COPY Arnheim's Principles of Athletic Training

CHAPTER 1 - THE ATHLETIC TRAINER AND THE SPORT MEDICINE TEAM

CHAPTER 1 - THE ATHLETIC TRAINER AND THE SPORT MEDICINE TEAM

When was NATA established?

- 1950

Performance domains of AT(6)

- prevention

- clinical evaluation and diagnosis

- immediate care

- treatment, rehabilitation, and reconditioning

- organization and administration

- professional responsibility

When was the NATA Education Council Founded

- 1997

- determined competencies that should be taught in accredited athletic training programs

Risk Management (5)

- Developing training and conditioning programs (or make recommendations to strength coach)

- Ensuring a safe playing environment (hazardous objects, weather conditions)

- Selecting, fitting, and maintaining protective equipment

- Explaining the importance of nutrition

- Using medications appropriately (proper administration, drug testing)

Clinical Evaluation and Diagnosis (4)

- Conducting physical examinations (PPEs, injury evaluation (on-field & off-field)

- Understanding the pathology of injury and illness

- Referring to medical care

- Referring to support services

Immediate Care of Injury and Illness

- Certified in CPR/First Aid, knowledgeable in emergency care procedures

Treatment, Rehabilitation, and Reconditioning (4)

- Designing a rehabilitation program

- Supervising rehabilitation programs

- Incorporating therapeutic modalities

- Offering psychosocial intervention

Organization and Administration (4)

- Record keeping

- Ordering equipment and supplies

- Supervising personnel

- Establishing policies for the operation of an athletic training program

Professional Responsibilities

- Stamina and ability to adapt empathy, sense of humor, communication, intellectual curiosity, ethical practice, professional memberships

CHAPTER 2 - HEALTH CARE ADMINISTRATION IN ATHLETIC TRAINING

CHAPTER 2 - HEALTH CARE ADMINISTRATION IN ATHLETIC TRAINING

Strategic planning

- involves critical self-examination to bring about organization improvement

Vision statement

- a concise statement that describes the ideal state to which an organization aspires

Mission statement

- a written expression of an organizations philosophy, purpose & characteristics

Accreditation

- formal recognition indicating a program meets certain prescribed quality standards

WOTS UP Ananlysis

- a data collection and appraisal technique designed to determine an organization's "weaknesses, opportunities, threats, and strengths underlying planning"

Operational planning

- defines organization activities in the short term, usually no longer than 2 years

Policies (2)

- expresses an organizations intended behavior relative to a specific program subfuction

- Not intended to answer detailed questions; intended as road maps (basic rules and principles)

Processes

- a collection of steps designed to direct the most important tasks of an organization

- EX: injury prevention, injury rehabilitation, injury recognition, organization & administration

Procedures (2)

- provides specific directions for members of an organization to follow

- procedure for discharge from rehabilitation

Practices

- the action that take place in response to administrative problems

PERT (program evaluation and review technique)

- a method of graphically depicting the time line for and interrelationships of different stages of a program

Gannt charts

- a graphic planning and control technique that maps discrete tasks on a calendar

Spending-ceiling model

- requires justification only for those expenses that exceed those of the previous budget cycle (also known as incremental model)

- often results in falling behind due to prices of supplies rising faster and inflation

Spending-reduction model

- financial crisis model; requires reallocation of institutional funds, resulting in reduced spending levels for some programs (should identify areas that could be cut w/o serious impact)

Zero-based Budgeting

- requires justification for every budget line item without reference to previous spending patterns; requires documentation of actual program needs and development of priorities (rank each item)

Fixed bugeting

- expenditures and revenues are projected on a monthly basis, thereby providing an estimate of cash flow; most appropriate for large, well-established sports medicine clinics during economic certainty

Variable budgeting

- requires adjustment of monthly expenditures so that they do not exceed revenues; rarely used by school-based programs (very difficult to estimate costs in advance)

Lump sum budgeting

- allocates a fixed amount of money for an entire program without specifying how the money will be spent; gives freedom to spend where it is needed most

