Licensure and Scope of Practice
What does a personal scope of practice entail?
PT must do own self-assessment to determine what they can competently and safely perform on pts. May need to refer out or expand our scope
What are the 3 types of disasters?
1. Natural (climate related): hurricane, cyclone, snow storm, tornadoes, etc.
2. Geologic: volcanoes, landslide, avalanche
3. Other: dz related, fires, drought, famine
Name federal AND State level agencies involved in regulating healtcare.
Federal: office of the inspector general (Medicare police), department of justice, FBI
State: department of public health
What are the most common risks in PT practice?
2. failure to supervise or monitor a pt
3. Improper performance of a biophysical agent
4. improper performance of therex
5. Improper performance of manual therapy
What are the qualities of the STEEEP model and what do they mean?
Safety: avoidance of injury and prevention
Timely: providing care in a timely manner and at the right time in a pts POC
Effective: care is provided at the right time, the right place, and right pt. tx had desired outcomes
Efficient: using resources wisely
Equitable: care is tailored towards the pt and there is consistency in their care
Pt. centered: needs and values of the pt are respected
What is a temporary license?
The ability to practice temporarily (under a licensed PT) before passing the board exam. Very vague and allows room for interpretation.
What is a complex emergency and how many one occur?
Occurs when populations suffer significant casualties as a result of war or civil/political conflicts.
There may be:
internal conflicts, large scale displacement of people, famine/food shortage, fragile or failing economic, political, or social institutions
What does accreditation and certification have in common? What is different?
They are both optional.
To be accredited, an organization must comply and follow predetermined standards.
To be certified, an organization must provide a specific expertise in a certain population (dz specific)
What are two ways to analyze risks? Explain each.
Failure mode analysis: done prior to an adverse event occurring. If one does occur, what will happen and how will it effect the pt.
Root Cause analysis: done after an adverse event has occurred and identifies why it happened (root causes)
Differentiate between culture of blame and just culture.
Culture of blame: the individual is at fault for their incompetent and reckless behavior and they are held accountable
Just culture: a balance between individual and system faults. The response to the error is based on the behavior associated with it, not just the consequence.
What is the order of obtaining a license?
1. Graduate from an accredited PT program
2. Pass NPTE
3. Pay a fee
4. Fill out application
5. Background checks, finger prints, drug screenings, juris prudence exam, etc.
What are the initial priorities in a disaster?
1. food/water
2. shelter
3. medical care
4. communciation
5. safe enviornment
Identify pts correctly (2 forms) - Name and DOB
Improve staff communication
Use medicines safely
Use alarms safely
Handwashing guidelines
Identify pt safety risk
Improve health care equity
When is the best time to intervene when a situation is escalating and the patient is getting aggravated, pacing, and yelling at you? What are your steps?
Intervene during the escalation before it becomes a crisis
Understand their anger, listen to them, and consider your environment
Empathize with their feelings but not their behavior. Try to understand what is is that they want
List the criteria to be eligible for a high reliable organization.
1. Communication: staff should not be afraid to speak up (safety huddles)
2. Improvement models: Root cause analysis
3. Continuous learning: things should be easy to report and systems should be of easy access
4. Accountability: holding people accountable for their behaviors
5. Transparency: incentivize reporting; want honesty
How would someone violate their license?
- malpractice or negligence
- fraudulently getting a license
- committing a crime
- over/under utilization of services
- sexual misconduct
List the PT's Roles and Responsibilities during a disaster.
1. Preparedness: prepare to decrease or prevent impact and mitigate effects on vulnerable populations
2. Response: immediately respond to consequences
3. Recovery: stabilization and restoration of the community to it's pre-event stage
4. Rehab and reconstruction: address long-term effects of a disaster
5. Evaluation: ongoing process that leads to better planning, mitigation, response, and recovery
Name standards that the Joint Commission requires.
- assess, re-assess pts needs and plans, provides, and coordinates care
- provides access to disciplines necessary to meet pts needs
- Mgmt of risk of falls
- Behavior mgmt
- Pain mgmt
- Effectice communication
- D/C plan
- Environment of care
- Emergency mgmt
- HR
- Rights and responsibilities of pts
List strategies to decrease risk of inappropriate sexual behavior.
- 2nd clinician in room
- behavioral contracts
- warning letters
- Transfer/discontinue tx
- distract/redirect, ignore/let it go, tell them what they said was inappropriate
Your a PT at a clinic and only got 2 hours of sleep the night before. You felt out of it and kind of foggy. You were giving the pt heat and only applied 2 layers instead of 6 and burned the pt doing so. What type of mistake was this?
Elapse: this is something PT's do routinely but since they weren't fully with it, they made an inadvertent mistake
What is the department of public health's role when processing complaints of a PT?
They review the complaint and conduct an investigation (interviews, gather witnesses, documentation, etc.).
hearing is then placed before the BOE
What did the 21st century Cures Act of 2016 allow? What are major challenges for EHR systems that are in place?
allowed for more data sharing and interoperability across EHR systems. Gave patients and providers secure access to EHI.
challenges: lack of interoperability, interruptions of work flow, lack of usability, false sense of security
- Validates the conformance of CMS' conditions of participation
- Performance measures must be prescribed
- Minimum standards for the mgmt of patients with amputations, SCI, BI, and ventricular dependence is established
job stress, turnover rate, job satisfaction, workplace injuries
You were double booked on your schedule and decided to give the aide the responsibility of taking BP on your pt. The aide read 170/90 and still continued to put them on the bike. What level of pt safety does this correlate to?
Level B: the functioning of the department/organization