Test 2 hospital settings

What are the three main teamwork models in the course?

Multidisciplinary; interdisciplinary; and transdisciplinary.

What is multidisciplinary teamwork?

Different professions work with the same client while largely retaining discipline-specific roles.

What is interdisciplinary teamwork?

Different professions collaborate closely around shared goals and integrated care.

What is transdisciplinary teamwork?

Team roles overlap and skills may be shared across traditional professional boundaries.

What supports effective teamwork?

Clear roles; communication; mutual respect; shared goals; collaboration; and appropriate leadership.

What can interfere with effective teamwork?

Poor communication; unclear roles; conflict; lack of respect; hierarchy; and inconsistent goals.

What is clinical reasoning?

The process of collecting; analysing; and using information to identify problems; goals; and treatment focus.

What is procedural reasoning?

Reasoning about assessment; intervention; procedures; and how to manage the client's performance problem.

What is diagnostic or scientific reasoning?

Reasoning used to understand what is occurring clinically and why.

What is interactive reasoning?

Reasoning focused on communication and the therapist-client relationship.

What is narrative reasoning?

Reasoning about the client's story; experiences; roles; and priorities.

What is pragmatic reasoning?

Reasoning about practical constraints such as time; resources; services; and discharge requirements.

What is ethical reasoning?

Reasoning about what should be done considering rights; safety; autonomy; and professional responsibilities.

What should you distinguish in clinical reasoning scenarios?

Facts from inferences or assumptions.

What four headings can help analyse a clinical scenario?

Facts; inferences or assumptions; questions; and sources of further information.

What is the purpose of an OT assessment in hospital?

Identify occupational performance strengths; difficulties; safety issues; and intervention or discharge needs.

What should an OT establish about performance before admission?

Usual routines; valued occupations; previous difficulties; supports; equipment; and premorbid function.

What should an OT assess during admission?

Current occupational performance; change from baseline; safety; limiting factors; and client or carer concerns.

What are three main types of OT assessment?

Initial interview; functional or observational assessment; and standardised assessment.

What is a functional assessment?

Observation of the client completing an actual everyday task.

Give examples of functional OT assessments.

Showering; dressing; toileting; kitchen tasks; transfers; and functional mobility.

What is a standardised assessment?

An assessment completed using a standard procedure so results can be consistently interpreted or compared.

What is a non-standardised assessment?

A flexible assessment structured by the therapist according to the client's needs.

Why do OTs assess self-care?

Describe status; monitor change; support decisions and communication; and evaluate outcomes.

What does SOAP stand for?

Subjective; Objective; Assessment; Plan.

What belongs under S in SOAP?

Information from the client's or family's perspective; what was said.

What belongs under O in SOAP?

Observable and measurable information from the session.

What belongs under A in SOAP?

Interpretation of performance and clinical reasoning about the problem.

What belongs under P in SOAP?

Recommendations; goals; further assessment; intervention; or next steps.

What colour ink does the course specify for clinical documentation?

Black ink.

How should an error be corrected in written clinical documentation?

Place one line through it; then sign and date the correction.

Should white-out be used in clinical documentation?

No.

What information must clinical documentation include?

Date of service; date of recording; signature; printed name; and position.

What does SMART stand for in this course?

Specific; Measurable; Achievable; Realistic; Timed.

What should OT goals focus on?

Client-centred functional or occupational outcomes.

What does ISBAR stand for?

Identify; Situation; Background; Assessment; Recommendation.

What is included under Identify in ISBAR?

Who you are; your role; and appropriate patient identifiers.

What is Situation in ISBAR?

What is currently happening with the patient.

What is Background in ISBAR?

Relevant clinical and contextual history.

What is Assessment in ISBAR?

Your interpretation of the main issue or problem.

What is Recommendation in ISBAR?

What you recommend happens next; who should act; and relevant risks.

What factors should be considered when assessing self-care?

Purpose; client needs and interests; meaning of task; condition; context; and assessment tool.

What are the adult education principles?

Need to know; self-direction; prior experience; readiness; life or problem-centred learning; and motivation.

What is primacy?

Presenting the most important information first because early information is remembered well.

What is repetition?

Repeating important information to improve retention.

What is simplification?

Using short; clear; plain instructions.

What is stressed importance?

Explicitly highlighting information the client particularly needs to remember.

What is explicit categorisation?

Grouping a large amount of information into meaningful categories.

What are specific statements?

Clear and concrete instructions rather than vague directions.

What is backward chaining?

Teaching the last task step first then progressively adding preceding steps.

What is reinforcement?

A consequence that increases the likelihood a behaviour will occur again.

What is shaping?

Reinforcing progressively closer approximations to a target behaviour.

What is cueing?

Using a prompt such as a verbal; visual; object; or environmental cue.

What is modelling?

