Standards of Practice for Physical Therapy and the criteria: the Standards of Practice for Physical Therapy are promulgated by APTA's House of Delegates; Criteria for the Standards are promulgated by APTA's Board of directors. Criteria are italicized beneath the Standarfs to which they apply.PREAMBLE A clause at the beginning of a constitution or statute explaining the reasons for its enactment and the objectives it seeks to attain. Generally a preamble is a declaration by the legislature of the reasons for the passage of the statute, and it aids in the interpretation of The physical therapy profession's commitment to society is to promote optimal health and function in individuals by pursuing excellence in practice. The American Physical Therapy Association The American Physical Therapy Association (APTA) is a national professional organization representing more than 66,000 members. Its goal is to foster advancements in physical therapy practice, research, and education. attests to this commitment by adopting and promoting the following Standards of Practice for Physical Therapy. These Standards are the profession's statement of conditions and performances that are essential for provision of high quality professional service to society, and provide a foundation for assessment of physical therapist practice. I. ETHICAL/LEGAL CONSIDERATIONS A. Ethical Considerations The physical therapist practices according to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. the Code of Ethics Code of Ethics can refer to:
The physical therapist assistant complies with the Standards of Ethical Conduct for the Physical Therapist Assistant of the American Physical Therapy Association. B. Legal Considerations The physical therapist complies with all the legal requirements of jurisdictions regulating the practice of physical therapy. The physical therapist assistant complies with all the legal requirements of jurisdictions regulating the work of the assistant. II. ADMINISTRATION OF THE PHYSICAL THERAPY SERVICE A. Statement of Mission, Purposes, and Goals The physical therapy service has a statement of mission, purposes, and goals that reflects the needs and interests of the patients/ clients served, the physical therapy personnel affiliated with the service, and the community. The statement of mission, purposes, and goals: * Defines the scope and limitations of the physical therapy service. * Identifies the goals and objectives of the service. * Is reviewed annually. B. Organizational Plan The physical therapy service has a written organizational plan. The organizational plan: * Describes relationships among components within the physical therapy service and, where the service is part of a linger lin·ger v. lin·gered, lin·ger·ing, lin·gers v.intr. 1. To be slow in leaving, especially out of reluctance; tarry. See Synonyms at stay1. 2. organization, between the service and the other components of that organization. * Ensures that the service is directed by a physical therapist. * Defines supervisory structures within the service. * Reflects current personnel functions. C. Policies and Procedures Policies and Procedures are a set of documents that describe an organization's policies for operation and the procedures necessary to fulfill the policies. They are often initiated because of some external requirement, such as environmental compliance or other governmental The physical therapy service has written policies and procedures that reflect the operation, mission, purposes, and goals of the service, and are consistent with the Association's standards, policies, positions, guidelines guidelines, n.pl a set of standards, criteria, or specifications to be used or followed in the performance of certain tasks. , and Code of Ethics. The written policies and procedures: * Are reviewed regularly and revised as necessary. * Meet the requirements of federal and state law and external agencies. * Apply to, but are not limited to: ** Care of patients/clients, including guidelines ** Clinical education ** Clinical research ** Collaboration Working together on a project. See collaborative software. ** Competency COMPETENCY, evidence. The legal fitness or ability of a witness to be heard on the trial of a cause. This term is also applied to written or other evidence which may be legally given on such trial, as, depositions, letters, account-books, and the like. 2. assessment ** Criteria for access to care ** Criteria for initiation and continuation of care ** Criteria for referral to other approp4ate health care providers ** Criteria for termination of care ** Documentation ** Environmental safety ** Equipment maintenance ** Fiscal management ** Improvement of quality of care and performance of services ** Infection control ** Job/position descriptions ** Medical emergencies ** Personnel-related policies ** Rights of patients/clients ** Staff orientation D. Administration A physical therapist is responsible for the direction of the physical therapy service. The physical therapist responsible for the direction of the physical therapy service: * Ensures compliance with local, slat< and federal requirements. * Ensures compliance with current APTA APTA American Physical Therapy Association. documents, including Standards of Practice for Physical Therapy and the Criteria, Guide to Physical Therapist Practice, Code of Ethics, Guide for Professional Conduct, Standards of Ethical Conduct for the Physical Therapist Assistant, and Guide for Conduct of the Affiliate Member. * Ensures that services are consistent with the mission, purposes, and goals of the physical therapy service. * Ensures that services are provided in accordance Accordance is Bible Study Software for Macintosh developed by OakTree Software, Inc.