AGING & DISABLED HOME HEALTH CARE ASSISTANT

AGING & DISABLED HOME HEALTH CARE ASSISTANT
COMPETENCY & SKILLS CHECKLIST—PHYSICAL THERAPIST/PHYSICAL THERAPIST ASSISTANT



Self Assessment
Do you have experience with this skill? Are you competent performing the following: Competency for the Occupational Therapist Proficiency Required Evaluation Method Competency Validation Indicated by Preceptors Initials and Date
YES NO YES NO
VITAL SIGNS/ BP & PULSE
a. Demonstration of BP & Pulse testing
b. Verbalization of alternate measure placements
c. Pulse Ox reading
d. Verbalization of HR/Pulse parameters
e. Indications for taking vital signs
COMPREHENSIVE ASSESSMENT
a. Heart Sounds
b. Lung Sounds
c. Bowel Sounds
ROM/GONIOMETRY
a. Demonstration of using goniometer at selected joints
b. Demonstration of checking functional ROM (recognizing pain limitations)
c. Demonstrate assessment of end feel/joint integrity
d. Verbalization contraindications for ROM testing
MMT/STRENGTH
a. Demonstration of testing muscle strength at selected joints (use of dynamometer as indicated)
b. Verbalization of testing functional strength
c. Verbalization contraindications for MMT testing
BALANCE
a. Verbalization of balance assessment during functional activities
COORDINATION
a. Examples of coordination/gross motor function tests (finger to nose, heel to shin, heel to toes, alternating rapid movement, cross body movement)
SENSATION/PROPRIOCEPTION
a. Verbalization of examples of sensation tests (Hot/Cold, Two point, Sharp/Dull, Light Touch/Pressure)
b. Recognize deficits in proprioception and provide treatment strategies
MUSCLE TONE/REFLEX
a. Verbalization of muscle tone (i.e. increased, decreased, flaccid, paraesis, paralysis, paresthesia, hyperesthesia, kinesthesia)
EDEMA
a. Demonstration of pitting test
b. Edema measurement sites
c. Examples of edema reduction techniques
d. Identify indications for lymphedema management
AMBULATION DEVICES
a. Cane, Walker, WW, Crutches
1. Height adjustment- demonstrate
2. Monitor patient during functional use
3. Use- PT will demonstrate institution of AD use
4. Evaluation of gait patterns and strategies toimprove
BEDS
a. Appropriate height of bed, location
1. Verbalizes proper position of patient sitting at edge and promoting safe transition thru height and location of bed.
b. Modifications- discuss rails vs. trapeze vs. hospital bed (electrical vs. manual)
O2
a. Change tank
b. Adjust liter flow
c. Flow rate reading
d. Nasal canula application
e. Safety instruction  no smoking
f. Pulse ox- indication, order
CPM
a. Demonstration and instruction to patient of proper use- axis of rotation, heel plate, ROM, setting position of leg
b. Able to identify indications and contraindications for use of CPM.
STRENGTHENING PROGRESSION
a. List options for strengthening modalities
1. Creative strengthening tools, T-band, weights, pedal bike, wheelchair pushups
2. Bed  sitting  standing progression
3. Functional- how can strength be functional?
HOYER LIFT
a. Verbalizes safe use of hoyer, sling sizes, adjustment/fixation to hoyer, and instruction to caregiver with demo, if able.
b. Indications (trunk control)
SEATING AND MOBILITY-WHEELCHAIR
a. Indications for power vs. manual
b. Proper fitting  leg rests, arm rests, seat depth, seat width, height, ability to go to table (take cushion into account)
c. Proper fitting of cushion and indication for different cushion types.
ORTHOTICS/PROSTHETICS
a. Indication and types of bracing- based on prognosis
b. Make appropriate recommendations based on physical presentation of the patient
ENDURANCE
a. Borg/RPE (rate of perceived exertion scale)
b. Recognize signs and symptoms of endurance limitations
POSTURE
a. Demonstrate proficiency in normal postural alignment in sitting and standing
BODY MECHANICS
a. Use of transfer/gait belt
b. Body mechanics for bending, lifting, reaching and computer ergonomics
PAIN
a. Faces Scale
b. Verbal analog scale
c. Visual analog scale
d. Pain management techniques- verbalize traditional and alternative therapies
e. Identify ineffective and inappropriate pain management and appropriate follow-up
MENTAL/COGNITIVE STATUS
a. Alert and oriented x3
b. Patient’s current level of alertness, orientation, comprehension, concentration, and immediate memory for simple commands.
HOME SAFETY/ENVIRONMENTAL ADAPTATIONS
a. Evaluation and adaptation of environmental barriers in bathroom, bedroom, kitchen, entrance/exit
b. Suggestive adaptive equipment
FUNCTIONAL MOBILITY
a. Demonstrate, assess and teach:
1. bed mobility
2. transfers
3. ambulation
4. wheelchair management
INTEGUMENTARY
a. Identification of impaired integumentary system
b. Treatment ideas and referral indications
c. Recognize signs and symptoms of infection
USE OF PHYSICAL AGENTS
a. List 3 contraindications/List 3 indications:


b. Hot/cold massage- can demonstrate safe use on agency specific machine
CARDIO-PULMONARY
a. Identify indications for:
1. Pulm ex
2. Postural drainage
3. Energy conservation
b. Teach Caregiver/Patient
c. Demonstrate- Percussion post drainage
DME
a. Recognize providers in area
b. Verbalize ordering process
c. Be familiar with insurance coverage
OTHER:
a. Acknowledge precautions for the population being treated:
1. Allergies
2. Medication reaction
3. Bleeding precautions
4. Fall precautions
5. Seizure precautions
b. Medication baseline knowledge