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Different transmission based precautions
- airborne precautions: (measles, TB, varicella), respiratory protection must be worn in room
- droplet precautions: (flu, strep, meningitis, rubella, mumps), may share room w/ person w/ same active infection, wear a mask when working w/in 3 feet
- contact precautions: (GI, skin/wound infections, scabies, impetigo, herpes), use gloes, use gowns if will be in very close contact
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Accessibility Requiriments
- Ramp: 8.3% grade, 1' to every 1"
- doorway: minimum 32"
- hallway: 36"
- bathroom sink: >29" tall, 17" depth
- bathroom toilet: 17-19"
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Documentation Recommendations
- must demonstrate skilled care
- must support billing codes
- include missed or canceled appts
- must demonstrate progress
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Ethical Principles
- autonomy: wishes of competent individuals, self-determination
- beneficence: health care providers to act for the benefit of others
- confidentiality: holding of professional secrets or discussions
- duty: obligations that individuals have to others in society
- fidelity: moral duty to keep commitments that have been promised
- justice: quality of being just and fair
- nonmaleficence: do no harm
- paternalism: when someone fails to recognize another individuals right and autonomy
- rights: ability to take advantage of a moral entitlement to do something or not to do something
- veracity: obligation of health care providers to tell the truth
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Nagi Model
- Pathology: interruption of interference in body's normal processes (spinal cord tumor at T12)
- Impairment: loss or abnormality at tissue, organ, or body system level (loss of motor function below T12)
- Functional limitation: ability to perform an action or skill in a normal manner (unable to ambulate)
- disability: any restriction or inability to perfrom a socially defined role (can't continue to work)
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Rules for PTA supervision
- must always be accesible by phone when PTA is working
- must have regularly scheduled & documented conferences
- available upon PTA request
- at least once a month must see pt to update POC, discharge, etc
- evaluate needs for recommendations for outside services
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Medicare & Medicaid
- health insurance for pts over 65 yo and disabled
- Part A: benefits for care in hospitals, outpt diagnostic services, extended care facilities, hospice, short term care, part A is automatic
- Part B: outpt care, physician services, services ordered by physicia, part B is voluntary
- Medicaid: provides basic medical services to the economically indigent population- low income
- use current procedural terminology codes to bill
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Maslow's Hierarchy of Needs
- self actualization: realize on'es full potential as a person
- esteem needs: the need to feel good about oneself and capabilities
- affiliative needs: need for security, stability, and safe environment
- physiological needs: need for basic things like food, water, shelter
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Health Belief Model
- perceived susceptibility: one is at risk for problem
- perceived severity: the health problem is serious
- perceived benefit: changing the behavior will reduce the threat
- perceived barriers: recognize obstacles required to change
- cues to action: strategies to activate readiness
- self-efficacy: ability to change behavior
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Stages of Change
- precontemplation: not intending to change
- contemplation: intending to change in near future
- preparation: making a plan to change behavior
- action: implementing plan to change
- maintainence: continuation of behavior change
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Domains of Learning
- affective domain: attitudes, values, emotions
- cognitive domain: knowledge & understanding
- psychomotor domain: physical action or motor skill
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Stages of Dying
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
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Stages of Evidence Based Medicine
- identify a problem
- focus clinical question (Patient, Intervention, Comparison, Outcome)
- search literature
- crittically appraise
- integrate relative findings
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Types of Research
- Descriptive: recording, analyzing, and interpretting conditions that exist for purpose of classification and understanding clinical phenomenom
- experimental: comparing 2 or more conditions for purpose of determining cause and effect
- exploratory: examin the dimensions of a phenomenom of interest and it's relationship to other factors
- qualitative: data from observation, interviews or verbal interactions, that focus on the meaning
- quantitative: data are measurments of outcomes that can be subject to analysis
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Ethics for human subjects must maintain
- Respect for persons: right for self-determination
- beneficience: keep well being of subjects first
- justice: fair treatment of subjects
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Types of Data and MEasurement
- Continuous: any value along a continous scale, accuracy limited by measuring instrument (weight, ROM, distance, time)
- Discrete: measured in whole units (HR, number of visits to PT clinic)
- Dichotomous: discrete data limited to only 2 values (male or female)
- Qualitative: categorical data representing different categories distinguised by non-numeric characteristics (blood type, eye color, hand dominance)
- Quantitative: numbers that represent counts of measurements, number assigned to an object or even
- Nominal: qualitative rather than quantitative, mutually exclusive and exhaustive (blood type, breath sound, type of arthritis)
- Ordinal: ranking scale, based on property of variable, but intervals may not be equal or known (MMT, levels of assistance)
- Interval: intervals between numbers are equal but no true 0 point (body temp)
- Ratio: intervals between numbers are equal with a true zero point (ROM, distance walked, time)
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Measurement Validity
- Face validity: measurement appears to test what it is supposed to
- Content validity: measurement reflects meaningful elements of a construct & items in a test reflect the content domain of interest
- Construct validity: how a theoretical construct is measured by a test or measure
- Concurrent validity: interpretation is justified by comparing to a "gold" standard
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Sensitivity
- Percentage of people who test positive for specific disease
- SNOUT: high sensitivity means that a negative diagnostic test rules out the diagnosis
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Specificity
- Specificity percentage of people who test negative for a specific disease who do not have the disease
- SPIN: high specificity means that a positive test rules in the diagnosis
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