[] As well as a standalone program, it is the base software packaged by Zondervan in their Bible Study suites for Macintosh. with established policies and procedures. * Reviews and updates policies and procedures. * Provides for training of physical therapy support personnel that ensures continued competence for their job description. * Provides for continuous in-service in-service In-service training adjective Referring to any form of on-the-job training noun In-service training of an employee training on safety issues and for periodic safety inspection of equipment by qualified individuals. E. Fiscal Management The director of the physical therapy service, in consultation with physical therapy staff and appropriate administrative personnel, participates in planning for, and allocation The apportionment or designation of an item for a specific purpose or to a particular place. In the law of trusts, the allocation of cash dividends earned by a stock that makes up the principal of a trust for a beneficiary usually means that the dividends will be treated as of, resources. Fiscal planning and management of the service is based on sound accounting principles. The fiscal management plan: * Includes a budget that provides for optimal use of resources. * Ensures accurate recording and reporting of financial information. * Ensures compliance with legal requirements. * Allows for cost-effective cost-effective, n the minimal expenditure of dollars, time, and other elements necessary to achieve the health care result deemed necessary and appropriate. utilization of resources. * Uses a fee schedule that is consistent with the cost of physical therapy services and that is within customary norms of fairness and reasonableness. * Considers option of providing pro bono Short for pro bono publico [Latin, For the public good]. The designation given to the free legal work done by an attorney for indigent clients and religious, charitable, and other nonprofit entities. services. F. Improvement of Quality of Care and Performance The physical therapy service has a written plan for continuous improvement of quality of care and performance of services. The improvement plan: * Provides evidence of ongoing review and evaluation of the physical therapy service. * Provides a mechanism for documenting improvement in quality of care and performance. * Is consistent with requirements of external agencies, as applicable. G. Staffing The physical therapy personnel affiliated with the physical therapy service have demonstrated competence and are sufficient to achieve the mission, purposes, and goals of the service. The physical therapy service: * Meets all legal requirements regarding licensure licensure (lī´s  nsh and certification of appropriate personnel. * Ensures that the level of expertise within the service is appropriate to the needs of the patients/clients served. * Provides appropriate professional and support personnel to meet the needs of the patient/client population. H. Staff Development The physical therapy service has a written plan that prorides for appropriate and ongoing staff development. The staff development plan: * Includes self-assessment Self-assessment in an organisational setting, according to the EFQM definition, refers to a comprehensive, systematic and regular review of an organisation's activities and results referenced against the EFQM Excellence Model. , individual goal setting, and organizational needs in directing continuing education continuing education: see adult education. continuing education or adult education Any form of learning provided for adults. In the U.S. the University of Wisconsin was the first academic institution to offer such programs (1904). and learning activities. * Includes strategies for lifelong learning Lifelong learning is the concept that "It's never too soon or too late for learning", a philosophy that has taken root in a whole host of different organisations. Lifelong learning is attitudinal; that one can and should be open to new ideas, decisions, skills or behaviors. and professional and career development. * Includes mechanisms to foster mentorship “Protégé” redirects here. For other uses, see Protégé (disambiguation). Mentorship refers to a developmental relationship between a more experienced mentor and a less experienced partner referred to as a mentee or protégé activities. I. Physical Setting The physical setting is designed to provide a safe and accessible environment that facilitates fulfillment ful·fill also ful·fil tr.v. ful·filled, ful·fill·ing, ful·fills also ful·fils 1. To bring into actuality; effect: fulfilled their promises. 