Line item budgeting

- allocates a fixed amount of money for each subfunction of a program

Performance budgeting

- allocates funds for discrete activities; not commonly used due to expense and difficulty of analyzing specific activity costs

Expendable supplies/equipment

- cannot be reused (tape, bandages, hydrogen peroxide)

Nonexpendable supplies/equipment

- can be reused (compression wraps, scissors, neoprene sleeves)

Noncunsumable capital supplies/equipment

- usually not removed from athletic training facility (ice machine, tx table, modality unit)

Consumable capital supplies/equipment

- crutches, coolers, and kits

Request for quotation

- document that provides vendors with the specifications for the bidding on the sale of goods and services

Negotiations

- the process of bargaining (capital equipment, medium-priced annual rebuys, lower-cost consumable supplies)

Requisition

- formal or informal communication used for requesting authorization to purchase goods/services

Purchase order

- a document that formalizes the terms of purchase and transmits the intentions of the buyer to purchase goods or services from a vendor

Receiving

- process of accepting delivery of goods; should be immediately checked to make sure packing slip matches contents and to determine whether all goods specified in order were received; inspect for damage

Avoidance

- avoid a risky activity (especially when negative consequences of activity have high costs)

Transference

- activities associated with high financial risk but low frequency (catastrophic sports injury) or lower financial risk but high frequency (fractures, joint injuries requiring surgery)

Retention

- activities with an acceptable level of risk that are viewed as part of the cost of doing business

Reduction

- careful development, implementation, monitoring & evaluation of policies & procedures can reduce risks

Real-world observation

- making inferences regarding the risk of certain activities based on clinical practice and experience (can often lead to spurious conclusions)

Recruitment

- the process of planning for human resource needs and identifying potential candidates to meet those needs

Validity (in staff selection)

- criteria that predict how well a candidate will perform in a role

Reliability (in staff selection)

- consistency of staff selection procedures

Position description

- a formal document that describes the qualifications, work content, accountability, and scope of a job

Job description

- a written description of the specific responsibilities a position holder will be accountable for in an organization

Job specification

- a written description of the requirements or qualifications a person should have to fill a particular role in an organization

Clinical supervision

- the process of direct observation of an employee's work, with emphasis on measurement of specific behaviors, and the subsequent development of plans to remediate deficiencies in performance

Work sampling

- identifies the type of work that ATs do & the amount of time they spend doing it

Developmental supervision

- emphasizes collaboration between supervisors and supervisees to help them solve problems and develop professionally

Inspection production supervision

- emphasizes the use of formal authority and managerial prerogatives to improve employee efficiency and efficacy (focus on achieving goals & attainment of program mission)

Propriety

- standards intended to help ensure that process is legal and fair

Utility

- standards intended to ensure usefulness of appraisal to workers, employers, & others

Feasibility

- standards intended to help foster practicality in the evaluation process

Accuracy

- standards intended to improve the validity & reliability of the process

Ergonomics

- scientific study of human work

Standpipe drain

- drain raised above floor level; to prevent splashing

Mixing valve

- fixture designed to blend hot and cold water, eliminating need for separate controls

Foot-pedal activator

- for hand-washing stations

HIPAA (Health Insurance Portability and Accountability Act)

- (1996) helps employees transfer their health insurance when they switch employers, ensures that their health information will remain private ,and gives people more access to their own healthcare administration (created due to increased electronic transmission of records)

FERPA (Family Educational Rights & Privacy Act)

- 1974 federal law requiring student authorization to release educational records to a third party and ensuring access for students to their records (also called the Buckley Amendment)

Common Elements of the PPE (9)

1) Health history

2) Physician's Examination

3) Cardiovascular Screening

4) Maturity Assessment

5) Orthopedic Examination

6) Wellness Screening

7) Special Test

8) Sport Disqualification

9) Physical Fitness Testing

Health history

- past/existing medical problems; athletes should be reassured info is held in confidence

Cardiovascular Screening

- critical task of identifying life-threatening conditions (recognition of abnormal heart sounds and other signs of pathology)

