Non Systems 1 Lecture

HIPAA

patients right to continuity in healthcare

privacyy and security of healthcare records

patient condfientiality is maintained in all oral, written and electric forms

written consent from pateint before disclosing information about personal health

reduce physical identification of the patient

patient’s right to access all their medical records

altruism

therapist shall adhere to core values of the profession and act in the best interest of the patient’s over therapists interests

ex) extend work hours to accomodate patient who arrived late

autonomy

therapist shall provide all necessary information to allow patients to make informed decision about care

professional judgement

therapist shall be accountable for making sound professional judgement

non maleficence

obligation of the therapist not to harm the patient

it also known as the “do no harm” principle

ex) screening for contraindications or risks that may make treatment harmful

a patient’s daughter who works in the same hospital on a different floor as a nuse, visits him in the hospital. She asks to access her father’s medical records. what is the MOST APPROPRIATE regarding healthcare record access?

a. she cannot see the chart because she could misinterpret information

b. she can visit her father and access his chart records as she could provide insight as a nurse

c. she must have the permission of her father before accessing the chart

d. she must have permission of the physician before she can access the chart

c. she must have the permission of her father before accessing the chart

the patient refuses PT treatment within the hospital. following patient education from the therapist, the patient continues to deny PT. which is the MOST APPROPRIATE response of the therapist?

a. call the patient’s daughter and ask her to speak with him about cooperating with PT as with his condition it is neccessary

b. respect decision not to utilize PT services today

c. start treatment as patient will most likely cooperate once he is sat upright and PT is neccessary for him to be discharged

d. discharge d/t non cooperation

b. respect decision not to utilize PT services today

during treatment the patient makes an inappropriate statement to the therapist about their body. the therapist ignores the comment but the patient persists making the therapist uncomfortable. what is the most appropriate response?

a. refuse to treat and refer to another therapist

b. ignore the flirty and continue treating

c. inform patient you will notify his wife if behavior continues

d. report to doctor and HR and continue to treat patient

a. refuse to treat and refer to another therapist

a patient is being treated in clinic following a femur fx. the POC states “gait training, NWB on the L LE” the PTA works with the patient and notices patient is ambulating safely with good stability and progress patient to PWB status. which of the following is most appropriate regarding situation?

a. the PT will be responsible for any injury sustained

b. the PTA will be responsible for any injury sustained

c. the PTA appropriately progressed the patient and cannot be at fault if injury is sustained

d. the PTA must update POC to PWB

b. the PTA will be responsible for any injury sustained

utilization

the PT is directly response for actions of PTA related to patient/client management

PTA may perform selected PT interventions under direction and general superivison of PT

a patient is getting treated for pelvic pain and accompanied by their spouse to the PT session. during treatment the patient expressed marital life and shared how they plan to end their life. what is the BEST action for this PT?

a. ask patient to seek appoinment with PCP

b. disagree with patient and say positive things about living life

c. call 911 and stay there until emergency medical techs arrive

d. inform the patient’s spouse that this problem is outside scope of PT practice

c. call 911 and stay there until emergency medical techs arrive

Joint commission on accreditation of healthcare organization (JACHO)

accredits hospitals, SNF, home health agencies, PPO, HMO, mental health institutions

commissions of accreditation rehab facilities (CARF)

accredits free standing rehab programs/facilities

center for medicare and medicaid services (CMS)

determines what and how much will be reimbursed by medicare for patient care

occupational safety and health administration (OSHA)

responsible for determining safety of the work environment

OSHA is responsible for which of the following?

a. determining how much compensation therapist should get yearly

b. ensuring minimum standards are met as hospital to maintain accreditation and prevent negligence in patient care

c. ensuring minimum stands met in clinics to maintain accreditation and safety of patients

d. ensuring adequate steps are taken to prevent exposure to harmful radiation to employees at Xray center

d. ensuring adequate steps are taken to prevent exposure to harmful radiation to employees at Xray center

a clinician is treating a patient with tuberculosis. which of the following options BEST describes the appropriate precautions and type of PPE that should be used?

