Physical Dysfunction OTA

What is a payer to a health care provider?

The organization that negotiates or sets rates for provider services, collects revenue, processes provider claims, and pays provider claims.

What are major public payor sources?

Medicare, Medicaid, Children's Insurance Program (CHIP), Veteran's Administration.

What is the major payment source in the U.S.?

The Centers for Medicare and Medicaid Services.

What does Part A of Medicare cover?

Hospital Insurance.

What does Part B of Medicare cover?

Covers 80% of all medical costs not covered by Part A.

What is Part C of Medicare?

Medicare Advantage, offered by private insurers and approved by Medicare, often providing extra benefits.

What is Part D of Medicare?

Prescription Drug Coverage, which is optional and requires payment from recipients.

What is TRICARE?

A health insurance program for members of the U.S. Military, covering service members, families, and retirees.

What is CHAMPVA?

The Civilian Health and Medical Program of the Department of Veteran's Affairs, sharing costs of covered health services with eligible beneficiaries.

What are Health Maintenance Organization (HMO plans?

Insurance plans that restrict patients to a network of physicians and require referrals to specialists.

What are PPO plans?

Preferred Provider Organization plans that contract with medical providers to create a network, offering lower payments for in-network services.

What is a POS plan?

A plan that requires referrals from a primary care doctor to see specialists and offers lower costs for using in-network providers.

What is the 3-Day Medicare Rule?

Patients must have a medically necessary 3-day consecutive inpatient hospital stay before qualifying for Skilled Nursing Facility coverage.

What is medical necessity according to Medicare?

Health-care services or supplies needed to prevent, diagnose, or treat an illness, injury, condition, or disease.

What is evidence-based practice?

An approach to care that encourages clinicians to use the best available evidence applied to individual patient circumstances.

What is the gold standard of research?

The Randomized Controlled Trial (RCT), designed to eliminate bias and errors in scientific research.

What is peer review?

The process where recognized researchers evaluate a paper for publication, indicating quality scholarship.

What is the difference between CPT codes and ICD-10 codes?

CPT codes are used for billing purposes; ICD-10 codes are used for diagnosing conditions.

What is the 8-minute rule in Medicare?

For time-based codes, direct treatment must be provided for at least eight minutes to receive reimbursement.

What determines reimbursement in Inpatient Rehabilitation Facilities (IRF)?

The initial evaluation using the Inpatient Rehab Facility-Patient Assessment Instrument (IRF-PAI).

What is the Patient-Driven Payment Model (PDPM)?

A model that determines reimbursement in subacute rehabilitation, simplifying previous reimbursement methods.

How is reimbursement determined in long-term care?

Through Medicare Part B, based on services provided and time spent, using CPT codes.

What is the initial evaluation in Home Health?

The OASIS: Outcome and Assessment Information Set, completed by healthcare professionals.

What is the reimbursement method for outpatient services?

Fee-for-service based on services provided through CPT codes.

What should be included in documentation for Medicare reimbursement?

Clear evidence-based documentation showing interventions are working and that the provider is skilled.

What is the importance of advocating for your profession?

To demonstrate worth, maintain high standards of care, and promote occupational therapy practice.

What is the purpose of documentation in OT?

To communicate skilled client care and ensure services are reimbursable.

What does EHR stand for?

Electronic Health Record

What framework does the ICF represent?

International Classification of Functioning, Disability, and Health.

What does the ICF classify and measure?

Disability and health from the perspectives of physical health and functional abilities.

What is the importance of the OTPF-4th edition in OT?

It provides professional terminology and guidance for documenting the OT process.

What are the key areas to document in OT?

ADLs, IADLs, Work, Leisure, Play, Education, Social Participation, and Rest and Sleep.

What is the purpose of an Initial Evaluation Report?

To determine if OT is appropriate and to outline interventions and assessments.

What is documented in Contact Notes?

Interventions and contact with the client, often using the SOAP note format.

What do Progress Reports include?

Records of the client's progress toward goals and any changes in the intervention plan.

What is the purpose of Reevaluation Reports?

To modify the intervention plan based on the client's needs and changes in status.

What is documented in a Transition Plan?

The plan for a client transferring from one service setting to another.

What is included in Discontinuation Reports?

A summary of changes in the client's ability at the end of intervention.

What is the content of an intake note?

Acknowledgment of physician referral and the plan to evaluate.

What does the SOAP note format stand for?

Subjective, Objective, Assessment, Plan.

What does the Subjective section of a SOAP note include?

Interview material, background information, and occupational profile.

What is documented in the Objective section of a SOAP note?

Tests, results, and clinical observations.

What is the Assessment section of a SOAP note?

The OT's professional assessment of the data presented in the Subjective and Objective sections.

What should the Plan section of a SOAP note include?

Frequency and duration of planned interventions and long and short term goals.

What is the role of the OTA in the intervention plan?

To think creatively and independently to select appropriate methods and techniques.

What is a good OT activity designed to achieve?

Working on several goals at once.

What should be considered when choosing activities for intervention?

should be appropriate, realistic, and meaningful to achieve goals efficiently.

What is an occupational profile?

An occupational profile is a comprehensive understanding of a client's occupational history, daily life tasks, interests, and values, established by the OT/OTA.

How is an occupational profile obtained?

Information is collected through formal and informal conversations, interviews, and both primary and secondary sources throughout the OT process.

What are the components included in an occupational profile?

Occupational history, daily life tasks (roles, routines), interests, and values.

What is the purpose of an occupational profile?