Demonstrating a behaviour so the client can observe and imitate it.

Why is return demonstration important?

It allows the OT to confirm that the client can actually perform the skill safely.

What is transfer or generalisation?

Applying a learned skill or principle in another setting such as the client's home.

What are the medical or surgical options for hip fracture?

Internal fixation; hemiarthroplasty; or total hip replacement.

What is internal fixation for hip fracture?

Stabilising the fracture with devices such as pins; rods; plates; or screws.

What is hemiarthroplasty?

Replacement of the femoral head while the natural acetabulum remains.

What is a total hip replacement?

Replacement of the femoral and acetabular joint surfaces with prosthetic components.

What are the posterior THR precautions taught in this course?

No hip flexion beyond 90 degrees; no adduction past midline; and avoid hip rotation or twisting.

How long are THR precautions commonly followed in the course material?

Approximately 6 to 8 weeks as directed by the surgeon.

Why should a posterior THR client avoid pivoting on the operated leg?

Pivoting can rotate the hip and increase stress and dislocation risk.

How should a THR client turn instead of pivoting?

Step around while keeping the nose and feet pointing in the same direction.

How can THR affect lower-body dressing?

Hip precautions prevent bending to the feet and make pants; socks; and shoes difficult.

How can THR affect toileting?

Low toilet height and bending or twisting during hygiene and clothing management may breach precautions.

How can THR affect cooking?

Standing tolerance; bending; reaching; and carrying items with a walking aid may be difficult.

What dressing equipment may help after THR?

Reacher; dressing stick; sock aid; and long-handled shoehorn.

What bathroom equipment may help after THR?

Shower chair or stool; raised toilet seat; over-toilet frame; long-handled sponge; and bottom wiper.

What is grading?

Adjusting the demands of an occupation.

What types of demands can be graded?

Physical; cognitive; social; and emotional demands.

What does grading down mean?

Reducing occupational demands to make performance easier.

What does grading up mean?

Increasing occupational demands as performance capacity improves.

Why is grading used?

To establish or restore performance skills progressively.

What is adaptation?

Changing the person; occupation; or environment to enable occupational performance.

What is occupation as means?

Using occupation therapeutically to improve underlying capacities or skills.

What is occupation as end?

Successful engagement in the occupation itself is the therapeutic goal.

What is an MI?

A myocardial infarction is blockage of coronary blood supply causing inadequate blood flow to the myocardium.

How may MI be diagnosed according to the course proforma?

ECG; cardiac enzyme blood tests; history; examination; and cardiac catheterisation.

What medical or surgical management should you know for MI?

Medication to reduce thrombosis; angioplasty or stent; CABG; and cardiac rehabilitation.

What is CABG?

Coronary artery bypass graft surgery.

What is cardiac rehabilitation?

A program involving exercise; education; counselling; and support after cardiac illness.

How can MI affect occupational performance?

Reduced endurance; weakness; anxiety; symptoms with exertion; and temporary restrictions can affect everyday occupations.

What is the OT role after MI?

Grade occupations; monitor exertion; teach pacing; conserve energy; manage anxiety; and support return to roles.

What should be monitored during activity after MI?

Heart rate; shortness of breath; perceived exertion; and adverse symptoms.

What adverse symptoms should be monitored after MI?

Chest tightness; dizziness; palpitations; and angina.

What HR rule after MI is specifically taught for the exam?

Initially avoid increasing HR more than 20 bpm above rest or above 120 bpm; and aim for return toward baseline within 5 minutes.

What does MET stand for?

Metabolic Equivalent of Task.

What is 1 MET?

The energy expenditure associated with sitting quietly.

How are METs useful in OT?

They help estimate and compare energy demands of occupations.

What is the Borg scale used for?

Rating perceived exertion during activity.

What does the mMRC scale measure?

The impact or severity of breathlessness during activity.

What is COPD?

Permanent and progressive airflow obstruction that interferes with gas exchange and lung functional capacity.

What two major conditions are associated with COPD?

Chronic bronchitis and emphysema.

What are common COPD symptoms?

Dyspnoea; fatigue; chronic cough; sputum; chest tightness; and wheezing.

What medication categories are listed in the COPD quiz?

Bronchodilators; anti-inflammatory drugs; antihistamines; antibiotics; antileukotrienes; mucolytics; anticoagulants; and immunisations.

What is cardiopulmonary rehabilitation?

A program combining breathing; graded activity; exercise; education; and self-management strategies.

What breathing interventions may be included in COPD rehabilitation?

Breathing retraining; controlled coughing; airway clearance; and coordinating breathing with activity.

What functional strategies are used in COPD rehabilitation?

Graded activity; reconditioning; pacing; work simplification; and energy conservation.

What is the OT role in COPD?

Manage the occupational impact of dyspnoea; fatigue; reduced endurance; anxiety; and environmental demands.