Mercer County Community Collegebehrensb/documents/PTA210handbookFall2015...2 COURSE DESCRIPTION: Addresses patient care and handling, including patient positioning and bed mobility,

Mercer County Community College Physical Therapist Assistant Program

Course Handbook (to be used in conjunction with the PTAP Student/Learner Handbook)

PTA 210: PTA Techniques

Fall 2015

Holly Beinert Course Director

OFFICE HOURS: Mondays and Wednesdays 1:00-3:00 pm in MS 157

**Other availability by appointment**

MS 157 [email protected]

609-570-3478

Course #: PTA 210

Course Title: PTA Techniques

Credit Hours: 3/2

Contact Hours in Semester: 45/30

Number of weeks: 15

Number of Clinical weeks: 00

Clinical Contact Hours: 00

Pre-requisite Course(s): PTA 107 Therapeutic Measurement PTA 112 Pathology

Co-requisite Course(s): PTA 211 Physical Agents

TEXT(S):

Required: Johansson, C., Chinworth, S.A., (2012), Mobility in Context: Principles of Patient Care Skills. F.A. Davis: Philadelphia, PA. ISBN 978-0-8036-1527-4

Kisner, C., Colby, L.A., (2012), Therapeutic Exercise: Foundations and Techniques,6th ed. FA Davis: Philadelphia, PA. ISBN 978-0-8036-1584-7

Fruth, S.J., (2014), Fundamentals of Physical Therapy Examination. Jones & Bartlett: Burlington, MA. ISBN 978-1-4496-5268-5 Kinesiology text previously used in PTA 105:

Mansfield, P.J., Newmann, D.A., (2009), Essentials of Kinesiology for the Physical Therapist Assistant, Mosby: St. Louis, MO. ISBN 978-0-323-03616-0 OR Lippert, L.S. (2011). Clinical Kinesiology and Anatomy, 5

th ed.,

Philadelphia, PA: FA Davis. ISBN 978-0-8036-2363-7 Text Required for PTA 211 Physical Agents:

Behrens, B.J., Beinert, H., (2014), Physical Agents: Theory & Practice 3rd ed., FA Davis Co: Philadelphia. ISBN 978-0-8036-3816-7

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COURSE DESCRIPTION: Addresses patient care and handling, including patient positioning and bed mobility, vital signs, transfers, gait and posture, massage, aseptic techniques, wound care and bandaging, edema management, and continuous passive motion devices. Students develop their skills through practice with each other. Competencies evaluated throughout the course.

COURSE OUTLINE: I. Aseptic Technique XI. Normal Gait II. Vital Signs XII. Abnormal Gait III. Bloodborne Pathogens XIII. Gait with an assistive device IV. Pharmacology XIV. Massage V. Positioning and Draping XV. Edema & Intermittent Compression VI. Wound Care & Burns XVI. Emergency Procedures VII. Body Mechanics XVII. Radiography VIII. Bed Mobility & Transfers XVIII. Medical Labs and Equipment IX. Wheelchair Components & Fit XIX. Cardiac Pathology & Cardiac Rehabilitation X. Therapeutic Exercise & CPM XX. Pulmonary Pathology & Chest PT

COURSE GRADING:

Domain Assessment Timeline Possible

Points Earned Points

Cognitive Written Exam #1

Week 3 Tues - Sat (testing center)

7

Written Exam #2 Week 5 Tues – Sat (testing center)

7

Written Exam #3 Week 8 Tues – Sat (testing center)

7

Written Exam #4 Week 10 Monday (in class)

7

Written Exam #5 Week 15 (in class)

7

Psychomotor 4 SOAP Notes with SOAP Note Assessment Form

Due by Thursday of Weeks 3, 5, 6, 8

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6 Competency Tests** Weeks 3,4,6,7,8,9 10

1 Practical Examination* ∞ Week 10 25

Affective Generic Abilities Assessment Ongoing 20

TOTAL: 100

* In the event that a student/learner is unsuccessful in passing the Practical Examination, the student/learner

will not receive a passing score for the course. Please refer to the “Practical Examinations” section of the PTAP Student/Learner Handbook

∞ If a student/learner is unsuccessful in his or her final practical examination attempt, the score for the practical

exam will be graded as 0 since the student/learner was deemed unsafe, which is the minimum requirement to

demonstrate competence and pass the practical exam.

** Please note that competency tests are scheduled outside of regularly scheduled class time

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GENERIC ABILITIES ASSESSMENT: Commitment to Learning: 1. Attends class consistently (25%) (In an effort to prepare for clinical experiences and a career in health care, it is expected that student/learners

will attend all classes. If a student/learner is unable to attend class, professional behavior would include contacting the course instructor via email.) Scoring: Ten point deduction for each absence

2. Demonstrates evidence of preparation prior to lab and class (25%) (Lab preparation includes wearing appropriate lab attire, fingernails and hair.) Scoring: Ten point deduction for

each class time in which the student was not prepared

Communication Skills:

3. Communicates with classmates and guest speakers appropriately in class, lab and small groups (25%) (see Ground Rules for Class Discussion and Participation) Scoring: Ten point deduction for each class time that the student communicated inappropriately

Responsibility & Professionalism: 4. Comes to class on time (25%)

(In an effort to prepare for clinical experiences and a career in health care, it is expected that student/learners will arrive on time for class. If a student/learner is unable to, professional behavior would include contacting the course instructor via email.) Scoring: Ten doing deduction for each late arrival or early departure

OPERATION: SOAP NOTE Documentation is probably one of the most challenging aspects of the clinical environment. To assist learners with gaining experience with documenting and in particular the use of the SOAP note format for documentation, the PTA program has adopted the following policy for each lab course within the curriculum. This will provide learners with the opportunity to practice their documentation skills prior to the clinical education component of the curriculum and strengthen their skills through the collaboration of their peers. Learners will be required to hand in four (4) SOAP notes during the semester for each lab course. Each SOAP note will come from one of the lab experiences which has been previously identified by the Course Director in the course syllabus and will be completed at the end of that lab experience. Each SOAP note must meet the following criteria prior to being submitted for grading:

1. It must be written by a "clinician" who performed an activity during lab. 2. It then must be reviewed by a classmate utilizing the SOAP Note Assessment Forms that are available

in the PTA Lab. (To get the most out of your peer review, have the classmate who was your patient during your lab experience perform the peer assessment.)

3. Submit the completed SOAP Note Assessment Form with your final SOAP note. There should be evidence that you have incorporated some of the feedback from your classmate into your documentation.

4. Please note that SOAP notes will not be accepted after the due dates that have been specified by your Course Instructor. Due dates help prepare student/learners and assure that there is sufficient time to receive feedback prior to subsequent SOAP notes and prior to the next clinical education course.

Graded SOAP note from LAB Due

Week 2 Wound Care Lab Thursday of Week 3 (9/17/15)

Week 4 Bed Mobility & Transfers Lab Thursday of Week 5 (10/01/15)

Week 5 Wheelchair & Therex Lab Thursday of Week 6 (10/08/15)

Week 7 Gait with Assistive Devices Lab Thursday of Week 8 (10/22/15)

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PTA 210 SOAP NOTE GRADING RUBRIC

Clinician:____________________________________Received: ________________________

Reviewer:___________________________________ Lab: Wound/Transfer/Therex/Gait

Content Quality Possible Points

Points Received

Use of black ink 1

Include the patient’s full and real name 1

The complete date 1

Did the clinician include everything that happened in the treatment session in the SOAP note?

3

Did the clinician only include relevant patient statements in the subjective portion? 3

Is the data in the objective section detailed enough that it can be easily reproduced by another clinician? Are all parameters present?

3

Does the objective portion of the SOAP note contain NO verbs? 1

Is the assessment section valuable and meaningful?

3

Is everything that is contained in the assessment section first documented either in the subjective or objective sections?