To facilitate goal setting, meaningful activities, individualized treatment planning, and to identify discrepancies.

What is the Canadian Occupational Performance Measure (COPM)?

A tool that addresses self-care, productivity, and leisure, focusing on performance abilities and satisfaction.

What is motivational interviewing in occupational therapy?

A technique that focuses on the client's narrative and self-efficacy to enhance motivation.

What are the components of activity analysis?

Occupational demands (who, what, where, when, how), context and environment, and performance skills.

What are the types of performance skills observed by OT practitioners?

Motor skills, process skills, and social interaction skills.

What does grading an activity involve?

Adjusting the demands of the task or altering the environment to enhance occupational performance.

What does adapting an activity mean?

Finding an alternative way to perform a task or modifying/substituting objects used.

What are the activity demands to consider?

The what (objects & properties), who (participants), where (physical space), and how/when (sequential steps).

What is the significance of cultural awareness in occupational therapy?

It involves respecting differences and preferences, and ensuring cultural sensitivity in treatment.

What are the levels of assistance in occupational therapy?

Levels of assistance refer to the amount of help a client needs to perform an activity, such as total assistance or minimal assistance.

What is the relationship among body structures, body functions, and performance skills?

Body structures and functions influence the development and execution of performance skills in occupational tasks.

What are the three types of performance skills identified in occupational therapy?

Motor skills, process skills, and social interaction skills.

How can the COPM contribute to intervention planning?

By identifying areas of concern in self-care, productivity, and leisure, and assessing client satisfaction with performance.

What is the role of self-assessment activities in occupational therapy?

They help clients reflect on their occupations, distinguishing between those they choose to do and those they must do.

What is the importance of individualized treatment planning?

It ensures that therapy is tailored to the unique needs, preferences, and goals of each client.

What is the significance of analyzing occupational performance?

It helps identify the client's abilities and challenges in completing daily activities, guiding effective intervention.

What does the term 'activity demands' refer to?

The specific requirements and considerations involved in performing an activity, including objects, participants, and environment.

What is the focus of the self-assessment activities in the context of occupational therapy?

To encourage clients to review their occupations and understand their motivations and needs.

What does PPE stand for?

Personal Protective Equipment

What are the types of precautions that determine the type of PPE used?

Standard and contact, droplet, or airborne infection isolation precautions.

What is the first step in putting on PPE?

Put on the gown, covering the torso from neck to knees and wrapping around the back.

How should the gown be fastened?

Fasten in the back of the neck and waist.

What is the correct way to secure a mask or respirator?

Secure ties or elastic bands at the middle of the head and neck, and fit the flexible band to the nose bridge.

What should you do to ensure a respirator fits properly?

Fit-check the respirator.

How should goggles or a face shield be adjusted?

Place over face and eyes and adjust to fit.

What is the last piece of PPE to put on?

Gloves, which should extend to cover the wrist of the isolation gown.

What is a safe work practice to protect yourself while wearing PPE?

Keep hands away from face and limit surfaces touched.

When should gloves be changed?

When they are torn or heavily contaminated.

What should you do if your hands become contaminated during glove removal?

Immediately wash your hands or use an alcohol-based hand sanitizer.

What is the first step in safely removing PPE?

Remove gloves, as the outside of gloves are contaminated.

How should goggles or face shields be removed?

Remove from the back by lifting the headband or ear pieces.

What should be done with a contaminated gown?

Unfasten the gown ties, pull it away from the body, turn it inside out, and discard in a waste container.

What is the proper way to remove a mask or respirator?

Grasp the bottom ties or elastics first, then the top ones, and remove without touching the front.

What should you do immediately after removing all PPE?

Wash hands or use an alcohol-based hand sanitizer.

What should be done if hands become contaminated during any step of PPE removal?

Perform hand hygiene immediately.

What is the sequence for removing PPE?

1. Gloves, 2. Goggles or face shield, 3. Gown, 4. Mask or respirator.

Why is it important to remove PPE in a specific sequence?

To avoid contaminating your clothing, skin, or mucous membranes with infectious materials.

What should be done with reusable goggles or face shields after removal?

Place in a designated receptacle for reprocessing.

What is the risk associated with touching the front of a mask or respirator?

The front is contaminated, and touching it can lead to infection.

What should you do with discarded PPE?

Place it in a waste container.

Why is infection control important?

It decreases the incidence of Hospital Acquired Infections, decreases length of stay, improves patient outcomes, and keeps healthcare workers safe.

What are examples of Hospital Acquired Infections?

Catheter-associated urinary tract infections, surgical site infections, bloodstream infections, pneumonia, and Clostridium difficile.

What are the modes of infection spread?

Contact, droplet, and airborne.

What role does handwashing play in infection control?

It is essential for preventing the spread of infections and should be performed regularly.

What is the average adherence rate of healthcare workers to handwashing protocols?

On average, healthcare workers adhere to handwashing protocol 40% of the time.

When should soap be used instead of hand sanitizer?

Use soap after doffing gloves, after contact with body fluids, and under certain isolation protocols.

What personal protective equipment (PPE) is commonly used?

Gown, gloves, mask, and goggles, depending on the type of isolation.

What precautions are taken for contact precautions?

Wear gown and gloves when touching the patient or items the patient has touched, clean equipment, and bag laundry in the room.

What are droplet precautions for infections like flu and pertussis?

Use contact precautions plus a surgical mask.

What are airborne precautions for infections like TB and COVID-19?

Use contact precautions plus a negative pressure room, respirator, and have the patient wear a mask outside the room.