Maturity Assessment

- commonly used methods include the circumpubertal (sexual maturity), skeletal & dental

Tanner Staging

- evaluates pubic hair/genitalia development in boys & pubic hair/breast development in girls. Other indicators include facial and axillary hair

- stage 1: puberty not evident; stage 5: full development

- Crucial stage = 3 (fastest bone growth - growth plates are 2-5x weaker than the joint capsule and tendon attachments)

Orthopedic Examination (5)

- ROM, joint stability, leg length, previous injury history, postural observation

Wellness Screening

- evaluate healthy lifestyle behaviors (drug use, eating/exercise habits, stress control, safety)

Special tests

- common: urinalysis (detect protein or sugar), Snellen eye chart

Sport Disqualification

- the individual athlete is the only person who can make the final decision

Physical Fitness Testing

- establish baseline for athlete's fitness (should be last element completed)

Problem-oriented medical record (POMR)

- organizes information around a patient's specific complaint

Cover sheet

- patient's past history, any personal habits, and a list of patient problems with a brief description of the plans implemented to ameliorate those problems

SOAP note

- organized by subjective and objective evaluation, assessment of the patient's problem, and development of a plan for treatment

Focus charting

- medical record that registers a patient's complaint date, the health care practitioner's actions, and the patient's response

Charting by exception

- type of medical record that notes only those patient responses that vary from predefined norms (makes record keeping more efficient and less time consuming, inappropriate for recording initial injury evaluation, has many potential uses for recording treatments and rehab; requires strict treatment protocols)

Computerized documentation

- difficult to maintain confidentiality (harder to safeguard digitally stored data)

Narrative charting

- method of recording the details of a patient's assessments and treatments using a detailed, prose-based format

Dictation

- act of orally recording (cassette tape or directly onto computer) the details of a healthcare assessment or treatment for later transcription and filing

Annual Reports

- Serves as a means for making program changes and improvements

- Commonly includes: # of athletes served, survey of the number & types of injuries, analysis of program, and recommendations for future improvements

Accident

- an unplanned event capable of resulting in loss of time, property damage, injury, disablement, or death

Injury

- damage to the body that restricts activity or causes disability to such an extent that the athlete is not able to practice or compete the next day

CHAPTER 3 - LEGAL CONCERNS AND INSURANCE ISSUES

CHAPTER 3 - LEGAL CONCERNS AND INSURANCE ISSUES

Liability

- the state of being legally responsible for the harm one causes another person

Malpractice

- liability-generating conduct associated with the adverse outcome of patient treatment

Liability may be based on:

- Negligent patient care

- Failure to obtain informed consent

- Intentional conduct

- Breach of a contract

- Use/transfer of a defective product

- Abnormally dangerous treatment

Negligence

- failure to act as a reasonably prudent athletic trainer would act under the circumstances

Standard of reasonable care

- assumes that an individual is neither exceptionally skillful nor extraordinarily cautious, but is a person of reasonable and ordinary prudence

Tort

- a legal wrong, other than breach of contract, for which a remedy will be provided, usually in the form of monetary damages

3 types of tort

- intentional tort

- negligence tort

- strict liability tort

Nonfeasance (act of omission)

- when an individual fails to perform a legal duty

Malfeasance (act of commission)

- when an individual commits an act that is not legally his to perform

Misfeasance

- when an individual improperly does something they have the legal right to do

Sovereign immunity

- states that neither the government nor any individual who is employed by the government can be held liable for negligence

Good Samaritan law

- provides limited protection against legal liability to any person who voluntarily chooses to provide first aid

- not able to to be used by AT in work setting

To prove negligence, plaintiff must prove that the defendant is guilty of 5 components:

1. conduct

- must prove that AT did something that links him to case (either by omission or commission)

2. existence of duty

- duty to provide services to athletes actively engaged in the institution's athletic programs

3. breach of duty

- Must show the athletic trainer breached a duty owed to patient

4. Causation

- Plaintiff must prove that the breach was the legal cause of the injury (or made injury worse)

5. Damage

- An actual adverse outcome exists