FNDH 120 EXAM 1

Record Keeping

- Major responsibility - Be accurate and up-to-date - Medical records, injury reports, insurance information, injury evaluations, progress notes, equipment inventories, annual reports

Accessing Community Based Health Services

- Must have knowledge of local and community health services and agencies in the event of referrals - Referrals should be made with assistance from a physician - Parental involvement is necessary when dealing with psychological and sociological events

Proving Negligence

- care giver does something a reasonably prudent individual would not - care giver fails to do something a reasonably prudent individual would not

Referring to other personnel

-ATC must be aware of available medical and non-medical personnel (ex. pregnant athlete, suicidal athlete) -Patient of athlete may require special treatment outside of traditional sports medicine team -Must be aware of community based service

ATC and Team Physician

-ATC works under direct supervision of physician (ex. licensure requirements) -Physician assumes a number of roles -Both must be able to work together

Immediate and Emergency Care

-Administration of appropriate first aid and emergency medical care (CPR, AED-BLS: Basic life support) -Activation of emergency action plans (EAP)

Human Resources and Personnel issues

-Assembling appropriate personnel to achieve program goals and objectives -Recruitment, hiring and retaining qualified personnel -Specific policies are established for hiring, firing, performance evaluations and promotions -Job description, job specifications, accountability, code of conduct and scope of practice -Head AT must serve as supervisor and work to enhance professional development of staff

Professional Responsibilies

-Athletic Trainer as an educator -Athletic Training and continuing education -Athletic trainer as a counselor Athletic trainer as a researcher

CEU's are awarded for

-Attending workshops, conferences, meetings -Serving as a speaker or panelist -Certification Exam Writer -Authoring a researching article or textbook -Completing post-graduate work

Sports Medicine and Athletic training

-BROAD FIELD of medical practices related to physical activity and sport -Involves a number of specialties and various active populations -Typically classify it as relating to performance enhancement or injury care and management

Roles and Responsibilities

-Charged with injury prevention and health care provision for an injured patient -This often requires the assistance and supervision of a broad range of other healthcare professions -ATCs deal with the patient and their injury/illness from its inception until they return to full competition

Guidelines

-Completion from CAATE accredited program -Upon meeting educational guidelines, applicants are now eligible to sit for exam -Exam is computer based: 4 hours, various question/scenarios, access 5 domains -Passing the certification exam=recognized ATC and get ATC behind you name -BOC certification if often a pre-requisite for licensure in most states Must maintain certification

Treating the physically active

-Consist of athletic, recreational or competitive activities -Requires physical skills and utilizes strength, power, endurance, speed, flexibility, range or motion and agility

Legal Concerns for the ATC

-Critical to be mindful of the litigious nature of our society as it relates to healthcare -ATCs are held accountable for their patient -Potential issues of liability and negligence

Treatment and Rehabilitation

-Design preventative training systems -Design Rehabilitation program for variety of injuries -Supervise rehabilitation programs -Incorporation of therapeutic modalities and exercise -Offering psychosocial intervention

System of Healthcare Management

-Determine why there is a need for a program -Determine the function of program and what its goals should be -The decision of administration will determine the extent of health care program in AT -Develop written mission statement to focus direction of program -Includes: admins, other allied healthcare providers, student-athletes, coaches, physicians, ATs, parent, community health leaders

ATC and the Coach

-Each must understand their specific role -Coach must clearly understand the limits of their ability to function as a healthcare provider -Directly responsible for injury prevention (coaches put athletes through conditioning programs) -Coach mist be aware of risk associated w/ sport -Provide appropriate training and equipment -Should be CPR and first aid certified -Must have thorough knowledge of skills, techniques and environmental factors associated with the sport -Develop good working relationships with staff

Athletic Training Education

-Education council was formed in 1997 to dictate course of educational prep for AT student -Focuses on: evidence based practice, prevention and health promotion, clinical examination and diagnosis, acute care of injury and illness, therapeutic interventions, psychosocial strategies and referrals, healthcare administration, profession development and responsibilities