2

Is the plan section meaningful (ie. not “cont. c POC”) 3

Is the SOAP note easy to read and follow? 2

Were abbreviations used appropriately? & only approved abbreviations used? 1

Did the clinician sign the note with their professional designation? 1

TOTAL Points Earned 25 /25

Content Omissions, Penalties or Errors Penalty Deductions

Did the clinician leave any blank spaces or lines? 1

If the clinician corrected an error, was it done correctly? 1

Was white out utilized or anything obliterated? 1

Was the addendum documented correctly? 1

Is the note legible? 1

Can you read the clinician’s signature, and if not, did they print their name underneath it?

1

TOTAL Deductions 6 /6

Total Points-deductions:_________________

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PTAP POLICY ON COURSE GRADING:

One of the goals of the MCCC PTAP is to prepare student/learners to ultimately practice as PTAs after completing the PTA program. In New Jersey, as in many other states, PTAs are required to be licensed. Licensure is granted following the successful completion of a standardized licensing exam, which has a normalized passing score above what Mercer uses as a passing score.

A 93-100 B 83-86 C 70-76

A- 90-92 B- 80-82 D 60-69

B+ 87-89 C+ 77-79

Grades below 77 are not considered passing grades for PTAP courses, and are therefore considered unacceptable. All PTAP courses must be completed with a grade of “C+” or higher.

WRITTEN ASSIGNMENTS: Grading Criteria for all written assignments is provided with the assignment and it is the responsibility of the student/learner to consult with the grading criteria or grading rubric for the assignment prior to submitting the assignment, to assure that the requirements have been met to the best of his or her abilities. *Please note that a penalty of 5 points per day may be imposed for late submission of assignments.

COURSE GOALS: Following the successful completion of this course with a grade of C+ or higher, the learner will be able to:

1. Explain and demonstrate the importance of the utilization of safe body mechanics for transporting, transferring, and/or lifting patients.

2. Describe the characteristics of a patient’s vital signs at rest and in response to exercise, and appropriately measure and document vital signs.

3. Describe the components of normal gait, and typical abnormalities of gait dysfunction. 4. Formulate a general program of therapeutic exercises to increase ROM, improve strength, and

promote endurance for the upper and lower body regions. 5. Measure an ambulatory assistive device for a classmate and instruct the classmate in the appropriate

use of that device. 6. Discuss and demonstrate the therapeutic benefits of soft tissue massage within the physical therapy

plan of care. 7. Describe the benefits of CPM, mechanical compression, aseptic techniques, wound care, and/or

pulmonary techniques for specific patient diagnoses within a physical therapy plan of care.

PTA 210 COURSE OBJECTIVES: Following the successful completion of this course, the student/learner will possess skills in the following domains:

Cognitive/Knowledge: The student/learner will be able to successfully: 1. differentiate between clean and sterile techniques and describe the difference between them 2. describe the components of all vital signs 3. describe the sequence for tissue healing 4. describe the differences between normal and abnormal tissue healing characteristics

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5. identify the components of tissue healing that need to be documented in a patient record 6. describe the principles of body mechanics that would prevent injury to self and others 7. differentiate between safe and unsafe patient handling techniques and demonstrate safe patient handling

techniques 8. describe how to position a patient in supine, prone, side lying or sitting to decrease weight bearing on

bony landmarks and to improve postural drainage 9. define the levels of assistance for patient activities and transfers 10. describe the principles and components of a therapeutic exercise program 11. identify therapeutic exercises to strengthen prime-mover muscles that have been tested and identified as

needing strengthening 12. describe the components of an aerobic conditioning therapeutic exercise program 13. describe the difference between strength and endurance 14. identify the indications and contraindications for the use of a continuous passive motion device and

intermittent compression 15. describe how to prepare a patient for the application of continuous passive motion or intermittent

compression 16. describe the components of intermittent compression devices and continuous passive motion devices 17. describe non-pathologic gait patterns and differentiate them from pathologic gait patterns 18. describe the safety and progression of patients while performing gait, wheelchair and mobility activities 19. list the possible ambulatory assistive devices that can be utilized for a patient with compromised weight

bearing status 20. recognize major groups of medications prescribed for musculoskeletal conditions 21. demonstrate safe patient interaction and support during an emergency episode with a patient

communicating with the supervising PT after ensuring the safety of the patient 22. recognize an emergency situation in the physical therapy clinical environment and care for the safety of

the patient, consulting others as appropriate 23. recognize abnormal signs including cyanosis, orthostatic hypotension, dyspnea, tachycardia, bradycardia,

etc., and act appropriately to care for the safety of the patient 24. describe the sequence for postural drainage for the lobes of the lungs 25. describe the use of intermittent compression as a therapeutic intervention for edema 26. describe chest wall expansion and excursion during inspiration and what may limit it 27. describe the characteristics of cough and sputum differentiating normal from infected sputum 28. recognize positions, activities and postures that aggravate or relieve pain

consult the supervising PT when there is a question about an unanticipated patient response to a therapeutic intervention to preserve patient safety

29. recognize activities that aggravate or relieve edema, pain or dyspnea and preserve patient safety

Psychomotor: The student/learner will be able to successfully: 1. question a patient to determine his or her subjective complaints suitable for the patient record 2. demonstrate appropriate aseptic techniques to control the spread of disease 3. measure resting vital signs including blood pressure, heart rate, respiratory rate, and pain 4. demonstrate safe and effective treatment technique in practicing universal precautions, standard

precautions, and clean and sterile techniques while changing the dressing of a wound. 5. Demonstrate accurate methods for measuring the size of a wound (including length, width, depth and

tunneling) 6. perform safe assisted patient transfers utilizing appropriate body mechanics (including stand pivot, squat

pivot and sliding board transfers)

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7. maintain safety for all people involved by preparing the treatment environment and demonstrating safe and appropriate body mechanics

8. ensure proper patient positioning to maintain patient safety while achieving clinical goals & draping techniques to maintain patient dignity, revealing only the treatment area

9. demonstrate effective instructional methods for teaching therapeutic exercises to patients, including verbal, visual and tactile cues

10. adjust the level of patient activity with therapeutic exercises to maintain patient safety 11. build a therapeutic exercise program that prepares a patient for activities of daily living (ADL), functional

mobility and/or endurance training within the PT established POC 12. demonstrate wheelchair operation for patient education and safety 13. measure a patient for ambulatory assistive devices 14. demonstrate and teach ambulation with assistive devices (walkers, crutches, canes) on all surfaces (level,

curbs, steps, ramps, carpets, tile and outdoor surfaces) 15. demonstrate safe and appropriate donning and doffing of gait belts and sterile gloves 16. demonstrate safe and effective guarding technique during various transfers and gait training 17. demonstrate safe and effective demonstration and instruction in various lower extremity weight bearing

restrictions (weight bearing as tolerated, partial weight bearing, toe touch weight bearing, non-weight bearing, and full weight bearing).

