines for Supervision, Roles, and Responsibilities During the Delivery of Occupational Therapy Services [pdf file]. (2014).” American Journal of Occupational Therapy 58.6 (2004)
Using the Kawa model incorporates identifying each component of the river metaphor and how it might be impacting “flow”. Which metaphor specifically relates to a patient’s social and physical environments?
C. Walls and floor
The walls and floor of the river are the social and physical environment, and they impact the flow in the same way that the walls and floor of a real river impact its flow.
In this model, the river is a metaphor for life from birth to death, water is one’s energy or flow, rocks are negative circumstances in life that you must work around, driftwood is your personal assets and liabilities that can either assist you or get in your way depending on whether they clog up on the rocks or knock the rocks aside, and the walls and floor of the river are the social and physical environment and they impact the flow in the same way that the walls and floor o