APTA Working with PTAs
Regarding the clinical decision making, PTAs can:
- modify an intervention as long as it is written in the POC - withhold an intervention even if it is written in the POC - determine if a delegated intervention should be terminated
What is the only setting where a PT aide can provide limited services when under "line of sight" of PT?
SNFs (APTA does not support this practice, though)
Under Medicare, __________ supervision is required for PTAs in all settings except private practice, which requires __________ supervision.
general; direct
The term general supervision means:
the physical presence of a PT is not required but the PT must be available to the PTA by phone
In order for services to be reimbursed under Medicare Part B benefit, they may not be provided by a _____________ regardless of level of supervision.
physical therapy aide
Micah is a 50yo male who is 10 wks post Achilles tendon repair. He is self referred to PT due to inability to return to running. He has progressed to full AROM of the ankle joint. The patient continues to complain of unsteadiness with gait on uneven surfaces. The POC does not include activities to increase proprioception of the ankle/foot. The PT can expect the PTA to:
provide the PT with an update on the patient and request further instruction
If the plan of care requires modification because the patient's medical condition or situation has changed since the plan of care was developed, what will the PTA do?
request assistance from the PT, who will determine if the plan of care requires modification
PTAs may make modifications to the PT's plan of care for the patient. T or F?
F
PTA Value‐based Behavior
altruism compassion and caring continuing competence duty integrity PT/PTA collaboration Responsibility Social responsibility
According to APTA's policies and positions, a PT aide may perform which of the following tasks? a. apply superficial hot/cold to selected patients b. guide the patient in therapeutic exercises designed to increase strength/endurance c. provide gait training for routine post-op crutch instruction d. administer electrical stimulation to specified muscles given defined parameters
a
According to APTA's position, which of the following interventions are performed by the PT only? a. wound debridement with scalpel and scissors b. instruction in body mechanics and postural alignment c. NMES and biofeedback d. balance and agility training
a
Based on the PTA clinical problem solving algorithm, which decision falls outside of the scope of work of the PTA? a. decision to refer to other med professional b. decision to initiate treatment c. decision to terminate treatment d. decision to activate emergency procedures
a
The patient is unable to manage gait training with a walker d/t pain and fear of falling. Which statement reflects the PTAs best choice in this scenario? a. The PTA should discontinue attempts at gait training until the PT has re-evaluated the patient. b. the PTA should continue attempts at providing gait training using a walker or cane per POC c. The PTA should use the parallel bars for gait training and be sure to document why the parallel bars were used instead of the walker. d. Unable to determine from the info provided
a
Which of the following statements regarding the role of the PTA is inaccurate? a. The PTA can complete routine screening exams designed to determine if the patient would benefit from PT b. The PTA can progress a patient from short term goals to long term goals when written in the POC c. The PTA can participate with the PT in d/c data collection, d/c planning, or f/u care d. The PTA can participate in developing and educating a patient and/or caregiver on a HEP
a
Which of the following would not qualify as direct supervision of a PTA? a. PTA is conducting home visit; PT is available by phone b. PTA is providing bedside interventions; PT is down the hall documenting in the patient's record c. PTA is providing interventions in the clinic; PT is in a meeting two floors away d. PTA is instructing patient and caregiver in car transfers outdoors; PT is in the same building working with a patient in the clinic
a
A PT aide consistently clocks out at 5pm regardless of the number of patients yet to be seen for the day. Which of the following apply to the work of PT aide and would serve as a resource in managing this employee? a. state PT practice act b. facility rules and regulations c. PT codes and standards of ethics d. professional behaviors expected of PT aides
b
John is a PTA with 10 years of experience at a private practice clinic. As his supervisor, you notice that he seems to be frustrated by his inability to advance any further in the clinic. Which of the following would be the best choice for assisting John? a. teach John components of the clinic's standard fitness screening exam so that he can assist with community events b. help John ID areas of interest and develop goals and a plan to obtain the required knowledge and skill c. encourage John to put family and work obligations aside to pursue PT education d. encourage John to seek employment elsewhere as he has reached the limit of his potenital at your clinic
b
The patient is unable to manage gait training with a walker d/t pain and fear of falling. The next day, the patient's pain and anxiety are well managed and he is able to ambulate 50' with rolling walker PWB before becoming fatigued. Having prior experience ambulating with ADs, he requests that he be permitted to advance to a quad cane for gait training. The PTA's best choice in this scenario is: a. begin gait training with an intermediary device like a walking cane or quad cane per the patient's request b. Insist the patient continue using the walker until he has achieved the full distance expected by the PT in the POC c. consult the PT for a change in the POC to allow the patient to advance to an intermediary device as soon as possible. d. advance the WB status to WBAT and decrease the distance of ambulation
b
Which of the following HCPs can also direct and supervise the work of a PTA? a. a physiatrist in a rehab setting b. only the PT in any setting c. an orthopedist in an OP surgery setting d. a chiropractor in a private practice setting
b