18. perform a therapeutic massage to the cervical and lumbar musculature to relieve muscle guarding and pain

19. document treatment techniques utilized with classmates in the formulation of a SOAP note 20. demonstrate and perform passive range of motion exercises with patients on all peripheral joints 21. Identify which CPT Code(s) you would bill for and the rationale for choosing the code(s). 22. consult the supervising PT (or clinical instructor when appropriate) when there is a question about an

unanticipated patient response to a therapeutic intervention to preserve patient safety

Affective:

The student/learner will be able to successfully: 1. Display communication styles utilized in the clinical setting 2. Appropriately communicate with classmates and guest speakers in class, lab and small groups

demonstrating empathy and professionalism 3. Attend class consistently and punctually 4. Appropriately discusses grades and other concerns with the instructor, demonstrating respect and

listening to feedback when offered 5. Demonstrate evidence of preparation prior to class by reading the required reading and bringing in

preparatory questions provided each week

CONFIDENTIALITY EXPECTATIONS: Classmates: Periodically during the course of the semester, individuals among your classmates may be asked to share physical anomalies or previous injuries and treatments with the PTAP class. If an individual chooses to share this information with the class, it is NOT to leave the classroom. If an individual does not wish to share a personal diagnosis or anomaly with the class, it is within his or her right not to do so. Volunteers will be solicited for laboratory demonstrations. Information obtained during lab exercises is intended for demonstration purposes only. It is the right of every individual NOT to volunteer for a demonstration. However, all student/learners are expected to participate in lab activities to the best of his or

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her ability. This participation may involve the removal of minor articles of clothing. In the event that clothing is removed, draping techniques will be employed to preserve the dignity of the individual. Faculty: Any and all individuals who elect to allow themselves to be "the patient" during class and lab activities can expect that all information gained during the activity will remain confidential. This extends to all MCCC faculty and MCCC staff members, who volunteer to be “patients.” Patients in a Clinical Environment: During the academic preparation to become a physical therapist assistant, there will be instances when student/leaners will be expected to collect data regarding a patient that is being seen or who is being treated. This data is intended to be used for educational purposes only. Under NO circumstances, should this data be identified with a particular patient or individual by the use of proper names. Photocopying patient information in a clinical environment is strictly prohibited by law without prior written consent from the patient! Sample acceptable data for collection: diagnosis prescribed medications age, gender overall medical condition of the patient previous medical history physical therapy plan of care summary of PT visits physical therapy evaluation findings

CLASS PHILOSOPHY: Those who enroll in PTAP courses will be expected to accept responsibility for their learning, and as such will be considered learners. Learners identify:

• topic areas that are of particular interest to them for the purpose of paper assignments

• topic areas that present challenges to them

• strategies for meeting his or her individual needs to master the information

Learners also:

• actively participate in the presentation/discussion of course materials

• actively participate in the negotiation of a class schedule that meets the objectives for the course and for the learners

• respect the interests and needs of other learners or faculty

• work together toward a meaningful understanding of the materials presented.

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REASONABLE ACCOMMODATIONS: On July 26, 1990, the President of the United States signed the Americans with Disabilities Act (P.L. 101-336). The ADA is intended to remove barriers against the more than 43 million people with disabilities in the United States. If you have a documented learning disability, psychological disability, physical disability, or other hidden disability that requires an accommodation, it is your responsibility to make an appointment to meet with the course director and potentially the PTA program coordinator prior to the due date for any course examinations or assignments to discuss what accommodations might be necessary. Mercer County Community College & the Americans with Disabilities Act Mercer County Community College is committed to ensuring the full participation of all

students in all activities, programs and services. If you have a documented differing

ability or think that you may have a differing ability that is protected under the ADA

and Section 504 of the Rehabilitation Act, please contact Arlene Stinson in LB 216

[email protected] for information regarding support services.

If you do not have a documented differing ability, remember that other resources are

available to all students on campus including academic support through our Academic

Learning Center located in LB 214.

A list of Essential Functions for the PTA program student/learners and graduates is available through the PTA program website.

EXAMS IN THE ACADEMIC TESTING CENTER (ATC): Mercer County Community College has an Academic Testing Center on campus in the Student Center which makes it possible for exams to be administered outside of class time, allowing student/learners the ability to schedule their own time for testing. This also permits more judicious use of class time for lectures and labs rather than testing. Exams provided in the Testing Center will only be available on the West Windsor Campus. The following list represents some things to remember when using the (ATC) 1. Anyone taking "Scantron" exams in the testing center will need to keep the “Testing Center Report Form”

that is provided at the completion of the exam. a. This form indicates the grade that was earned and which test questions were incorrect. b. This form should be retained as a record of the exam.

2. Anyone taking an exam in the testing center is required to present a current Mercer ID a. one that has a sticker on it indicating the current semester

i. issued by the security office in the student center 3. The Academic Testing Center typically is open on the West Windsor Campus as follows:

Fall and Spring Semesters M-R 9am-7:30pm and Saturdays 9am-2:30pm closed on Fridays

and during the Summer Sessions M-R 9am-7:30pm and Saturdays 9am-12:30pm closed on Fridays

a. It is the responsibility of the student/learner to make sure that he/she has verified the operating hours for the Academic Testing Center

i. This is subject to change from semester to semester

mailto:[email protected]

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RECORDING AN INSTRUCTOR:

1. Audio recording of the instructor during lecture and lab will only be permitted for those student/learners

who have documentation stating that audio recordings are a reasonable accommodation for that student/learner.

a. Information regarding Documentation for Reasonable Accommodation can be obtained from Arlene Stinson the Director of Academic Support Services. Ms. Stinson’s office is LB217, and she can be reached at (609) 570-3525 or via email at [email protected] .

2. Audio recording under these circumstances will be permitted once a copy of the appropriate documentation has been provided to the instructor.

3. Video recording of the instructor during lecture and lab are not permitted under any circumstance without prior written approval from the instructor.

ATTENDANCE FOR PTA PROGRAM COURSES:

1. Mercer County Community College does not have a "cut system." Student/learners in PTA program courses are required to attend all lecture, lab, competency testing and clinical affiliation sessions. Attendance records are maintained.

2. Attendance is required for all courses for all learners. If someone is going to be absent from a scheduled

class, it is the responsibility of the individual to notify the course instructor in writing to inform him or her of the absence and how the work for that day will be made up. Copies of any class handouts that might have been distributed will be available in the course folders within the classroom. It is the responsibility of the learner to check the folder for the class that was missed to see if there was a new handout. It is not the instructor’s responsibility to attempt to keep track of who might have been present or who might have missed something that was discussed in class.

3. Official college closings or delayed openings are broadcast via several different mechanisms including local

radio stations, the college radio station WWFM, 89.1 and MAlert which will text smartphones and send emails to registered users affiliated with Mercer County Community College. It is the student/learner's responsibility to observe these notifications when they occur and act accordingly. Notices of emergency closings are also announced on the college website at www.mccc.edu.

Continued matriculation following acceptance in the PTA program indicates that the student/learner has

agreed to accept and uphold his or her commitment to these policies.

EXPECTATIONS FOR LAB SESSIONS:

Student/learners are to come to lab sessions prepared to perform the lab activities assigned for that day.

Student/learners are expected to be appropriately attired to participate fully in the lab activities scheduled for that day. Comfortable clothing that allows for full and unrestricted ease of movement, and protects the dignity of the individual (e.g. clothing that does not compromise an individual’s modesty nor expose unnecessary parts of the body) is strongly recommended. These include but are not limited to: sweat pants, gym shorts, tank tops, halter tops, sports bras, sneakers, and rubber soled


http://www.mccc.edu/

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closed-toe shoes. Clothing worn to labs must cover the entire body of the sternum. If the body of the sternum is not covered, you will be asked to leave and return with appropriate attire. Chewing gum is not permitted during lab activities.

Student/learners will have locker facilities available for storage of lab clothing and supplies. Student/learners must provide their own combination lock for the lockers.

Student/learners are expected to act the role as both clinician and as patient with lab partners for each scheduled lab session.

COMPETENCY TESTS:

The focus of all health related professions is the patient. As health care providers and educators, we are

striving to assure that the safety of our patient is not compromised in any way by the actions of our

student/learners. All PTA program laboratory courses involve direct interaction between the student/learners

and the PTA faculty. All PTA program student/learners both administer and receive care with fellow classmates

as both “patients” and “clinicians”.

PTA laboratory courses also involve individualized competency testing for specified skills that have been

identified as entry level skills student/learners should possess. Competency testing presents a method of

assuring the clinical community that the PTA student/learner is competent and safe to perform procedures and

techniques with patients. Competency tests for these skills take place prior to the Practical Exam in each of the

semesters so that a minimal level of competence can be established prior to the start of the next clinical

education course.