2. of the mission, purposes, and goals of the physical therapy service. The equipment is safe and sufficient to achieve the purposes and goals of physical therapy. The physical setting: * Meets all applicable legal requirements for health and safety. * Meets space needs appropriate for the number and type of patients/clients served. The equipment: * Meets all applicable legal requirements for health and safety. * Is inspected routinely. J. Collaboration The physical therapy service collaborates with all disciplines as appropriate. The collaboration when appropriate: * Uses a team approach to the care of patients/clients. * Provides instruction of patients/clients and families. * Ensures professional development and continuing education. III. PATIENT/CLIENT MANAGEMENT A. Patient/Client Collaboration Within the patient/client management process, the physical therapist and the patient/client establish and maintain an ongoing collaborative col·lab·o·rate intr.v. col·lab·o·rat·ed, col·lab·o·rat·ing, col·lab·o·rates 1. To work together, especially in a joint intellectual effort. 2. process of decision-making decision-making, n the process of coming to a conclusion or making a judgment. decision-making, evidence-based, n a type of informal decision-making that combines clinical expertise, patient concerns, and evidence gathered from that exists throughout the provision of services. B. Initial Examination/Evaluation/Diagnosis/Prognosis The physical therapist performs an initial examination and evaluation to establish a diagnosis and prognosis prognosis /prog·no·sis/ (prog-no´sis) a forecast of the probable course and outcome of a disorder.prognos´tic prog·no·sis n. pl. prog·no·ses 1. prior to intervention A procedure used in a lawsuit by which the court allows a third person who was not originally a party to the suit to become a party, by joining with either the plaintiff or the defendant. . The physical therapist examination: * Is documented, dated, and appropriately authenticated au·then·ti·cate tr.v. au·then·ti·cat·ed, au·then·ti·cat·ing, au·then·ti·cates To establish the authenticity of; prove genuine: a specialist who authenticated the antique samovar. by the physical therapist who performed it. * Identifies the physical therapy needs of the patient/client. * Incorporates appropriate tests and measures to facilitate outcome measurement. * Produces data that are sufficient to allow evaluation, diagnosis, prognosis, and the establishment of a plan of care. * May result in recommendations for additional services to meet the needs of the patient/client. C. Plan of Care The physical therapist establishes a plan of care and manages the needs of the patient/client based on the examination, evaluation, diagnosis, prognosis, goals, and outcomes of the planned interventions for identified impairments, functional limitations, and disabilities. The physical therapist involves the patient/client and appropriate others in the planning, implementation, and assessment of the plan of care. The physical therapist, in consultation with appropriate disciplines, plans for discharge of the patient/client taking into consideration achievement of anticipated goals and expected outcomes, and provides for appropriate follow-up follow-up, n the process of monitoring the progress of a patient after a period of active treatment. follow-up subsequent. follow-up plan or referral. The plan of care: * Is based on the examination, evaluation, diagnosis, and prognosis. * Identifies goals and outcomes. * Describes the proposed intervention, including frequency and duration. * Includes documentation that is dated and appropriately authenticated by the physical therapist who established the plan of care. D. Intervention The physical therapist provides, or directs and supervises, the physical therapy intervention consistent with the results of the examination, evaluation, diagnosis, prognosis, and plan of care. The intervention: * Is based on the examination, evaluation, diagnosis, prognosis, and plan of care. * Is provided under the ongoing direction and supervision of the physical therapist. * Is provided in such a way that directed and supervised su·per·vise tr.v. su·per·vised, su·per·vis·ing, su·per·vis·es To have the charge and direction of; superintend. [Middle English *supervisen, from Medieval Latin responsibilities are commensurate com·men·su·rate adj. 1. Of the same size, extent, or duration as another. 2. Corresponding in size or degree; proportionate: a salary commensurate with my performance. 