Prevention

-Ensure safe practice and competition environment -Conduct pre-participation physical/exams -Develop training and conditioning programs -Select and fit protective equipment -Explain important diet and lifestyle choices -Ensure appropriate medication use while discouraging substance abuse

Adolescent athlete

-Focused on organized competition -Number of sociological issues are involved -Skeletal maturity presents some challenges with respect to healthcare -Physically and emotional adolescents can't be managed same way as adults

HIPAA

-Health Insurance Portability and Accountability Act -Description of info to be disclosed -Identification of parties to authorized to provide and make use of info -Description of each purpose of the use -Expiration date -Individual signature -Description of his/her authority to act for the individual if signed by personal representative

ATC responsibilities and Sports Med team

-Healthcare profession which encompasses the: prevention, examination, diagnosis, treatment and rehabilitation of efferent, acute or chronic injuries or illnesses -ATC's are highly qualified, multi-skilled healthcare professionals who collaborate with physicians to provide: preventative services, emergency care, clinical diagnosis, therapeutic intervention and rehab of injuries and illnesses

Athletes with disabilities

-Increase physical activity and sport in enhancing health and quality of life -Sports for athletes w/ disabilities has transition away from rehab and moved toward rec, competitive and elite level sports -amputations, spinal injuries, visual or hearing impairments, mental or other ailments -special needs when engaging in sports

Organization and Professional well-being

-Keeping detailed and up to date records -Ordering supplies, equipment; maintain inventory -Establishing policy and procedures -Supervising personnel (students, interns, graduate assistants

State Regulations for the ATC

-Laws specifically governing the practice of AT, prior to 1970, were nonexistent -To date, 49/50 states have enacted some type of regulatory statues governing the practice of athletic training -Regulations governing the practice of AT vary tremendously from state to state

Product Liability

-Liability of any or all parties involved in manufactured product for damages caused by product. -Includes: manufacturers of components, assemblers, wholesaler and retail store owner -ATCs should not alter equipment. Results in placing liability solely on ATC

ATC and the athlete

-Major concern of ATC should be the injured athlete -All decisions made impact the athlete -Injured athlete should always be informed -Athlete must be educated on injury prevention and management -Instructions should be provided regarding training and conditioning -Inform athlete to listen to their body in order to prevent injuries (difference between sore and injured)

How do you become an ATC?

-Must have extensive background in formal academic preparation and supervised clinical/practical experience -Guideline set forth by the Board of Certification (BOC)

ATC and parents

-Must keep parents informed, particularly in secondary school setting -Parents decision regarding healthcare must be a primary consideration -Insurance plans may dictate care -ATC, physician and coaches must be aware of the Health Insurance Portability and Accountability Act (HIPPA)

For a negligent suit to be successful

-Must prove the ATC had a duty to exercise reasonable care -That person breached that duty -Must established a connection between the failure to use reasonable care and the injury suffered by the individual **All 3 much exist for a negligence suit to be successful

Occupational Athlete

-Occupational athletes are involved in strenuous, demanding or repetitive physical activity which could result in injury -Involves: instruction on ergonomic techniques to avoid injury, correcting mechanics, postures, strength deficits, lack of flexibility -Injury prevention is still critical

Athletic Training Profession

-Our role today is more in line with a health care provider. About 40% of ATCs are employed in clinics, hospitals, industrial and occupational settings

Terminology changes

-Patients and client vs. athletes -Athletic Clinic or facility vs. Athletic Training room -Athletic trainer... NOT TRAINERS

Aging Athletes

-Physiological and performance capability changes overtime -Function will increase/decrease depending on point in life -High levels of physiological function can be maintained through an active lifestyle -Exercise should be gradual and progressive as long as no unusual signs or symptoms develop -Individuals over age 40 should have testing before engaging in an exercise program

