PTA 120 Prep for patient care

Generally, Who should you speak to about care

Speak directly to the patient—not only to the caregiver or interpreter

What kind of language should you use during patient care

respectful, understandable and avoid unnecessary jargon

What should you consider during patient care

hearing, vision, cognition, language, health literacy, culture, age, and environment

What should you do before providing assistance during patient care

Ask before; do not assume what a person with a disability needs

What do you use in patient care

visual, tactile, written, or demonstration-based cues when appropriate

What should you confirm during patient care

understanding instead of assuming that “yes” means the patient understood

How should you explain something during patient care

the purpose of the activity in language the patient understands

What should you do first during patient care

Demonstrate when appropriate, then supervise return demonstration

What should you include during patient care

precautions, safety instructions, equipment use, frequency, and duration as appropriate

What do you adapt to the patient’s needs

written instructions; use pictures or diagrams when helpful.

What should you determine during patient care

what assistance and environment are available outside therapy

What should you document from patient care

education provided and the patient/caregiver response.

prevention practices.

Perform hand hygiene and follow required infection

When should you prepare the treatment area

before the patient arrives

What should you do to the floors and pathways

clear and dry.

What should you do to the equipment used for patient care

Secure as appropriate

What should you do appropriately during patient care

guarding, assistance, and body mechanics.

What do you do to the patient during patient care

Attend to the patient throughout the activity—do not “set them up and walk away.”

What do you do to the equipment before use for patient care

Check equipment

what do you remove from service for patient care

unsafe equipment from service.

what are the 7 safety checks before you begin in patient care

Is this the correct patient, Do I know the precautions?, Is the patient appropriate to proceed?, Is the environment ready?, Is the equipment safe and positioned correctly?, Do I need another person to assist?, What will make me STOP and reassess?

What does Joint Commission state

no new requirements were introduced

A health-care POA generally becomes the decision-maker when

the patient cannot make or communicate health-care decisions, according to the document and applicable policy/law.

When a surrogate is acting for the patient, what should you do

Include the surrogate in explanations and consent/refusal discussions that are within the PTA’s role, while continuing to involve the patient as much as possible.

The presence of a POA does not mean you stop talking to who

the patient

how is patient safety evaluated

through systems, processes, behaviors, and outcomes.

What shows up in everyday PTA care

Correct patient identification, infection prevention, communication, environment, pain, and patient rights

Safety concerns should be what

recognized, communicated, and documented

Quality improvement depends on what

measurable information, which makes accurate PTA data collection important.

what should you do before patient care

Review chart & POC, Check precautions, prepare environment, Identify & explain

what should you do during patient care

Guard & monitor, communicate clearly, collect objective data, Recognize change

what should you do after patient care

Reassess response, Secure patient/environment, Report concerns, Document accurately

If your measurement is wrong, what should you check

landmarks, position, stabilization, substitution, alignment, reading

Look straight at the goniometer when reading it — avoid viewing from where

the scale from an angle

If in a sagittal plane what is the axis

Frontal / medial-lateral

if in a Sagittal plane what is the common motion

flexion, extension

If in a Frontal plane what is the axis

Sagittal / anterior-posterior

if in a frontal plane what is the common motion

Abduction • Adduction

if in a transverse plane what is the axis

Vertical / superior-inferior

if in a transverse plane what is the common motion

Internal • External rotation

Motion occurs in a plane and around what

perpendicular axis

End feel

The quality of resistance felt at the end of the available range

soft end feel

Soft-tissue approximation

example of soft end feel

knee flexion

firm end feel

Muscle, ligament, or capsule tension

example of firm end feel

Hamstring SLR • forearm supination

hard end feel

Bone on bone

hard end feel example

Elbow extension

Empty end feel

Pain prevents reaching end range

Example of empty end feel

Abnormal

End feel is what

subjective

When does end feel develop

with practice

To maximize reliability, keep these as consistent as possible

Goniometer, Patient positioning, Measurement procedure, Examiner

Small differences may reflect what

measurement error rather than true change

At minimum, your documentation should make the measurement

reproducible

Abnormal End Feels: • Firm or spasm occurs where

abnormal point in ROM; may reflect increased tone or muscle/ligament shortening

Abnormal End Feels: Hard

occurs where soft or firm is expected; examples: osteophytes, myositis ossificans, fracture

Abnormal End feels: Empty

pain prevents reaching a true end feel

Abnormal End feels: Soft occurs where

firm or hard is expected; examples: edema or synovitis

Anatomical position is the starting reference for

most motions

UE and LE flexion/extension and abduction/adduction are what degrees in anatomical postion

0

For IR/ERm what is the degrees for the midpoint in starting position

0

Extension is return from what

flexion and may continue beyond zero; greater-than-normal extension is hyperextension

• If AROM is full and pain-free what might not be neccessary

PROM

• If AROM is limited or painful what is indicated

further testing

Limited AROM with normal PROM suggests what

a contractile deficit; limited PROM may indicate ligamentous/capsular restriction

Sagittal plane + frontal (medial-lateral) axis =

flexion/extension

Frontal plane + sagittal (anterior-posterior) axis =

abduction/adduction

Transverse plane + vertical axis =

= internal/external rotation

• Intratester measurement error:

approximately 4–5°

Intertester measurement error:

approximately 6°

Original course material uses at least what degree difference as clincically significant

6

Maximize reliability with the

same goniometer, positioning, procedure, and examiner when possible