3. with the qualifications and the legal limitations of the physical therapist assistant. * Is altered in accordance with changes in response or status. * Is provided at a level that is consistent with current physical therapy practice. * Is interdisciplinary in·ter·dis·ci·pli·nar·y adj. Of, relating to, or involving two or more academic disciplines that are usually considered distinct. interdisciplinary Adjective when necessary to meet the needs of the patient/client. * Documentation of the intervention is consistent with the Guidelines for Physical Therapy Documentation (BOD BOD: see sewerage. 02-02-16-20). * Is dated and appropriately authenticated by the physical therapist or, when permissible per·mis·si·ble adj. Permitted; allowable: permissible tax deductions; permissible behavior in school. per·mis by law, by the physical therapist assistant. E. Reexamination re·ex·am·ine also re-ex·am·ine tr.v. re·ex·am·ined, re·ex·am·in·ing, re·ex·am·ines 1. To examine again or anew; review. 2. Law To question (a witness) again after cross-examination. The physical therapist reexamines the patient/client as necessary during an episode of care to evaluate progress or change in patient/client status and modifies the plan of care accordingly or discontinues physical therapy services. The physical therapist reexamination: * Is documented, dated, and appropriately authenticated by the physical therapist who performs it. * Includes modifications to the plan of care. F. Discharge/Discontinuation of Intervention The physical therapist discharges the patient/client from physical therapy services when the anticipated goals or expected outcomes for the patient/client have been achieved. The physical therapist discontinues intervention when the patient/client is unable to continue to progress toward goals or when the physical therapist determines that the patient/client will no longer benefit from physical therapy. Discharge documentation: * Includes the status of the patient/client at discharge and the goals and outcomes attained at·tain v. at·tained, at·tain·ing, at·tains v.tr. 1. To gain as an objective; achieve: attain a diploma by hard work. 2. . * Is dated and appropriately authenticated by the physical therapist who performed the discharge. * Includes, when a patient/client is discharged prior to attainment of goals and outcomes, the status of the patient/client and the rationale rationale (rash´  nal´),n the fundamental reasons used as the basis for a decision or action. for discontinuation dis·con·tin·u·a·tion n. A cessation; a discontinuance. Noun 1. discontinuation - the act of discontinuing or breaking off; an interruption (temporary or permanent) discontinuance . G. Communication/Coordination/Documentation The physical therapist communicates, coordinates and documents all aspects of patient/client management, including the results of the initial examination and evaluation, diagnosis, prognosis, plan of care, interventions, response to interventions In education, Response To Intervention (commonly abbreviated RTI or RtI) is a method of academic intervention that is designed to provide early, effective assistance to children who are having difficulty learning as part of the process of diagnosing learning disabilities. , changes in patient/client status relative to the interventions, reexamination, and discharge/discontinuation of intervention, and other patient/client management activities. Physical therapist documentation: * Is dated and appropriately authenticated by the physical therapist who performed the examination and established the plan of care. * Is dated and appropriately authenticated by the physical therapist who performed the intervention or, when allowable by law or regulations, by the physical therapist assistant who performed specific components of the intervention as selected by the supervising physical therapist. * Is dated and appropriately authenticated by the physical therapist who performed the reexamination, and includes modifications to the plan of care. * Is dated and appropriately authenticated by the physical therapist who performed the discharge, and includes the status of the patient/client and the goals and outcomes achieved. * Includes, when a patient/client is discharged prior to achievement of goals and outcomes, the status of the patient/client and the rationale for discontinuation. IV. EDUCATION The physical therapist is responsible for individual professional development. The physical therapist assistant is responsible for individual career development. The physical therapist, and the physical therapist assistant under the direction and supervision of the physical therapist, participate in the education of students. The physical therapist educates and provides consultation to consumers and the general public regarding the purposes and benefits of physical therapy. The physical therapist educates and provides consultation to consumers and the general public regarding the roles of the physical therapist and the physical therapist assistant. The physical therapist: * Educates and provides consultation to consumers and the general public regarding the roles of the physical therapist, the physical therapist assistant, and other support personnel. V. RESEARCH The physical therapist