Which of the following describes the appropriate role of the PTA in the patient/client management model? a. PTA conducts standard tests and measures to contribute to the exam b. PTA collects measurements related to the intervention provided to contribute to the progress report c. PTA conducts final tests and measurements and describes patient progress relative to goals in the d/c summary d. PTA modifies POC as patient condition improves
b
The PTA in the clinic has extensive clinical experience (10+ years) in orthopedic PT, an impressive record of CE, and has obtained Recognition of Advanced Proficiency for the PTA in MSK PT. Given this, which of the following patient care activities should the PT direct to the PTA? a. The clinic's standard initial intake, including review of hx and problem description b. initiation of standard post-op protocol w/ or w/o PT initial eval c. implementation of advanced therapeutic exercises per POC d. documentation of d/c summary including patient's progress towards goals
c
Which of the following statements about documentation completed by a PTA is accurate? a. PTAs should assist the PT in completing all documentation as directed, even if the PTA did not provide the intervention b. documentation completed by PTAs should always be co-signed by the supervising PT c. PTAs should always document the components of intervention and related data collection that they performed, including the patients' response d. PTAs can and should write Medicare progress reports (701) and d/c summaries
c
With respect to data collection (performing T&M's), PTAs can:
collect data to measure the patient's response to a directed intervention
To work as a PTA in most jurisdictions of the US, a PTA must:
complete a CAPTE accredited program, pass the NPTE, attain a certification or licensure
A payer requires that the PT provide direct supervision of the PTA to be eligible for reimbursement of services. Which of the following describes the supervision that must be provided by the PT? a. the PT must be immediately available by telecommunications b. the PT must be physically present and immediately available c. the PT must have contact with the patient during at least one clinical visit within a 24 hr period d. B and C
d
Kesha is a PT that has recently moved to a new state to practice. She has direct responsibility for the direction and supervision of the 2 PTAs and a PTA student that is starting next week. She has downloaded the new state practice act. Which of the following regulations must she check due to variability in regulations across jurisdictions? a. max PT to PTA supervision ratio b. required level of supervision c. limitations on PTA scope of work d. all of the above
d
Micah is a 50yo male who is 10 wks post Achilles tendon repair. He is self referred to PT due to inability to return to running. The PT's eval indicates that the primary problem is a loss of ROM at the talocrural joint. According to APTA positions, which of the following components of the intervention would be appropriate to direct to the PTA? a. passive ROM of the ankle b. grade 1 and 2 joint mobs c. instruction in HEP of ROM and flexibility exercises d. A and C
d
Raj is a new graduate PT that has asked for guidance on which of his patients he can expect a PTA to be competent in providing selected interventions. Which of the following should Raj consider before directing an intervention to a PTA? a. patient acuity and complexity b. risk management cocerns c. predictability of treatment outcomes d. all of the above
d
Takaka is a PTA with Recognition of Advanced Proficiency in geriatric PT. She has been working at SNFs for 20 years and has a bachelor degree in gerontology in addition to her PTA degree. Which of the following activities would be appropriate to direct to Takaka? a. community education to increase awareness of health and fitness in the geriatric population b. in-service education for new nurses on safe patient handling techniques for the geriatric patient c. new resident screening to assess need for PT services d. A and B
d
The PTA in the clinic has extensive clinical experience (10+ years) in orthopedic PT, an impressive record of CE, and has obtained Recognition of Advanced Proficiency for the PTA in MSK PT. Which of the following statements is true regarding tasks that may be directed to the PTA upon completion of a specified CE course? a. new skills learned may be implemented in patient care only if the PT has tested the PTA for competence b. new skills learned may be implemented in patient care only if the course taken is approved by the state board of PT and results in CEU's c. new skills learned may be implemented in patient care only if the knowledge and skill fall within the legal scope of work of the PTA d. A and C
d
The client has been progressing well through a work conditioning program and is now ready to begin functional training in specific tasks using the same tools that he uses in the workplace. Which of the following PTAs would be appropriate for directing selected elements of IADL training? a. Stephen, a PTA student in his final clinical education experience b. George, a new graduate PTA who has a background in the same area of work c. Jose, a newly hired PTA who is unfamiliar to you but reports that he provided similar client instruction and supervision with a previous employer. d. none of the above
d
Procedural Interventions not covered in the entry-level PTA curriculum:
• Joint mobilization/manipulation. • Selective sharp debridement. • Airway clearance techniques: Assistive devices, chest wall manipulation, suctioning, ventilatory aids • Functional training in work: IADL training, use of tools, instruments, and accommodations specific to a task.
The following tasks must always be completed by the PT:
• Performing the examination and evaluation. • Providing diagnosis and prognosis. • Interpreting referrals. • Developing a plan of care. • Determining who will provide an intervention. • Conducting re-examinations or re-evaluations. • Overseeing care and documentation. • Performing discharges and completing documentation.
The PTA can perform all aspects of interventions, including:
• Reviewing the physical therapist's plan of care and asking questions as needed. • Assessing the patient's readiness to participate in physical therapy. • Providing selected procedural interventions. • Providing patient/client instruction. • Documenting services provided and patient responses. • Progress patient/client through plan of care. • Collecting data to document the patient's progression. • Responding to emergency situations