1. What is a competency test? a. a 15 or 30 minute “appointment” by the student/learner with a clinician tester

b. an opportunity for the student/learner to demonstrate skill level by performing the identified

procedures on a fellow classmate in the presence of a tester

c. a method for the clinician tester to assure competence, safety, and skill level for a specific procedure

or technique

Competency Tests consist of: i. course #

ii. title of the test

iii. skill demonstration items

iv. critical safety indicators

2. How do student/learners “sign up” for Competency Tests? a. A notebook labeled “PTAP Competency Testing” is located on the bookshelf inside MS352.

b. The notebook has a calendar of available testing times for student/learners to select from.

Appointments may be made by other means at the discretion of the PTA Program faculty member.

c. If a learner is absent during a competency test sign-up date, his/her name will be added to the last

remaining slot. The learner will need to check the competency binder after an absence.

d. If a learner is required to re-take a comp test, he/she should place his/her name in a slot labeled “re-

take.”

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3. What should a student/learner do if a true emergency prevents the ability to show up for a scheduled comp test? a. If a leaner has a true emergency that causes him/her to have to cancel a competency test at the last

minute, he/she needs to email Holly Beinert and inform the classmate for whom he/she was

scheduled to be a patient.

4. How do student/learners prove that they have been tested and are “competent” to perform a

particular task? a. Student/learners have a “Comp Test Sign-Off Sheet (CTSOS) Packet” (blank copies are located in

the competency testing notebook) that the competency tester must sign once the objectives for the

test have been satisfied. It is the responsibility of each of the student/learners to obtain the signature

of their competency tester once each of the objectives has been met.

b. It is NOT the responsibility of the comp tester to remind the student/learner to supply the CTSOS

packet to be signed.

c. Once the CTSOS Packet is complete for a given course, it must be handed in to the ACCE

(Academic Coordinator of Clinical Education).

d. Receipt of the completed CTSOS Packet by PTA Program Faculty/ACCE establishes eligibility to

take the practical exam for a course.

e. Failure to hand in the completed CTSOS Packet will result in penalties dependent upon the

circumstances and discretion of the course director and PTA program coordinator.

f. Each comp test has a list of skills that need to be demonstrated. Some of those skills are identified

with an asterisk (*) as Critical Safety Indicators. Critical Safety Indicators (CSI) are skills that have

been determined to impact the safety of a patient, and are therefore a minimum requirement to be

considered “competent” by the competency tester.

5. How is a grade for competency testing calculated?

a. There are two requirements to pass a competency test. The first requirement is that the

student/learner demonstrate all critical safety indicators (CSI) during the competency test. The

second requirement is that the student/learner earn a minimum of 77% of the skill demonstration list

provided for each competency test.

b. If a second attempt is required to successfully complete a competency test, the highest grade

possible for that competency test is a 79.

c. If a third attempt is required to successfully complete a competency test, the highest grade possible

for that competency test is a 77.

d. The overall competency test grade for each course will be the average of all final individual competency test grades for that

course.

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No more than 3 attempts are permitted for competency tests. Failure to perform at a level of competent

indicates that there is a problem and a need for program counseling.

It is the responsibility of the student/learner to contact the course instructor if more than a second

attempt is required for any one competency test.

What is the difference between a practical exam and a competency test? During a competency test: During a practical exam:

the comp tester interacts freely with the student/learner

being tested the practical exam proctor does not interact with

the student/learner, they take notes the student/learner may ask for clarification from the

comp tester the practical exam proctor provides no additional

information to the student/learner being tested the student/learner may submit their documentation

the day after the test has been completed the documentation for the test is due at the

completion of the test Student/learners sign up for competency tests in

advance Student/learners are assigned a specific testing

time. Student/learners know exactly what test they will be

demonstrating competence with Student/learners are provided with a patient

problem at the time of the test. They do not know

the content of the problem in advance. Student/leaners may “switch” spots with a classmate Practical Exam times are determined by program

faculty, not student/learners and student/learners

may not “switch” times with a classmate.

1. What are the responsibilities of the PTA student/learner?

a. signing up in advance to take a competency test b. arriving 30 minutes prior to his or her scheduled competency test, for those competency tests that

require a patient, to act as a patient for the classmate who is scheduled at that time. c. preparing and cleaning up the appropriate treatment environment d. having the competency tester sign off that he or she performed the test in a safe and competent

manner e. submitting the completed & signed CTSOS Packet to the appropriate faculty member by the due

date listed on the CTSOS Packet.

2. Where would a student/learner find information about competency tests for a specific course? a. Each semester, students are given a Comp Test Sign Up Sheet (CTSOS) Packet, containing all of the

competency tests for the semester.

b. The competency testing notebook in MS352 has a copy of all of the competency tests for all of the

lab courses.

3. What remedy is there for a student/learner who does not successfully complete a competency test on the first try?

a. Clinician testers work with student/learners to help them refine skills. If the student/learner is able to

demonstrate the basic foundation of the skill, then the tester will work with the student/learner for

the allotted comp test time.

b. In PTA laboratory courses, the student/learner is capable of retaking the competency test up to 2

times as they need to. However, points will be deducted for each unsuccessful attempt.

c. Prior to the third attempt, the learner must first meet with the course instructor.

d. If a learner is required to re-take a comp test, he/she should place his/her name in a slot labeled “re-

take”.

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Terminology

Term Forms of use Explanation Competency Testing Comp Tests,

Comps skills that will be tested for courses that have a lab component

Comp Test Check This refers to the number of attempts for each competency test for each of the individual skills that have been identified by the course instructor. The skills must be demonstrated to a level of competence to pass the test in addition to demonstrating competence with each of the critical safety indicators

Critical Safety Indicators CSI minimum skills that must be demonstrated for patient safety during competency testing and practical exams and all interactions with patients

SOAP Notes Documentation, SOAP Note

Documentation in a patient record to indicate the treatment intervention that took place. If the intervention was one that was done in a lab, then the SOAP note would be a mock SOAP note but would still be referred to as a SOAP note. The acronym refers to: S-subjective patient information, O-objective patient information (tests and measurements), A-assessment following the treatment intervention during that session regarding the potential change that might have taken place as a result of the intervention and P-plan for the next session based upon the " A" as it relates to the O and S from that treatment intervention for that patient and the overall plan of care.

Patient pt. During competency testing and/or practical exams, the patient is a PTA program classmate who is currently enrolled in the professional phase of the PTA program or a PTA program faculty member.

clinician During competency testing and/or practical exams, the clinician is a PTA program classmate who is currently enrolled in the professional phase of the PTA program.

Physical Therapist Assistant

PTA Either the acronym or full spelling may be used however it is understood that this refers to the individual

Physical Therapist PT Either the acronym or full spelling may be used however it is understood that this refers to the individual and not to a department or to physical therapy

15

PTA 210: Vital Signs

Equipment:

Watch or clock with a second hand

Stethoscope

Sphygmomanometer

Stable, non-rolling wooden chair

Paper and pen with black ink

Setting the Scene: The patient has arrived in the treatment area and is ready for his/her vital signs to be assessed prior to participation in physical therapy. The patient is experiencing pain (location and rate to be provided to patient by the comp tester). You will need to demonstrate competence in the following:

CSI Skill Demonstration Comp Test Check

1st 2nd 3rd Arrive prior to the start of the competency test and be prepared to begin on time 1 1 1

Provide the CTSOS Packet to the competency tester prior to performing the hand hygiene 2 2 2

Wear a lab coat and a name tag that ensures the clinician’s name is visible 3 3 3

Perform safe and appropriate hand-hygiene before touching the patient 4 4 4

Introduce yourself to your patient using the program approved introduction as outlined in the practical examination rubric

5 5 5

Explain to the patient what you will be doing during the session prior to assessing vitals 6 6 6

