Nbcot Review Ch 1: Ot Process

Front 1

What 3 main aspects comprise service delivery for Occupational Therapy?

Back 1

Evaluation
Intervention
Outcomes

Front 2

What is a referral?

Back 2

A basic request for OT services. AKA: order or consultation.
Content can range from the highly specific (a resting hand splint) to the very general (eval for developmental delay)

Front 3

Where can a referral come from?

Back 3

The individual
Family
Caregivers
Physicians
Social workers
PTs
Nurse Practitioners
Teachers Administrators
Insurance companies
Employers
State and local/public/private agencies

Front 4

What is the purpose of a screening? What type of information does it provide?

Back 4

To determine the need for an evaluation. It provides a preliminary understanding of an individual's needs, limitations, assets, and resources.

Front 5

What are types of screening tools?

Back 5

Chart/Medical record review
Checklists
Structured Observations
Brief interviews with individual, family, or caregivers

Front 6

What are (6) considerations in determining an appropriate assessment for an evaluation?

Back 6

1. Patient's baseline functional, concerns, and needs
2. Environmental context where eval is performed: Length of stay, focus of setting, legislative guidelines & restrictions, facility's space/equipment/supplies
3. Patient'c current/expected environmental context: sociocultural & physical environments
4. Temporal context of patient & disability: Age, duration of disability, exacerbation of condition, stage of illness
5. Eval tool's compatibility with frame of reference in treatment approach
6. Ethical concerns/conflicts [table 1-1, pg 3)
(pg 2)

Front 7

What does a standardized assessment mean?

Back 7

Indicates an assessment is uniform and well established. Content, administration, and scoring are always the same.

Front 8

What are characteristics of a standardized instrument?

Back 8

1. Description of its purpose
2. An administration and scoring protocol.
3. Extablished norms and validity.

Front 9

What is normative data and why is it used?

Back 9

Information based on age, gender and diagnostic groupings.
Used for comparative analysis of an individuals score. (ex: a 50 yr old cannot be compared to a 10 yr old)

Front 10

What is Validity?

Back 10

Validity measures the assessment's accuracy to determine if the tool actually measures what it was intended to measure.

Front 11

What is face validity?

Back 11

How well the assessment appears at face value to meet its stated purpose.

Front 12

What is content validity?

Back 12

Content validity establishes that the content included in the evaluation is representative of the content that COULD be measured.
E.g. Does the content of a role checklist provide an adequate listing of roles?

Front 13

What is criterion validity? What are types of criterion validity?

Back 13

Criterion validity compares an assessment tool to another with established validity.

1. Concurrent validity: compares the results of two instruments given at about the same time.
2. Predictive Validity: compares the degree to which an instrument can predict performance on future criterion.

Front 14

What is reliability?

Back 14

Reliability establishes the consistency and stability of the assessment.

Front 15

What is inter-rater reliability / inter-observer reliability?

Back 15

Establishes that different raters using the same tool will achieve the same results.

Front 16

What is test-retest reliability?

Back 16

Establishes that the same results will be obtained when the evaluation is administrated twice by the same administrator.

Front 17

How are reliability and criterion validity scored?

Back 17

Crierion validity is reported as a correlation; the higher the better. Reliability is scored either as a correlation or a percentage to identify the degree to which the two items agree/relate.

Front 18

List the 8 general types of assessment tools

Back 18

1. Observation
2. Interview
3. Self report
4. Checklists
5. Rating scales
6. Performance tests
7. Norm-referenced assessments
8. Criterion-referenced assessments

Front 19

How should you answer personal questions from an interviewee?

Back 19

In a direct honest manner. These questions can help develop a therapeutic relationship, and may indicate hidden meaning (interviewee wondering about personal concern). However, you should immediately re-direct interviewee to purpose of interview following your answer.

Front 20

What are the 5 types of intervention?

Back 20

1. Prevention
2. Meeting health needs
3. The change process
4. Management
5. Maintenance

Front 21

Types of Intervention:
What is primary prevention?

Back 21

The reduction of the incidence or occurrence of disease or disorder within a population that is currently well or considered to be potentially at risk.
"Create/Promote"

Front 22

Types of Intervention:
What is Secondary prevention?

Back 22

The early detection of problems in a population at risk to reduce the duration of a disorder/disease and/or minimize its effects through early detection/diagnosis, early appropriate referral and early/effective intervention.

Front 23

Types of Intervention;:
What is tertiary prevention?

Back 23

The elimination or reduction of the impact of dysfunction on an individual.

Front 24

Types of Intervention:
What interventions are designed to satisfy inherent, universal human needs?