a. airborne, N95 respiratory

b. droplet, surgical mask

c. airborne, surgical mask

d. droplet, N95 respiratory

a. airborne, N95 respiratory

D' “on” ning PPE

gown

mask

googles

gloves

D “off” ing

gloves

goggles

gown

mask

D “off”ing trick

alphabetical order

contact clinican syndromes

MRSA, VISA, VRE, C-dif, lice, scabies, gram - bacteria, uncontrolled diarrhea, hep A, hep B, dermatitis, rota virus

contact hand hygeine

hand wash before and after being in room

contact PPE

gloves and gown when in direct contact with patient or items in room

remove BEFORE leaving room

contact room type

private or cohort with patient with same infection

contact patient transport

minimize

pt washes hands if leaving room

droplet clinical synrdomes

rubella, strept, neisseria meningitis, pneumonia, influenza, pertussis

droplet hand hygeige

hand wash when entering and leaving room

droplet PPE

mask when working within 3 ft of patient

contact precautions only if skin lesions present

droplet room type

private room

WITHOUT negative airflow

droplet patient transport

minimize

patient in surgical mask when leaving room following cough etiquettes

airborne clinical syndromes

measles, tuberculosis, varicella, SARs, disseminated herpes zoster, chickenpox, smallpox

airborne hand hygeine

hand wash entering and leaving room

airborne PPE

N95 mask

gown and gloves if servere contamination

discard mask before leaving room

airborne room type

private with

WITH negative air flow

door remains closed

airborne patient transport

minimize

patient in surgical mask when leaving and following cough etiquettes

abuse

infliction of physical or mental injury or the deprivation of food, shelter, clothing or services needed to maintain physical or mental health

sexual abuse

sexual assult, sexual intervourse without consent, indecent exposure, deviate sexual conduct, or incest adult using a child for sexual gratification without physical contact is considered sexual abuse

physical abuse

physical injury results in pain, impairment or bodily injury of any bodily organ or function, permanent or temporary disfigurement or death

emotional abuse

anguish inflicted through threats, intimidation, humiliation isolation, embaressing, blaming or rejecting behaviors from adult towards child, withholding love affection and approval

mental abuse

impairments of person’s wellbeing, intellecutal or physiological functioning

an elderly person arrives to the clinic with hand size brusiing at the wrists and underneath their sleeves and clothing. the patient demeanor is quiet, withdrawn, and they avoid questions regarding bruises. which of the following is the most appropriate for treating therapist to take?

a. administer massage for bruising, TENs, and ice modalities for pain as indicated by examination findings

b. inquire caregiver about origin of bruising when they pick up patient from clinic

c. wait to report findings until reasonable suspicion can be confirmed

d. presentation of physical findings and demeanor is sufficient to report to appropriate athorities

d. presentation of physical findings and demeanor is sufficient to report to appropriate athorities

telehealth guidelines

responsiblity for and appropriate use of technology

verification of identity

informed consent

licensure

supervision

standards of care

privacy and security

tech guidelines

emergency/safety procedures

a PT located in NY conducts telehealth sessions with patient located in same state. the patient is moving to florida in a week and enquires if she can continue telehealth services. which of the following is the most appropriate to ensure compliance with licensure requirements?

a. continue to provide telehealth services under NY license

b. discontinue until a FL license is acquired and refer patient to a FL licensed PT

c. continue telehealth services as cash based visits

d. delay further telehealth services until confirming FL does not require separate license for telehealth

b. discontinue until a FL license is acquired and refer patient to a FL licensed PT

Ergonomic Guidelines

monitor 18-28 in away

monitor screen slightly below eye level

elbows bent 90 degrees wrist in neutral and free while typing

use a mouse that contours hand

thighs horizontal and feet flat on floor

space under desk: 30 in W, 19 in D, 25-34 H (2-3 in between top of thighs and desk)

a safety workshop is being conducted for warehouse employees. the therapist observes a worker repeatedly lifitng boxes from the floor to shoulder height. which of the following insutrction would be the most appropriate to reduce risk of low back injury during lifting?

a. keep the knees straight and bend at waist to reduce lumbar strain

b. hold load away from body to maintain clear visiblity of feet

c. use a wide BOS and lift with the legs while keeping the spine neutral

d. lift slowly and avoid pivoting at feet to maintain stable spine

c. use a wide BOS and lift with the legs while keeping the spine neutral

lifting guidelines

always attempt to increase base of support

maintain proper lumbar curve while lifting

pivot your feet while lifting, do not twist back

maintain slow and consistent speed