Ask the patient relevant questions prior to assessing vital signs 7 7 7

When vital signs do not fall within normal values, ask the patient relevant questions after the assessment vital signs

8 8 8

* Position the patient on a stable, wooden chair with back and feet supported, legs uncrossed 9 9 9

* Use the pad of the index and long fingers to assess heart rate 10 10 10

* Measure heart rate using at least 30 seconds 11 11 11

* Palpate the radial pulse at the appropriate location (anterior, distal radial aspect of forearm) 12 12 12

Position the upper extremity so that it is supported and at the level of the heart for the measurement of blood pressure

13 13 13

* Properly don the sphygmomanometer and place the stethoscope 14 14 14

* Demonstrate appropriate inflation, deflation and reading of the sphygmomanometer 15 15 15

Demonstrate appropriate trouble shooting if any difficulty with equipment is encountered 16 16 16

Measure respiratory rate discreetly and respectfully 17 17 17

Use the numeric pain scale to gather the patient’s subjective report of pain for a specific location, using a zero to ten scale, defining zero and ten

18 18 18

Share the results of all findings with the patient and perform appropriate verbal wrap-up/termination

19 19 19

* Outline the proper steps to take in a clinical setting when a patient’s vital signs are not within normal values

20 20 20

Document the treatment session with the patient in SOAP note format 21 21 21

* One additional skill from a previous competency test (either from the current or previous semester) will be expected. This skill will be provided by the competency tester at the start of the test.

22 22 22

All CSI must be demonstrated to pass each Competency Test.

16

PTA 210: Wound Care

Equipment:

Non-sterile gloves

Sterile gloves

One sterile field

4 X 4 gauze

Paper tape

Cotton Tipped Swabs

Alcohol wipes

One clear goniometer

A draping Sheet

a wound care model

Setting the Scene: The patient has a wound that needs to be measured, assessed and re-dressed today. You will need to demonstrate competence in the following:

CSI Skill Demonstration Comp Test Check 1st 2nd 3rd

Arrive prior to the start of the competency test and be prepared to begin on time 1 1 1


Wear a name tag that ensures the clinician’s name is visible and a lab coat 3 3 3

Gather all supplies 4 4 4

Perform safe and appropriate hand-hygiene prior to touching the patient 5 5 5


6 6 6

Explain to the patient what you will be doing during the session 7 7 7

Gather subjective information from the patient without using leading questions 8 8 8

Drape the patient appropriately 9 9 9

* Don clean gloves prior to removing the dressing and doff gloves in a manner that appropriately contains the dressing

10 10 10

* Set up a sterile field with no contamination 11 11 11

* Don sterile gloves using sterile technique prior to measuring the wound 12 12 12

Measure the wound using accurate and standard methods for : length, width, depth and tunneling 13 13 13

Verbalize additional wound assessments including shape, wound bed tissue, stage, and peri-wound skin integrity

14 14 14

* Redress the wound using appropriate aseptic technique and re-drape the patient 15 15 15

* Clean up the area and equipment consistent with aseptic technique 16 16 16

Share results with the patient and provide appropriate verbal wrap-up/termination 17 17 17

* Perform safe and appropriate hand hygiene upon completion 18 18 18



20 20 20


PTA 210: Therapeutic Exercise

Equipment:

Exercise equipment as necessary, which may include free weight, cane, Theraband, etc. Setting the Scene: The competency tester will identify an activity of daily living (ADL) that the patient is having difficulty with. The clinician will identify which muscle group is likely to be weak and will instruct the patient in a strengthening exercise for the weak muscle group. The clinician will be prepared to discuss how to identify when the patient would be ready to progress and how to progress the exercise. The clinician will also instruct the patient in a therapeutic activity to address the limited ADL.

The student/learner is expected to demonstrate one strengthening exercise and one stretching exercise for each of the 2 muscle groups discussed. This is a total of 4 exercises.

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To fulfill the requirement of the competency test, student/learners are expected to perform 3 of the 4 exercises correctly and without assistance/prompting from the competency tester.

If the student/learner is unable to demonstrate 3 of the 4 exercises correctly and independently, the Critical Safety Indicator will not have been satisfied.

You will need to demonstrate competence in the following:




Wear a lab coat and a name tag that ensures the clinician’s name is visible 3 3 3

Perform safe and appropriate hand hygiene prior to touching the patient 4 4 4


5 5 5

Gather pertinent subjective information from the patient 6 6 6


* Instruct the patient in one strengthening exercise for each of the two muscle groups provided by the comp tester: include demonstration and verbal instruction.

8 8 8

* Ensure the patient is performing the strengthening exercises in a safe and effective manner by providing appropriate verbal, visual and tactile feedback

9 9 9

Verbalize indications for when the exercises should be progressed and how to progress them 10 10 10

* Instruct the patient in one stretching exercise for each of the two muscle groups provided by the comp tester: include demonstration and verbal instruction.

11 11 11

* Ensure the patient is performing the stretching exercises in a safe and effective manner by providing appropriate verbal, visual and tactile feedback

12 12 12

Perform appropriate verbal wrap-up/termination 13 13 13


Identify which CPT Code(s) you would bill for and the rationale for choosing the code(s). 15 15 15


16 16 16


PTA 210: Transfers & Gait with Assistive Devices Equipment:

Wheelchair

Sliding (transfer) board

Walker

Curb or stairs

Two canes

Two axillary crutches

Gait Belt

Plinth or Low Mat

18

Setting the Scene: The competency tester will assign a lower extremity weight bearing (WB) restriction to the patient who is seated in a wheelchair and needs to be transferred to a treatment plinth. You will need to demonstrate a stand pivot, squat pivot, or sliding board transfer. The clinician will be prepared to discuss the factors involved in choosing the appropriate type of transfer for each patient. The clinician will identify which assistive devices can and cannot be used for the patient based on the WB status. The competency tester will then assign an assistive device for the patient. The clinician will measure and fit the assistive device for the patient, and perform gait training on level (and elevated) surfaces as assigned by the competency tester. Please note that the comp tester will require the clinician to demonstrate the skills listed below for two separate and distinct weight bearing statuses and assistive devices.






Perform safe and appropriate hand-hygiene prior to touching the patient 4 4 4


5 5 5

Gather relevant subjective information from the patient 6 6 6


* Transfer: Position the patient’s wheelchair appropriately to maximize safety and efficiency for the chosen transfer technique. This includes locking the wheel locks.

8 8 8

* Transfer: Discuss the transfer with the patient, providing clear instructions to the patient for what is expected of the patient

9 9 9

* Transfer: Don a gait belt to effectively maintain safety during the transfer 10 10 10

Transfer: Have the patient move toward the front edge of the surface 11 11 11

* Transfer: Prepare both surfaces for a safe transfer (including the removal of foot plates, leg rests, and armrests as appropriate)

12 12 12

* Transfer: Perform the chosen transfer technique safely with proper body mechanics, guarding techniques and verbal instructions

13 13 13

* Gait: Clearly teach the patient about a lower extremity weight bearing restriction (provided by comp tester) using verbal instructions and demonstration prior to having the patient bear weight

14 14 14

* Gait: Measure and fit an assistive device (chosen by the comp tester) to the patient prior to ambulation

15 15 15

* Gait: Perform gait training on level and elevated surfaces with the weight bearing status and assistive device provided by the comp tester.

16 16 16

* Gait: Properly guard the patient to ensure safety at all times. 17 17 17





21 21 21


19

PTA 210: Massage Equipment:

Treatment Plinth

Linens (sheets and towels)

Massage lotion

Setting the Scene: The patient is experiencing pain and muscle guarding in the upper trapezius area. The competency tester will identify the treatment side. Position and drape the patient appropriately and perform massage to minimize guarding and pain.


