PTP, PTP - Midterm

APTA Mission Statement

"further the profession's role in the prevention, diagnosis and treatment of movement dysfunctions and enhancement of physical and functional abilities of the members of the public"

APTA Vision Statement

"transforming society by optimizing movement to improve the human experience"

House of delegates

number of state representatives based upon number of members,

annual meeting (June)

elects Board of Directors

FPTA

Assembly of Representatives rather than HOD

Regional districts - 6 districts in Florida

PT as a profession : Profession

Distinct body of advanced knowledge

Specialized study at higher education institution

Self Regulating

Intellectual and varied work

Requires constant use of discretion and judgement

PT as a profession : Professionalism

-Skill, competence, character of a member of a highly trained profession

-Ability to exhibit appropriate professional conduct and represent the profession respectively

Guide of profession

-Individual - personal values/beliefs/culture/religion

-Organization - code of ethics/core values/standards to practice/APTA policies/generic abilities

-Societal - practice laws and regulations

APTA Core Values

Accountability

Altruism

Compassion

Excellence

Integrity

Professional duty

Social responsibility

APTA Core Values: accountability

active acceptance of responsibility of roles, observations, actions, including self regulation

APTA Core Values: altruism

devotion to patiens/clients

fiduciary responsibility to patients over self

taking care of patients

APTA Core Values: compassion

desire to identify with patient's experience, concern and empathy

APTA Core Values: excellence

consistently use current knowledge and theory

embrace advancement

challenge mediocrity

APTA Core Values: integrity

adherence to high ethical principles and professional standards

-abiding by rules and regulations

APTA Core Value: Professional duty

commitment to serve obligations to patients, profession, and society

APTA Core Value: Social duty

promotion of mutual trust between profession and public that necessitates responding to societal needs for health and wellness

Purpose of APTA Code of Ethics

-defines ethical principles that form the foundation of PT

-provides standards to behavior and performance

-provides guidance during ethical challenges

-educate

-establish standards of ethical and unethical conduct

APTA Code of Ethics #1

respect dignity and rights of all individuals

APTA Code of Ethics #2

be trustworthy and compassionate in addressing the rights and needs of patient/clients

APTA Code of Ethics #3

be accountable for making sound professional judgements

APTA Code of Ethics #4

demonstrate integrity in their relationships with patients, families, colleagues, students, research participants, other health care providers, employers, payers, public

APTA Code of Ethics #5

fulfill their legal and professional obligations

APTA Code of Ethics #6

embrace their expertise through life long acquisition and refinement of knowledge, skills, abilities and professional behavior

APTA Code of Ethics #7

promote organizational behaviors and business practices that benefit the patients and society

APTA Code of Ethics #8

participate in efforts to meet the health needs of people locally, nationally and globally

Florida Statues

Chapter 486

Practice Act

written by legislatures

Floridas Administrative Code

Chapter 64B17

written by Board of Physical Therapy

Subjective

-proceeding / taking place in a person's mind rather than external environment

-influenced by opinion

-info collected by patient/caregiver

Objective

-undistorted by emotion or bias

-based on observation

-data from tests

-observations made by PT

Assessment

-critical analysis and evaluation of judgement of status or quality of a particular condition/situation

-analysis of S&O

- diagnosis, goals, change in condition, progress

Plan

-specific treatment plan for identified problem

-frequency, duration, interventions, precautions

ACCE

Academic Coordinator of Clinical Education - faculty member who place students in internships and monitor performance

CEA

Clinical Education Associate - staff members who assist the ACCEWs with placements and monitor students compliance with CE requirements such as immunization records, HIPPA, and OSHA training, etc

CCCE

Clinical Coordinator of Clinical Education - employee of clinical site who organizes clinical placements for that facility

CI

Clinical Instructor - licensed PT at clinic site who supervises and teach

CPI

Clinical Performance Instrument - web-based instrument developed by APTA used to assess students performance during internships

Wilhelmine Write

trained in new procedure MMT

Two historical events at general timeframe formed PT career

Infantile Paralysis (Polio) and WWI

WWI Reconstruction Aids

Special Hospitals and Physical Reconstruction from US Surgeon general

Mary McMillan

First US Reconstruction Aide at Walter Reed General Hospital

APTA Vision Statement

"Transforming society by optimizing movement to improve the human experience"

APTA is governed by

House of Delegates (HOD) who create policies for professional association and elects Board of Directors

Profession

Distinct body of advanced knowledge; customarily acquired by a prolonged course of specialized study at higher education institution

Professionalism

Skill, competence, and character expected of a member of a highly trained profession. The ability to exhibit appropriate professional conduct and to represent the profession effectively

What guides our profession?