Easily described as "meeting health needs".

Back 24

Psychophysical: need for shelter, food, material goods, sensory stimulation, physical activity, rest
Temporal balance/regularity: balance btw work/productive activities, leisure/play, and rest.
Safety
Love and acceptance
Group association
Mastery
Esteem: need to be recognized for one's accomplishments
Sexual
Pleasure
Self actualization: need to engage in activities just for one's self and for personal satisfaction

p.8

Front 25

Types of Intervention:
What is the most commonly used intervention in OT practice?

Back 25

The change process: interventions designed to achieve behavioral changes and functional outcomes.

"Establish/restore/remediate" - related to interventions that change a person in some way.

Front 26

Types of Intervention:
Describe an intervention of focused on management.

Back 26

Designed to reduce or minimize disruptive or undesirable behavior that interfere with therapeutic activities or procedures needed to change areas of dysfunction.
"Modify/Compensation/Adaptation" - alter context or demands of activity to reduce distracting features.

Front 27

Types of Intervention:

What do you call an intervention designed to support and preserve the individual's current functional level?

Back 27

A maintenance program

Front 28

What criteria are necessary for a maintenance program?

Back 28

1. No improvement in function is planned due to progression of the disorder
2. Decline in function is prevented as long as possible
3. Must include familial, environmental, and social supports along with regular follow ups

*These programs are not reimbursed by 3rd party payers.

Front 29

What does it mean to use an occupation as a means?

Back 29

Method to change an individual's performance.

E.g. Playing a board game to increase fine motor skills.

Front 30

What does it mean to use an occupation as a end?

Back 30

The occupation IS the outcome.

E.g. Playing a board game to improve pt.'s ability to engage in age appropriate social play.

Front 31

What is clinical reasoning?

Back 31

The complex mental processes the therapist uses when thinking about the individual, the disability and the personal, social, and cultural meanings the individual gives to the disability, the uniqueness of the situation, and him/herself?

Front 32

What are the 5 types of clinical reasoning?

Back 32

Procedural reasoning/scientific reasoning
Interactive reasoning
Narrative reasoning
Pragmatic reasoning
Conditional reasoning

Front 33

Describe each type of clinical reasoning.

Back 33

Procedural reasoning/scientific reasoning:
-Involves identifying OT problems, goal setting, and treatment planning
-Involves implementing treatment strategies via systematic gatherings and interpreting of client data
-The actual technical "doing" of practice
-Documented most for reimbursement

Interactive Reasoning:
-Deals with how the disability or disease affects the person; focuses on the client as a person
-Involves therapeutic relationship between therapist and pt.
-Facilitates effective treatment
-Congruent with professions philosophy of caring

Narrative Reasoning:
-Deals with the pts. occupational story and focuses on the process of change needed to reach an imagined future
-Analyzes what valued activities and roles the pt. can perform now
-Explores what activities and roles can be performed in the future

Pragmatic Reasoning:
-Considers the context in which the OT practitioner's thinking occurs
-States that mental activities are shaped by the situation
-Focuses on treatment possibilities within a given treatment session
-Considers treatment environment and OT's values, knowledge, abilities and experience

Conditional Reasoning:
-Involves an ongoing revision of treatment
-Focuses on current and possible future social contexts
-Represents an integration of interactive, procedural, and pragmatic reasoning in the context of client's narrative
-Requires multidimensional thinking

Front 34

What is therapeutic use of self?

Back 34

The practitioner's conscious, planned interaction with the individual, family members, significant others, and/or caregivers

Front 35

Standard Precautions:

What are standard precautions for hand washing?

Back 35

Wash hands...
- After touching any bodily fluids/secretions/contaminated items with without gloves.
- After removing gloves, between pt contact, and when otherwise indicated to reduce any potential transmissions
- Between tasks and procedures on the same patient to prevent cross contamination of different body sites
- Use plain (non-antimicrobial) soap for routine hand washing
- Use antimicrobial agent or waterless antiseptic for specific circumstances as defined by Infection Control

Front 36

State Standard Precautions for wearing gloves

Back 36

Wear gloves when touching bodily fluids/secretions/contaminated items. Don clean gloves prior to touching mucous membranes and non-intact skin
-Change gloves between tasks and procedures on same patient after content with materials that may contain high concentration of microorganisms.
- Remove glove promptly after use, before touching anything. Wash hands immediately following removal.

Front 37

Standard Precautions:

for Mask/Eye protection and Faceshield

Back 37

Wear a mask/eye protection or face shield to protect mucous membrane of the face in situations that are likely to generate splashes or sprays of bodily fluids/secretions.