CSI Skill Demonstration Comp Test

Check 1st 2nd 3rd




Perform safe and appropriate hand hygiene prior to touching the patient 4 4 4


5 5 5


Gather relevant subjective data from the patient and ask at least 2 questions pertaining to possible precautions/contraindications to massage

7 7 7

* Ask the patient to inform you if he/she experiences any pain or discomfort during the application of massage

8 8 8

Drape the patient appropriately 9 9 9

* Visually inspect the patient’s skin and palpate to identify areas of muscle guarding, nodules or trigger points pre- and post- treatment to determine effectiveness of soft tissue massage

10 10 10

* Demonstrate at least 3 different types of massage strokes (effleurage, petrissage and tapotement) and identify their indications

11 11 11

* Terminate the massage appropriately, including draping and patient instruction 12 12 12

* Practice safe body mechanics during the application of massage 13 13 13





17 17 17


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FALL PRACTICAL EXAM INSTRUCTIONS: Preparing for Practical Day

LEARNERS: Come prepared with 2 outfits. One should be appropriate attire while in the role of clinician. Hair should be up. You

should also bring attire to be a patient. You should have shorts, tank tops, etc. Bring a black pen.

Your first arrival to the lab CLINICIANS:

Enter the room 10 minutes prior to your scheduled time with your lab coat and name tag in place and a pen in your pcoket, store your belongings in the front of the room by the coat hangers. It is your responsibility to enter the lab on time.

At a quarter of, sign in on the sign in sheet, (which will be just inside the classroom door on the clipboard) and choose your practical scenario. Otherwise, this will result in a one point per minute deduction from your final practical grade for each class.

PATIENTS:

Be in the hallway at least 15 minutes prior to your scheduled time.

Enter the lab 10 minutes prior to your scheduled time, sign in on the sign in sheet, (which will be just inside the classroom door on the clipboard) and have a seat in one of the wheelchairs in the waiting room. Otherwise, this will result in a one point per minute deduction from your final practical grade for each class. It is your responsibility to enter the lab on time.

Preparation CLINICIANS:

After you select your patient problem, read the scenario, make any notes you need to, and prepare yourself, your patient and your treatment area. You may not leave MS 352 once you have selected your patient problem.

You can take this time to ask your patient to put on a gown, to roll a pant leg up, put on shorts, tie something around a limb, etc.

After you are done preparing yourself, your patient, and the treatment area, YOU MUST inform your proctor that you are starting. This must happen BEFORE you perform a hand hygiene technique.

PATIENTS:

You will have time to read a summary of the patient problem while you are waiting in the waiting room, so that you are aware of the situation. You can keep the patient problem card with you if you wish.

Your clinician may ask you to don a hospital gown, a pair of shorts, a tank top, roll up a pant leg, etc.

Treatment Time CLINICIANS:

You have one hour to treat your patient and to clean up your treatment area. You should ideally “release” your patient at 10 of the hour and use that 10 minutes to clean up your treatment area.

PATIENTS:

You will be graded for being a patient. DO NOT assist the clinician with decision making skills, DO NOT give any hints, and stick to the scenario that you read.

Wrap-Up CLINICIANS:

Your SOAP note documentation is due by 15 minutes after the hour and it will be collected at that time regardless if it is complete or not. All patient related documentation must be handed in to your tester (this means all paper that you took any notes on).

PATIENTS:

When you have been released, you are to quietly retrieve your things from the locker room and leave the lab.

Reflections STUDENTS:

Reflections are to be completed and either placed in the bin in the lab, or emailed to Barbara (Barbara only!) or [email protected] by 5 pm.

Check for Results STUDENTS:

You will receive either an email or a phone call with the practical examination results once all practical examinations have been performed. Please keep your phone on you and check your emails.


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Fall 2015 Practical Examination Grading Rubric

Mercer County Community College Learner: Physical Therapist Assistant Program Patient: Practical Examination Rubric Scenario: Date: Course(s):

Instructions:

The learner will have one of the possible test scenarios that he or she will need to perform with an assigned patient. The selection will take place approximately __15___* minutes before the actual testing time. During that time notes may be made on a separate piece of paper that may be used during the testing. All papers must be turned in at the completion of the practical. Each test will take a total of __60___ minutes to complete. The tester will be looking for the following: (from the individual being tested)

1. preparation of the treatment/assessment area for the patient (before and after the session) Scores 210 211 Equivalent to: Observations

5 5 Entry level performance for a PTA

Set up with appropriate equipment, supplies, assistive devices, gait belt, towels, foot stool, all were put away at end of Rx

4 4 Competent for a PTA learner at this level

Set up was mostly appropriate with minor exceptions, the learner needed to leave the patient to get something, but the patient was safe & supported

3 3 Nervous but safe Set up was appropriate with minor exceptions, learner just forgot several things and left pt.(several times) but pt. was supported & safe

2 2 Inappropriate Did not use a sheet on the treatment plinth during Rx

2 2 Unsafe left the patient unsupported when going to retrieve something needed for treatment

1 1 Fraudulent N/A

1 1 Disrespectful to the patient

Not speaking to the patient to explain where/why leaving pt. to retrieve something ,leaving a patient in the treatment area at the conclusion of Rx, not concluding Rx with any type of remark to the pt.

0 0 Forgotten or incomplete task performance

Forgetting to clean up Rx area before starting to document or until prompted to do so

Comment: 2. preparation of the clinician, hand-washing before touching a patient, lab coat and name tag Scores 210 211 Equivalent to: Observations


hot water, towel to turn on and off water, 15 second scrub with soap, sleeves away from wrists, name tag with his or her name, coat buttoned & neat


hot water, towel to turn on and off water, 15 second scrub with soap, sleeves away from wrists, name tag

8 8 Nervous but safe hot water, towel to turn on and off water, 15 second scrub with soap, sleeves away from wrists, as above, but may have needed to start over

7 7 Inappropriate cold water, no towel to turn on and off water, 5 second scrub with soap ,no name tag , continually touching self and re-washing hands (leaving pt.) Circle infraction(s)

6 6 Unsafe cold water, no towel to turn on and off water, touching oneself after washing hands and not re-washing hands Circle infraction(s)

5 5 Fraudulent wrong name on name tag


no lab coat, or no name tag, exposed tattoos, inappropriate clinical attire, hair in face, colored nail polish, etc.


forgot to wash hands, touched self and forgot to wash hands, forgot lab coat or name tag

Comment:

22

3. to see how the clinician introduces him/herself to the patient (name & title), (clarity and speed) Scores 210 211 Equivalent to: Observations


My name is “”I am a Physical Therapist Assistant Student from Mercer County Community College and I will be working with you today.” Slow, clear, easily audible, looked for acknowledgment by pt. (name can be repeated by pt. name tag fully visible to pt.)


as above but the volume, speed or clarity could be improved

3 3 Nervous but safe as above but Physical Therapy Assistant Student and/or the volume, speed or clarity could be improved

2 2 Inappropriate as above but Physical Therapy Assistant or Physical Therapist Assistant and /or the volume, speed or clarity could be improved

2 2 Unsafe N/A

1 1 Fraudulent My name is “”I am a Physical Therapist Student (or “I am a Physical Therapist Assistant) and I will be working with you today. Slow, clear, easily audible, looked for acknowledgment by pt.