Milestones

-Recognition as healthcare providers and professionals -Increased diversity of practice settings -Passage of practice acts -Third party reimbursement for services -Constant revision and reform of AT education

Clinical Evaluation and Diagnosis

-Recognize nature and extent of injury -Involves both on and off-field evaluation skills and techniques -Understand pathology of injuries and illnesses -Referring to medical care and supportive services

Developing a risk management plan

-Security Issues -Accessibility to AT facility -AT students must be supervised -Coaches may have access AT facility -Fire safety (smoke detectors or alarm system) -Electrical and equipment safety -Aware of power distribution system to avoid accidents -EAP -Accessing emergency personnel outside of athletic facility in case of emergency

Maintaining Confidentiality in Record Keeping

-To release medical records, written consent is required and waiver must be signed -HIPAA

Evolution of the contemporary ATC

-Traditional settings of practice include colleges and secondary schools. Dealing solely with an athletic population. -Saw a rapid evolution of the profession following WW1 -Today, ATCs work in a variety of settings and with a variety of patient populations.

How to reduce litigation

-establish good working relationships -have an EAP -Become familiar with medical history of athletes -maintain good records -detailed action plan -have written consent before providing care -maintain confidentially -have caution w/ meds and modality use -safe equipment and facilities -understanding with coaches to know when athletes will be cleared -allow injured player to return following physician clearance -Follow physician's orders -purchase liability insurance -know scope of practice -use common sense

General Health Insurance

-policy that covers illness, hospitalization, and emergency care -For catastrophic insurance, organizations (NCAA, NAIA) provide additional coverage to deal with lifetime extensive care

Statues of limitation

-specific length of time an individual can sue for injury resulting from negligence -Varies by state: generally 1-5 years -Clock begins at time negligent act results in suit OR from the time injury is discovered following negligent act -Minors generally have an extension

Physician Responsibilities

1. Compiling medical histories and conducting PPEs (physicals) 2. Diagnosing injuries 3. Deciding on disqualifications 4. Attending practices and games 5. Committing to the various sports and athletes

Evidence based steps

1. Develop a clinical question 2. Search literature 3. Appraise evidence 4. Apply evidence 5. Access outcomes

establishing negligence

1. Duty of care exists between injured person and person responsible for injury 2. Conduct of defendant fell short of that duty of care 3. Defendant caused injury to occur 4. Personal damages resulted

Board of Certification Domains

1.Injury/illness prevention and wellness protection 2. Clinical evaluation and diagnosis 3. Immediate and emergency care 4. Treatment and rehabilitation 5. Organizational and professional health and well-being

Policy

A clear, written out statement of basic rules (ex. when to be there for treatment) critical for AT room or clinic

Procedure

A description of the process (ex. procedure for pregame or for a concussion) How things are going to be handled or carried out

What is evidence based practice?

A systematic method of reviewing the best evidence, combining it with the art of athletic training or your clinical expertise, and making informed choices to treat your athlete or patient

Settings

Clinics and hospitals, physician extenders, Industrial/Occupational, corporate, colleges, secondary schools, school districts, Pro sports, amateur/rec/youth sports, performing arts, military and law enforcement

Support personnel

Dentist, nutritionist, neurologist, social worker, massage therapist, etc

Billing Codes

Diagnostic code: specifies injury/condition that is being treated Procedural code: procedure being used ex. icepack

Career settings and opportunities

Employment opportunity are becoming increasingly diverse, starts out in college or high school setting, about 40% of ATCs are in hospitals and clincals

Good Samaritan Law

Enacted in most states to provide limited protection against legal liability to any individual who voluntarily choses to provide first aid, should something go wrong

FERPA

Family Educational Rights and Privacy Act -protects the privacy of student educational records -Provides parents with certain rights with respect to child's educational records -When child turns 18, rights are transferred to student -School must have written permission prior to releasing info

Patient Values

Ideas or beliefs each athlete or patient brings to you. Past experience plays a role in treatment. Athlete or patient's values, lack of understanding about body and supports can all pose challenges to their willingness to seek treatment