Individual - Personal values, beliefs, culture, and religion

Organization - code of ethics, core values, standards of practice, APTA policies, generic abilities

Society - Laws and regulations

7 core values of APTA

1. Accountability

2. Altruism

3. Compassion/Caring

4. Professional Duty

5. Integrity

6. Excellence

7. Social responsibility

1. Accountability

Active acceptance of responsibility of roles, observations, actions including self-regulation

2. Altruism

Devotion to patients; fiduciary responsibility to patients ahead of self (Pro Bono)

3. Compassion Caring

Desire to identify with the patient's experience; concern, empathy for others

Professional Duty

Commitment to serve obligations to patients, profession, society

Integrity

Adherence to high ethical principles and professional standards

6. Excellence

Consistently use current knowledge and theory; embrace advancement, challenge mediocrity

7. Social responsibility

promotion of mutual trust between profession and public that necessitates responding to societal needs for health and wellness

APTA Code of Ethics (8 principles)

1. PT shall respect the inherent dignity and rights of all individuals

2. PT shall be trustworthy and compassionate in addressing the rights and needs of pt

3. PT shall be accountable for making sound professional judgment

4. PT shall demonstrate integrity in their relationships with pt, families, colleagues, students, research participants, other health care providers, employers, payers, and public

5. PT shall fulfill their legal and professional obligations

6. PT shall enhance their expertise through the lifelong acquisition and refinement of knowledge, skills, abilities, and professional behavior

7. PT shall promote organizational behaviors and business practices that benefit pt and society

8. PT shall participate in efforts to meet the health needs of people locally, nationally, or globally

Types of ethics

1. Meta-ethics - Philosophical - is it possible to know right and wrong?

2. Normative ethics - Action

3. Descriptive ethics - Moral beliefs

4. Applied ethics - Specific question - business, military

Principles of ethics

1. Justice - Fairness

2. Autonomy - Self-determination

3. Beneficence - Doing good

4. Non-maleficence - Do no harm

5. Confidentiality - Hold information secret

6. Paternalism - Regulate another's conduct

7. Conflict of Interest - Clash between personal and professional interests

8. Professional Distance - Appropriate boundaries in a relationship with a patient with whom you also have a personal relationship

Ethics

- Study of morality

- study of moral behavior

Moral decisions

- What is right and wrong

- what is better and best

Ethical situation

contain important values or duties but require no problem solving or difficult decision making but ethical action may be part of the situation

Ethical problem

Ethical temptations - we know what we should do but do not want to do it

Ethical distress - we know what we would like to do but are prohibited from doing it by organizational policies and procedures

Ethical Dilemmas

Which is better and which is worse (acting on one moral conviction can break another

Jurisprudence

the science, study and theory of laws

Law

a rule or regulation that must be followed with the ramification of legal action if not followed

Federation of State Boards of Physical Therapy (FSBPT)

Licensing authorities, protects public, promotes safe and competent PT, Administers National Physical Therapy Examination (NPTE)

FSBPT 6 areas of Focus

1. Examinations

2. Membership

3. States' Rights, Responsibilities, and Professional Standards

4. Education

5. Leadership

6. Organization and Financial stability

Professional Scope of Physical Therapist Practice

Practice that is grounded in the profession's unique body of knowledge, supported by educational preparation, based on a body of evidence, and linked to existing or emerging practice frameworks

Sources of Law

Constitutional

Statutes

Admin Code

Common Law

Florida Law

Florida Statutes - Written by legislators (non PT)

Florida Admin Code (FAC) - Written by Board of PT (PT)

Jurisprudence 1. What is the legislative purpose of laws pertaining to the practice of physical therapy?

The legislative purpose of laws is to ensure every physical therapy practitioner in this state meets minimum requirements for safe practice

Jurisprudence 2. What is the definition of unlicensed personnel? What type of personnel are athletic trainers, massage therapists and/or exercise physiologist based on this definition? What type of supervision is required for unlicensed personnel?

- Unlicensed personnel - any individual, working or volunteering in a physical therapy setting, not holding a current license as a PT or PTA

- They are unlicensed personnel

- Direct supervision - "supervision by a PT who is licensed. Need presence of PT for consult and direction of the actions

Jurisprudence 3. How are general supervision and direct supervision defined? Is there any other term used for these types of supervision?

- Direct supervision - "supervision by a PT who is licensed. Need presence of PT for consult and direction of the actions

- General Supervision - PT is accessible at all times by two-way communication, available for consult during delivery of care, and within same geographic location

Onsite supervision

Jurisprudence 4. Who may delegate, direct, or supervise the PTA or unlicensed support personnel in the physical therapy setting? What types of activities may be delegated? How do these requirements differ between the in-patient and out-patient setting?

- A licensed PT

- Can NOT delegate skilled PT functions or tasks

- Inpatient - PTA can no be delegated for hospital or acute phase of injury unless PT is readily and physically available (direct supervision)

- Outpatient - PTA only needs General Supervision

Jurisprudence 5. What patient-related duties can a PTA perform under the direction of a PT? Under what specific circumstances is direct supervision of the PTA not required?

- Anything that is not skilled, and requires specific knowledge that the PT learned

- PTA does NOT need Direct Supervision in the Outpatient setting

Jurisprudence 6. What type of supervision is required for physical therapy students? Who may supervise the PT student?

- Direct Supervision

- The PT

Jurisprudence 7. How long can a patient be treated without a referral? What conditions may be treated? What is necessary for treatment to continue? What specific healthcare team members can be a practitioner of record?