No eye contact, utilization of poor grammar “Hi, I’m goin’ to be working with you today”


no introduction “Come with me”

Comment: 4. to see that the dignity of the patient is respected by making eye contact at eye level, draping the patient, allowing

the pt. to do as much as he/she can do for him/herself Scores 210 211 Equivalent to: Observations


intro at eye level, greet pt., have pt. propel him or herself to Rx area if capable, pt. Hx in Rx area, drape pt. at all times, pt. is responsible for w/c


as above, may not remember to speak to pt. from the front

3 3 Nervous but safe N/A

2 2 Inappropriate reviewing Hx.in Rx area or pushing pt. to Rx area, or not permitting able pt. to perform tasks (one of these) not allowing the pt. to perform skills that were practiced to his or her ability

2 2 Unsafe N/A

1 1 Fraudulent N/A


Not draping the pt and more than one of the items from “inappropriate”


N/A

Comment: 5. to see that the pt. is positioned appropriately for what is being done with them and that they are not asked to

change positions un-necessarily. Scores 210 211 Equivalent to: Observations


initially positioning the pt so that he/she can perform all activities that can be formed in one position before having a pt. change positions, pt’s feet are supported


as above but the initial position may need to be changed resulting in more than one position change pt’s feet are supported

3 3 Nervous but safe the SPTA realized that position changes were necessary and explained the need for a change to the patient accepting responsibility, pt’s feet are supported

2 2 Inappropriate the SPTA had the pt. change position more than 3 times including a return to a position due to poor planning, accepting NO responsibility, pt’s feet are not supported

2 2 Unsafe the SPTA repeatedly had the pt change position and failed to guard the changes , pt’s feet are not supported and the PTA left the pt. unattended to retrieve something

1 1 Fraudulent N/A


the SPTA repeatedly had the pt change position and failed to guard the changes or explain the reasons for the change


The SPTA did not have the pt change positions when it would have been more appropriate to do so

Comment:

23

6. to see that the clinician is demonstrating appropriate concern for the patient and him or herself during the treatment session and as manifested in the treatment environment and the observation and practice of body mechanics that represent good habits and an awareness of the principles for self and others

Scores 210 211 Equivalent to: Observations


The SPTA practices safe body mechanics techniques throughout the Rx session and explains them to the pt. as appropriate, (w/c, mat table, transfers, pt. positioning, and all aspects of care) Selected an Rx area that was conducive to both pt. needs and clinician needs. Reminded pt. of body mech during session and provided rationale behind it.


As above however, when sitting, The SPTA may need to improve upon personal body mechanics & posture but left something from above out. One omission

8 8 Nervous but safe Self-corrected errors in body mechanics during Rx session, More than one omission from a “10”

7 7 Inappropriate Bending at the waist to remove w/c parts, retrieve various items throughout session

6 6 Unsafe Bending at the waist to transfer pt. with a narrow BOS

5 5 Fraudulent N/A


N/A


N/A

Comment: 7. to see that things are explained to the patient in terms that he/she is capable of understanding Scores 210 211 Equivalent to: Observations


the SPTA explained all activities in lay terminology and demonstrated activities before expecting pt. to perform task, asked pt if he or she had any ?s


the SPTA used medical terminology and demonstrated activities before expecting pt. to perform task, asked pt if he or she had any ?s

8 8 Nervous but safe the SPTA explained all activities in lay or medical terminology and demonstrated activities before expecting pt. to perform task, but may have forgotten involved side

7 7 Inappropriate the SPTA explained all activities in medical terminology and did not demonstrate or ask pt if he/she had any ?s

6 6 Unsafe the SPTA explained some but not all of the activities OR did it in an inappropriate format for THIS patient OR did not demonstrate the activity before asking the patient to perform it OR did the teaching when the pt was standing, not sitting and supported

5 5 Fraudulent N/A


Did not ask the patient if he or she had ever performed the activity previously or how, OR did not ask the pt if he or she had any ? before proceeding


No instruction took place prior to the expectation that the pt. would be expected to respond or perform something

Comment: 8. to see that the documentation is meaningful and accurate and meets each of the following criteria:

correct abbreviations, spelling, and documentation format in black ink,

to see that session measurements are accurate and in agreement with the testers visual assessment of the measurements and the session, recording only what is done and planned

Scores 210 211 Equivalent to: Observations


All activities were documented in SOAP note format with appropriate abbreviations, including the side, # sets, # reps, Rx, pt. comments, outcome, etc. and signed leaving no blank spaces and the note was legible, and neat in black ink


As above but something could have been improved upon or was left out and would be with experience (e.g. side, # reps, S: too lengthy or not quoted when it should be, etc.) OR prof. designation may have been left out. Only one omission

8 8 Nervous but safe There may have been some items corrected with a single crossed out line that indicated that the SPTA was nervous, spelling errors were present, OR there was more than one omission OR measurements were not in agreement with the tester

7 7 Inappropriate Portions of the documentation do not match up with each other or relate to each other. MMT, ROM, Placement of items not within the correct area of the SOAP note etc. OR there might have been parameters for the application of a modality or exercises left out of the note OR illegible words in documentation

6 6 Unsafe N/A

5 5 Fraudulent Statement of test results that did not take place OR an adverse response of the application of a treatment intervention was left out of the documentation


Statement of assessments that are beyond the scope of practice for a PTA


The documentation was unsigned

Comment:

24

9. Patient Safety: to see that the treatment has been prioritized for the patient with evidence of a physiologically sound and rational plan for the session

Scores 210 211 Equivalent to:

Please refer to the Critical Safety Indicators Document which is attached.



15 15 Nervous but safe

12 12 Inappropriate

9 9 Unsafe

6 6 Fraudulent



10. Patient Safety: to see that the demonstration of the selected tasks with the patient is done with evidence of skill and safety in the techniques performed Scores 210 211 Equivalent to:

Please refer to the Critical Safety Indicators Document which is attached.



15 15 Nervous but safe

12 12 Inappropriate

9 9 Unsafe

6 6 Fraudulent



PTA 211 PTA Techniques Critical Safety Indicators

The student/learner is required to demonstrate the following to score a fifteen (15) or higher on items nine (9) and ten (10) for Patient Safety on the Practical Examination Grading Rubric: 1. Selects safe modality for treatment techniques that is not contraindicated for this patient diagnosis.

2. Palpates the skin in the treatment area pre and post treatment for sensation, scars and overall appearance & blanching and tissue compliance when palpated.

3. Positions the patient appropriately for the modality that is selected. This includes supporting and elevating the treatment area and supporting the area proximal to it.

4. Verbally checks on the patient within 3 minutes of the application of any thermal agent to determine whether or not adjustments need to be made to assure patient safety during the treatment and makes appropriate changes if indicated.

5. When initiating treatment with electrical stimulation, the learner follows a safe sequence to protect the patient which includes:

a. Plugging in the electrical equipment b. Turning the power on to the equipment c. Selecting electrical parameters d. Attaching electrodes to the patient (that have been attached to the lead wires) e. Progressing with the treatment time f. Explaining the treatment technique to the patient and asking for any questions g. Once the treatment time ends and all output intensities are back to zero h. Removing electrodes from the patient i. Turning the power to the stimulator off j. Unplugging the electrical stimulation unit

25

6. When utilizing Ultrasound, the learner follows a safe sequence to protect the patient which includes: a. Palpating the treatment area to determine treatment parameters b. Plugging in the ultrasound equipment c. Turning the power to the unit on d. Selecting the parameters except intensity e. Applying acoustically conductive lotion or gel to the transducer f. Explaining the treatment technique to the patient and asking for any questions g. Moving the transducer while increasing the intensity h. Treating an area no larger than twice the size of the selected transducer i. Once the treatment time has ended, removing and cleaning the transducer j. safely storing the transducer k. Cleaning the lotion/gel from the patient l. Re-palpating the treatment area m. Turning the power to the ultrasound off n. Unplugging the ultrasound unit

7. Includes only interventions indicated on the plan of care provided created by the physical therapist in the initial evaluation.

PTA 210 PTA Techniques Critical Safety Indicators

The student/learner is required to demonstrate the following to score a fifteen (15) or higher on items nine (9) and ten (10) for Patient Safety on the Practical Examination Grading Rubric:

1. Provides clear and adequate instructions regarding weight bearing status prior to the first time the patient is required to bear weight, and continue to provide instruction as necessary.

2. Provides adequate guarding to maintain patient safety at all times.

3. Appropriately prepares the wheelchair for safe transfers into and out of the wheelchair, including engaging wheel locks and making sure that foot plates, leg rests, and arm rests are in appropriate positions.