Assumption of Risk

Individuals made aware of inherent risk involved in sport and they voluntarily participate, written waiver, can be used defense against an negligence suit

Timeline

June 1990: American Medical Association (AMA) officially recognizes athletic training as an allied health profession June 1994: Commission on Accreditation of Allied Health Education Program (CAAHEP) is formed 2006: the Committee for Accreditation of Athletic Training Education (CAATE) was formed -As of 2014-2015, there are 375 CAATE accredited undergrad programs and 16 accredited post-professional athletic training programs

Licensure in Kansas

License works in all states To qualify: received degree from CAATE accredited school, passes BOC, submitted proper paperwork To maintain license: renew license each year for free, must report 20 CEUs for 1 year period

Forms of Regulation

Licensure: have to be BOC certified, limits practice of AT to those who have met minimal requirements by state, limits number of people who can perform functions related to AT, most restrictive Certification: State grants title protect to persons meeting standards, those without, may perform duties but not use the title Registration: least restrictive, requires individuals to file names, addresses and qualification with agency before practicing, may include filing fee

Express Warranty

Manufacturer's written guarantee that product is safe

Using injury data

May allow for: rule modification, assist coaches and players in understanding risk, help manufactures, educate parents, athletes and public on inherent risk associated with sports

Professional Liability Insurance

Most employees have insurance to protect against damages that may arise from injuries occurring on their property. Liability insurance covers against claims of negligence on part of individuals.

A number of ATCs are involved in:

NASCAR, performing arts, military, NASA, medical equipment and sales, law enforcement, and the US government

NOCSAE

National Operating Committee on Standards for Athletic Equipment -Establishes minimum standards for football helmets that must be met to ensure safety

Future direction of Athletic training

Ongoing re-evaluation, revision and reform of AT education, AT must continue to seek third party reimbursement, standardization of state practice acts, increase of secondary school employment of AT, increase recognition of AT ad physician extender, expansion for military, industry, and fitness settings, general population aging so ability to work with them, continue to research, continue to be available for local and community meetings, increase recognition internationally, most importantly: couture to focus efforts on injury prevention and to provide high quality health care to individuals regardless of the setting

PICO

P: Patient I: Intervention C: Comparison O: Outcomes

Misfeasance

Perform an action incorrectly that he/she has at the legal right to do

Malfeasance

Perform an action that is not his/hers to legally perform

third party reimbursement

Primary mechanism of payment for medical services in the US. The policyholder's insurance company reimburses health care professionals for services performed.

Continuing Education Requirements

Purpose: to encourage athletic trainers to obtain current professional development info, explore new knowledge, master new athletic training related skills and techniques, expand on current approaches to effective athletic training, further develop professional judgement, must maintain 50 Continuing Education Units (CEUs), 2 year period, 10 CEUs must be EBP (evidence based practice, maintain CPR cert

Clinical Research

Scientific process that generates evidence through hypothesis testing and sound methodology

Personal qualities or the sports medicine team

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

SWOT Analysis

Strengths (having medical care) Weaknesses (Only having one AT) Outcomes (fixing the injury) Threats (liability) -Use to routinely examine cost effectiveness of operating health care program and helps determine the value of the return on investment

Clinical Expertise

The culmination of experience treating and providing care to patients. Includes your values, preferences, experiences and wisdom. Accumulated through hours spent in AT room and trial and error.

Importance of engaging in EBP

The evidence you research can help drive you patient care. Failure to engage in evidence base care could jeopardize your patient care

Types of Record keeping documents

Treatment log, injury evaluation, supplies and equipment inventory, annual/seasonal report

Providing Coverage

facility personnel coverage: coverage of AT room, set up, schedule or treatment, rehab, pre game and post game sports coverage: ATCs should attend all practices and games, different settings have different levels of coverage (football needs a lot because concussions

Nonfeasance

failure to perform a legal duty

Negligence

failure to use ordinary or reasonable care

Liability

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