- 30 days

- Conditions within the scope of practice of PT

- Practitioners of record can be - Any physician (MD), Doctor of Osteopathy (DO), Doctor of Chiropractic (DC), Doctor of Podiatric Medicine (DPM), Doctor of Dental Surgery (DDS), Doctor of Surgical Medicine (DSM), Advanced Registered Nurse Practitioner (ARNP) - NO PA only (cosigned only)

Jurisprudence 8. How is the practice of physical therapy defined? Are there specific things in this definition the PT is prohibited from doing? If so, what?

- Means the performance of physical therapy assessments and the treatment of any disability, injury, disease, or other health condition of human beings, or the prevention of such disability, injury, disease, or other condition of health, and rehabilitation as related thereto by the use of the physical, chemical, and other properties of air; electricity; exercise; massage

- PT can not use roentgen rays and radium for diagnostic and therapeutic purposes and the use of electricity for surgical purposes including cauterization, practice chiropractic medicine including spinal manipulation

Jurisprudence 9. If you receive a referral from an approved practitioner, are you required to do what is written on the request even if you do not agree with the requested treatment? What actions are you expected to take if you do not plan to follow the request?

Not required, call source to get change

Jurisprudence 10. Can you practice as a PT before you have a permanent license? Is there a temporary license for the period of time between application and actual issuance of the permanent license?

Yes, temp permit for 6 months. If you don't pass exam permit gets revoked.

Jurisprudence 11. How many times will the state allow you to sit for the national licensing exam (NPTE)? Are there specific actions the applicant must take to be able to take the exam multiple times?

If you do not pass within the first 3 times you can request the board to allow two more changes for a total of 5 x.

Jurisprudence 12. What are the actual fees/costs associated with gaining licensure? Please include fees associated with application to the state, FSBPT, and testing site, as well as actual fees for the various tests ie. NPTE, state jurisprudence.

$400 to take exam, FL Jurisprudence $65 at prometric site ($85 fee). $180 application fee for FL, $175 to get license, $100 for application to take exam

Jurisprudence 13. How many hours of continuing education are required for renewal of your current license? What courses are required? Are there a maximum number of hours allowed in a specific area? How much of the requirement may be satisfied with home study/online courses?

- 24 hours required Continue Education every 2 years

- 1 hr HIV/Aids training (1st only)

- 2 hr medical errors training and rest in anything you want

- Online - 12 hours only

Jurisprudence 14. If you move (change address) within the same state, what steps must be taken to maintain licensure? How much time is allowed to make the necessary changes?

Notify within 60 days

Jurisprudence 15. What are 5 events that will result in disciplinary action? What are the potential disciplinary actions for each type of event?

- Not notifying move

- Not enough CE hours

- Complaint of misconduct

- Treating outside scope of practice

--- 1st - from letter and $1,000 - $6,000 and or 2 yr suspension and 2 yrs probation

--- 2nd - min $2,000 and 6 months probation - $10,000 and/or revocation of license

General Supervision

Pt available to PTA by TWO-WAY COMMUNICATION, in SAME GEOGRAPHIC LOCATION.

Direction supervision

PT is PHYSICALLY PRESENT and IMMEDIATELY AVAILABLE to subordinate personnel

What are the 3 realms

1. Individual

2. Organizational

3. Societal

Societal

Concerned with the common good, most complex realm

Organizational

Concerned with the good of the organization and uses structures and systems to facilitate organizational goals

Individual

Concerned with the common good of the patient and focuses on rights, duties, relationships and behaviors between individuals. Least complex problems.

Moral Judgments

Deciding on right vs. wrong action. Involves generating options, selecting and applying ethical principles.

Moral Courage

Implementing the chosen ethical action. Develop a plan, that preserves in face of barriers and adversity.

Moral Motivation

Places a priority on ethical values over other values such as self-interest, financial gain, or status. Primary motivator is professionalism.

Moral Sensitivity

Recognizes recognizing, interpreting and framing ethical situation

Issue/Problem

Important values are present and may be challenged

Dilemma

Two alternative courses of action. Both actions may fulfill an important duty, but it's not impossible to fulfill both obligations.

Distress

You know right course of action, but you aren't empowered to act. May present as a later complication.

Temptation

Involves a choice between right and wrong. You may stand to benefit from doing the wrong thing.

Silence

Ethical values are challenged, but no one is speaking about this challenge to values. May be course of action if you are feeling distressed.

Types of ethical situations

Issue/Problem

Dilemma,

Distress,

Temptation,

Silence

jurisdictional scope of practice

established by a state's practice act governing the specific PT's license, and the rules adopted pursuant to that act

Hints

Unit 2...Don't worry about knowing exact dates for the midterm.

Unit 3Concentrate on what we know in class and know unit objectives.

Unit 4... Know general definitions of 4 levels.

Beginning, intermediate, entry level and know standards of practice.

Know Advocacy very generally, while other stuff is more specific.

Part multiple choice and part short answer: SA will come from slides that she specifically showed us.