PCM unit 9&10 quiz
when do pt administrative items need to be used?
when pt is admitted into inpatient rehabilitation unit
when does a CARE tool assessment paperwork have to be completed?
within a 3-day assessment period upon admission and then again at discharge
what components are included within pt self care?
· Eating · Oral hygiene · Toilet transfer · Toilet hygiene · Shower/bathe self · UE dressing · LE dressing · Donning/doffing footwear · Understanding
what components are included within pt communication?
· Expression · Understanding
what does the PT included within a admission/goals/discharge?
· Numerous mobility items and includes scoring · Includes transfers, gait, AD use, bed mobility · Goal for discharge · Rescore at discharge · Uses codes
what does the PT included within a pt PLOF?
· Provides information on expectations and improvement through rehab process · Info obtain verbally through hx taking or will already be documented
what components are included within pt mobility?
· Roll L and R · Sit to lying · Lying to sitting eob · Sit to stand · Chair or bed to chair transfer · Walking · Stairs · Picking items up off floor · Wheelchair mobility
how is a pt scored on their admission/goals/discharge?
1- dependent 2 - max a 3 - mod a 4 - supervision 5 - setup or cleanup assistance 6 - independent
how is a pt scored on their PLOF?
1- dependent 2- needed some help 3 - independent 7 - refused 8 - unknown 9 - not applicable 10 - not attempted due to environmental limitations
what 4 things does the PT need to encompass when instructing the family on pt training?
1. answer all questions accurately and professionally 2. use communication/language that is understood 3. engage pt in establishing long-term and short0term goals 4. develop and instruct in a HEP
what is the PT process in creating a pt HEP?
1. determine need for continuation of treatment upon discharge 2. determine the environment and assistance available to pt 3. prepare the HEP 4. instruct and supervise pt performing the HEP 5. provide written instruction with descriptions using diagrams or pictures
how can the PT determine if pt learning was achieved?
1. watch and give feedback 2. ask them what else you can answer for them 3. ask open ended questions 4. have the pt or one family member teach another family member 5. ask if they think they can complete this task in their home environment 6. do a home visit 7. set family up with resources 8. document
which mobility OM assesses gait speed?
10-meter walk
which mobility OM assesses aerobic capacity/endurance?
2 or 6 min walk
which mobility OM assesses LE strength and functional mobility?
5X STS
which mobility OM assesses gait quality, balance, and fall risk?
DGI
what is the assessment associated with SNF?
MDS
what companies is CARE tool mainly used for?
Medicare and Medicaid (also used amongst other insurance companies)
what is the assessment associated with home health?
OASIS
what are the 2 sections within a pt administrative documents that the PT is responsible for?
PLOF and admission/goals/discharge
what pt considerations does the CARE tool include?
PLOF, comorbidities, and complications such as cognition, skin integrity, or anything that can impact pt outcome
which mobility OM assesses mobility, balance, walking ability and fall risk?
TUG
what are the 3 CARE tool functional domains?
communication, selfcare, mobility
who is responsible for completing a pt administrative document?
completed collectively between the administrative team (all health care professionals participating in pt POC), not the PT alone
which mobility OM assesses static balance and fall risk?
berg
in what settings is the CARE tool used?
inpatient, SKN, and home health (ALL post-acute care settings)
what 5 things must the interdisciplinary team conferences focus on?
- Assess ot progress toward goal - Consider resolutions to any problems interfering with pt goal - Reassess validity of rehab goals - Monitor and revise treatment plan - Measurable improvement to justify and continued IRF stay
what types of pt can I expect to see in inpatient rehab?
- CVA - TBI - Spinal cord injury - Multi-trauma - Neuromuscular - significant illness - complex ortho conditions - status post amputations
when is a pt POC completed and what does it include?
- Completed within first 4 days of IRF admission - Support medical necessity of admission - Detail pt prognosis and anticipated interventions · Intensity (number of hours per day) · Frequency (number of days per week) · Duration (number of total days during IRF stay) · Functional outcomes · Discharge destination from the IRF stay
what does the PT need to consider when educating a pts family?
- Complexity of pt condition - Respect - Traumatic illness/injury impact (emotionally, financially, physically) - Stages of acceptance of illness/injury - Timing - Helping pt and family work together
how does the PT instruct the pt family on hands-on pt training?
- Facilitate their involvement - Educate about the task - Do not rush - Remain safe - Demonstrate, ask them to assist, and then have them do it on their own
what is the assessment associated with inpatient?
- IRF-PAI
what are measurement tools used within inpatient rehab?
- IRF-PAI (inpatient rehab facility patient assessment instrument) is required to gather data to determine the payment for each Medicare Part A FES pt - CARE is apart of the IFR-PAI and addresses the PLOF and functional status
what are the 4 goals/points of focus in inpatient rehab?
- Improve function - Decrease burden of care - Interdisciplinary team care - Intensive therapy is focus for pt care · Pt schedule · Nursing services · Medication schedule
what information does the PT need to gather prior to starting patient and family training/education?
- Physical and cognitive function - Details of location of discharge - Who can assist the pt - AD/equipment needed or what the pt may already use - Family members current knowledge, skills, and availability - Time frame needed to train the family
what does the PT teach the family?
- Pt goals and POC - Info on pathology/condition/impairments - Functional activities (transfer, gait, bed mobility) - Prevention and safety (skin care, precautions, assistance level) - HEP - Community resources
what 3 things must be completed in interdisciplinary team participation documentation?
- Rehab physician with specialized training and experience in rehab services - Registered nurse with specialized training - Social worker or case manager
what are 6 pt criteria needed for admission into inpatient rehab facilities?
- Require active and ongoing intervention of multiple therapy disciplines PT, OT, speech-language - Requires 3 hrs of therapy a day for 5 days - At least 15 hours of intensive rehab therapy within a 7 consecutive day period beginning with the date of admission - Can actively participate and benefit significant from the program - Requires supervision by a physician with face-to-face visits at least 3 days per week to assess the pt both medically and functionally and to modify course of treatment - Requires intensive and coordinated interdisciplinary team approach
what does the PT need to include/consider within a pt HEP?
- State goals and expected results - Provide objective indicators of performance including frequency/duration - Provide indicators of successful completion - Indicate equipment and supplies needed - Indicate precautions and contraindications - Provide caregiver contact information - Include any scheduled reevaluation - Document the process
what are different forms of communication?
- Visual - Nonverbal attentive listening - Audiovisual aids - Written including electronic
what are barriers to effective communication?
- distance - noise/distractions - deficits - decreased feedback - interpretations - culture/gender/age - illegible writing
what does "CARE" tool stand for?
Continuity assessment record and evaluation
which mobility OM assesses functional mobility and vestibular?
HiMAT
what does an inpatient rehabilitation facility encompass?
Provide intensive rehab using interdisciplinary team approach in a hospital environment.
what does the CARE tool measure?
functionality regarding post-acute care pt
what items are included within a pt administrative document?
name, race, gender, PLOF, discharge info, hearing and speech abilities, cognition, mood, pain, functional abilities and goals, diagnosis, bowel and bladder function, health conditions, nutritional status, skin condition, medications.
what populations is inpatient rehabilitations facility for?
pt with complex nursing, medical management, and rehab needs
which mobility OM assesses gait function, balance, and fall risk?
tinetti