4. Maintains the patient in a safe position while propelling the patient in a wheelchair, which includes having the armrests, leg rests and foot plates in place and in use.

5. Utilizes a gait belt properly for all patient transfers and gait training.

6. Ensures that the patient is wearing appropriate footwear (shoes) during all transfers and gait training.

7. Teaches the patient how to engage and disengage the wheel locks and any other pertinent wheelchair components during wheelchair mobility training, when appropriate.

8. Ensures that the patient is left in a safe position when not guarding the patient.

9. Chooses the most appropriate assistive device to maintain safety (including weight bearing status) and allow for mobility for the patient.

10. Ensures that the patient uses the provided assistive device correctly.

11. Competently demonstrate the assessment of vital signs before and after treatment as appropriate.

11. Performs wound care utilizing sterile techniques when the patient has a wound that is being treated by the physical therapy department.

12. Includes only interventions indicated on the plan of care provided created by the physical therapist in the initial evaluation.

HB 8/15

26

The tester will be looking for the following from the “patient” during the test: that the patient does ONLY what he or she is told to do

the patient does NOT help the clinician

that the patient does NOT ask questions of the tester

that the patient does NOT prepare or clean up the area

that the patient respects the stress of the clinician and do not try to make it more difficult for the clinician to successfully complete the practical

that the patient wears appropriate attire, including the ability to expose the distal half of the humerus

that the patient enters the lab 10 minutes prior to the scheduled start time

Please note:

Patient safety is a critical component for the successful completion of this and all PTA program courses within the PTA curriculum. Items 9 & 10 on the list are considered to be skills that must have a score of “15” of higher for the learner to pass this practical examination and be considered “safe.” To achieve a score of 15 or higher on categories 9 & 10, the student/learner must demonstrate all critical safety indicators outlined for the course. Critical Safety Indicators demonstrated will be marked with a checkmark and those that are not demonstrated will be marked with an “X”. Additionally, a minimum score of 77 must be earned to pass the practical exam, consistent with all PTA program courses.

Summary Possible

Points

210 211 Total Score for the Clinician:

Review Date:

1 5 2 10 3 5 Point Deductions (as a

patient):

Learner Initials: 4 5 5 5 6 10 7 10 PTA 210 Final Score =

Safe/Unsafe

Pass/Fail

PTA 211 Final Score =

Safe/Unsafe

Pass/Fail

8 10 9 20

10 20

Total 100

Tester(s):

BJB 3/12 rev Rev 11/13 PTAP fac

27

FALL 2015 EXAM TOPICS:

Exam Topics

1 Aseptic Technique Vital Signs Wounds Burns

2 Wheelchair Components, Fit & Propulsion Therapeutic Exercise & CPM Positioning and Draping Body Mechanics

3 Bed Mobility Transfers Zero Lifting Normal Gait Abnormal Gait Gait with AD

4 Pharmacology Blood Borne Pathogens Massage Emergency Procedures Radiography Medical Labs & Equipment Cardiac Rehab

5 Cumulative

PTA 210 PTA TECHNIQUES

Course Schedule: Fall 2015

Lecture: Mondays and Wednesdays 10:00 am – 12:00 pm

Lab: Thursdays: 9:00 am – 12:00 pm OR 1:00 pm – 4:00 pm

Location: MS 352

PTA 210 PTA Techniques Competency Tests Lab Date: Test Week Semester Week

1. Vital Signs 9/3 9/14 3

2. Wound Care 9/10 9/21 4

3. Therapeutic Exercise 9/24 10/5 6

4. Transfers 10/1 10/12 7

5. Gait with Assistive Devices 10/15 & 10/22 10/19 8

6. Massage 10/29 10/26 9

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COURSE SCHEDULE:

Week Date Assessment Topic(s) Chapter(s) Objective(s) 1 8/31 M: Aseptic Techniques

Johansson Ch 4 C1, C10, C14, P1, P3, P4, P11, P17, A1, A4, A6, A7, A8

W: Vital Signs Johansson Ch 5; Fruth Ch 7 section 1, 2

2 9/7 Labor Day

Fruth, Ch 8 C4, C5, C6, C10, P4, P11, A1, A4, A6

W: Wound Care R: Burns

Johansson Ch 13

3 9/14 Comp: Vital Signs Exam 1: 9/15-9/19 test center

M: Wheelchair Fit, Components & Propulsion

C7, C8, C10, P2, P3, P11, P13, P18, A1, A2, A4, A6

W: Therapeutic Exercise

4 9/21 Comp: Wound Care

M: Therapeutic Exercise & CPM

C8, C9, C10, C19, C20, P2, P8, P11, P12, P14, P15, P16, P18, P20, A1, A4, A5, A6

W: Positioning & Draping Body Mechanics

Johansson Ch 2, 6, Ch 7 (from page 158 to end)

5 9/28 Exam 2: 9/29-10/3 test center

M: Bed Mobility Johansson Ch 10 C2, C10, C13, C15, C19, C20, P6, P8, P11, P12, P14, P20, A1, A4, A5, A6 M: Transfers, Zero Lifting Johansson Ch 11

W: Normal Gait Fruth Ch 9, Section 2

6 10/5 Comp: Therex M: Abnormal Gait W: Gait with Assistive Devices

Fruth Ch 9, Section 2

C8, C10, C11, C12, C13, P7, P9, P11, P18, A1, A4, A6

7 10/12 Comp: Transfers

M: Gait with Assistive Devices W: Pharmacology Blood Borne Pathogens (Attendance is Mandatory)

C10, C11, C12, C21, P7, P9, P11, P18, A1, A4, A6

8 10/19 Comp: Gait with AD Exam 3: 10/20 – 10/24 test center

M: Massage * W: Emergency Procedures Radiography

C8, C10, P5, P11, P19, P21, A1, A2, A3, A4, A6, A7, A8, A9

29

9 10/26 Comp: Massage M: Medical Labs & Equipment W: Cardiac Rehab

Fruth Ch 7 sections 4, 5, 6;

C10, P11, P21, P22, A1, A4, A6, A8

10 11/2

Exam 4: 11/2 in class PRACTICAL WEEK

M: Exam in class M: CTSOS due 11/2 W/R: Practical Exams F: 1:00 Practical Exam Review

11-14 PTA 224 Clinical Education I 15 12/9 W: Edema Management

& Intermittent Compression (Bring Physical Agents textbook to lab this week)

Behrens Ch 7, Fruth Ch 7 section 3

C10, C16, P6, P11, A1, A3, A4, A6, P11, A1, A8

16 12/14 Exam 5: Thurs 12/17 in class

M: Guest Lecture on Lymphedema W: Chest PT Thurs 12/17: 9 am: Exam 5 in class Fri 12/18: 10 am: Mandatory Review PTA 210 Exams 4 & 5 and PTA 226 Final Exam

C3, C8, C10, C17, C18, P10, P13, P20, P21, A1, A3, A4, A6, A8

* Massage lab will require students to expose the entire back (from the shoulders to the PSIS).

**Students need to be available from the first day of the semester through the end of the final exam period.

ACADEMIC INTEGRITY: The faculty members of the PTA program at Mercer County Community College believe in the ability of student/learners to succeed honestly, fairly and free from fraud or deception without inappropriate assistance. We also expect that student/learners enrolled in PTA program classes accept responsibility for their own work and exhibit honesty with all submissions of their academic work. The PTA program faculty members have a zero tolerance policy for failure to abide by this philosophy and will strictly adhere to the College's Academic Integrity Policy which can be found in the MCCC Student Handbook. OMB 210 PTAP Handbook Template Rev 7/2014

Documents

Mercer County Community Collegebehrensb/documents/PTA210handbookFall2015...2 COURSE DESCRIPTION: Addresses patient care and handling, including patient positioning and bed mobility,