applies research findings to practice and encourages, participates in, and promotes activities that establish the outcomes of patient/client management provided by the physical therapist. The physical therapist: * Ensures that their knowledge of research literature related to practice is current. * Ensures that the rights of research subjects are protected, and the integrity of research is maintained. * Participates in the research process as appropriate to individual education, experience, and expertise. * Educates physical therapists, physical therapist assistants, students, other health professionals, and the general public about the outcomes of physical therapist practice. VI. COMMUNITY RESPONSIBILITY The physical therapist demonstrates community responsibility by participating in community and community agency activities, educating the public, formulating public policy, or providing pro bono physical therapy services. The physical therapist: * Participates in community and community agency activities. * Educates the public, including prevention, education, and health promotion. * Helps formulate formulate /for·mu·late/ (for´mu-lat) 1. to state in the form of a formula. 2. to prepare in accordance with a prescribed or specified method. public policy. * Provides pro bono physical therapy services. GLOSSARY A term used by Microsoft Word and adopted by other word processors for the list of shorthand, keyboard macros created by a particular user. See glossaries in this publication and The Computer Glossary. STANDARDS AND CRITERIA Client--Individuals who engage the services of a physical therapist and who can benefit from the physical therapist's consultation, interventions, professional advice, health promotion, fitness, wellness, or prevention services. Clients also are businesses, school systems, and others to whom physical therapists provide services. Diagnosis--Diagnosis is both a process and a label. The diagnostic process includes integrating and evaluating the clam that are obtained during the examination to describe the patient/client condition in terms that will guide the prognosis, the plan of care, and intervention strategies. Physical therapists use diagnostic labels that identify the impact of a condition on function at the level of the system (especially the movement system) and at the level of the whole person. Evaluation--A dynamic process in which the physical therapist makes clinical judgments based on data gathered during the examination. Examination--A comprehensive screening and specific testing process leading to diagnostic classification or, as appropriate, to a referral to another practitioner. The examination has three components: the patient/client history, the systems review, and tests and measures. Intervention--The purposeful pur·pose·ful adj. 1. Having a purpose; intentional: a purposeful musician. 2. Having or manifesting purpose; determined: entered the room with a purposeful look. interaction of the physical therapist with the patient/client and, when appropriate, with other individuals involved in patient/client care, using various physical therapy procedures and techniques to produce changes in the condition. Patient--Individuals who are the recipients of physical therapy examination, evaluation, diagnosis, prognosis, and intervention and who have a disease, disorder, condition, impairment Impairment 1. A reduction in a company's stated capital. 2. The total capital that is less than the par value of the company's capital stock. Notes: 1. This is usually reduced because of poorly estimated losses or gains. 2. , functional limitation, or disability. Physical therapist patient/client management model The model on which physical therapists base management of the patient or client throughout the episode of care, including the following elements: examination, evaluation and reexamination, diagnosis, prognosis, and intervention leading to the outcome. Plan of care--Statements that specify the goals and the outcomes, predicted level of optimal improvement, specific interventions to be used, and proposed duration and frequency of the interventions that are required to reach the goals and outcomes. The plan of care includes the anticipated discharge plans. Prognosis--The determination of the predicted optimal level of improvement in function and the amount of time needed to reach that level. Treatment--The sum of all interventions provided by the physical therapist to a patient/client during an episode of care. HOD 06-03-09-10 [Amended a·mend v. a·mend·ed, a·mend·ing, a·mends v.tr. 1. To change for the better; improve: amended the earlier proposal so as to make it more comprehensive. 2. HOD 06-99-18-22; HOD 06-96-16-31; HOD 06-91-21-25; HOD 06-85-30-56; Initial HOD 06-80-04-04; HOD 06-80-03-03] BOD 03-04-19-44 [Amended BOD 03-00-22-53 BOD 11-99-20-53; BOD 03-99-15-45; BOD 02-97-03-05; BOD 03-95-22-58; BOD 11-94-30-100; BOD 03-93-21-58; BOD 03-91-31-79; BOD 03-89-28-88; Initial BOD 11-85-13-56] |
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