Level II Fieldwork Objectives

MOSSREHAB HOSPITAL OCCUPATIONAL THERAPY DEPARTMENT Level II Site-Specific Fieldwork Objectives

I. FUNDAMENTALS OF PRACTICE

1. Adheres to Ethics: Adheres consistently to the AOTA Code of Ethics and site’s policies and procedures including, when relevant, those related to human subject research. The student will: . Maintain strict patient confidentiality according to HIPPA guidelines . Interact professionally and respectfully with patients, families, and staff. . Maintain quality patient care and patient satisfaction as guidelines for professional behavior. 2. Adheres to Safety Regulations: Anticipates potentially hazardous situations and takes steps to prevent accidents. The student will: . Utilize infection control precautions and procedures. . Follow unit and facility policies and procedures in response to emergency codes and/or drill situations. . Follow unit and facility policies and procedures related to restraint reduction, fall prevention and incident reporting. 3. Uses judgment in safety: Uses sound judgment in regard to safety of self and others during all fieldwork-related activities. The student will: . Familiarize self with equipment and/or seek assistance for proper use. . Provide safe supervision of patients during high-risk activities. . Demonstrate clinical judgment to prevent falls and other adverse outcomes during treatment. . Seek assistance and be receptive to feedback to ensure patient safety.

II. BASIC TENETS

4. Clearly and confidently articulates the values and beliefs of the OT profession to clients, families, significant others, colleagues, service providers, and the public. The student will: . Articulate what occupational therapy is and what occupational therapists do in general and specific to this facility/program. 5. Clearly, confidently and accurately articulates the value of occupation as a method and desired outcome of occupational therapy to clients, families, significant others, colleagues, service providers and the public. The student will: . Explain, in understood terminology the meaning and value of occupation as it relates to each individual in this physical disabilities setting. 6. Clearly, confidently and accurately communicates the roles of the occupational therapist and the occupational therapy assistant to clients, families, significant others, colleagues, service providers and the public. The student will: . Verbalize and differentiate the roles of the OT, COTA, and rehab aide within this practice setting. 7. Collaborates with clients, family and significant others throughout the OT process. The student will: . Involve the patient and family in the information-gathering and goal-setting process of the initial evaluation and regularly communicate functional status and progress. . Consistently include the patient and/or family in treatment planning and adjust the treatment plan according to feedback. . Involve the patient and family in discharge planning.

III. EVALUATION AND SCREENING

8. Articulates a clear and logical rationale for the evaluation process. The student will: . Explain how and why a specific approach to the evaluation process is being used to patients, family members and team members. . Articulate the evaluation process clearly to patients, family members and significant others. 9. Selects relevant screening and assessment methods while considering such factors as client’s priorities, context(s), theories and evidence-based practice. The student will: . Demonstrate an understanding of standardized and non- standardized assessment methods appropriate to utilize on assigned unit. 10. Determines client’s occupational profile and performance through appropriate assessment methods. The student will: . Accurately gather information related to the patient’s occupational profile by obtaining information from multiple sources, including the medical record, client, family members and staff. . Recognize the importance of assessing the patient’s occupational performance in various contexts. 11. Assesses client factors and context(s) that support or hinder occupational performance. The student will: . Recognize the impact environment has on the patient’s performance and adjusts accordingly. . Determine appropriate areas requiring further assessment. 12. Obtains sufficient and necessary information from relevant sources such as client, families, significant others, service providers and records prior to and during evaluation process. The student will: . Accurately interpret information from the medical chart. . Consolidate information gathered from the client and family, as well as from other team members. . Clarify necessary information regarding medical precautions with the appropriate team member. 13. Administers assessments in a uniform manner to ensure findings are valid and reliable. The student will: . Familiarize him/herself with available assessments in the clinic/department and administer them as appropriate. . Maintain objectivity when administering non-standardized assessments. . Remain consistent in the implementation of standardized assessments. . Demonstrate adequate knowledge of the Functional Independence Measure (FIM) in order to provide accurate scores upon admission and discharge. 14. Adjusts/modifies the assessment procedures based on client’s needs, behaviors and culture. The student will: . Recognize the need for another discipline’s assistance and/or presence when necessary. . Request an interpreter to assist with language barriers if necessary. . Adjust the time of day and/or location of the assessment as necessary. 15. Interprets evaluation results to determine client’s occupational performance strengths and challenges. The student will: . Accurately interpret and document how the client’s strengths and limitations affect their occupational roles. 16. Establishes an accurate and appropriate plan based on the evaluation results, through integrating multiple factors such as client’ priorities, context(s), theories and evidence-based practice. The student will: . Set appropriate short and long-term goals with collaboration from the patient and/or family members. . Identify goals that are specific, objective and measurable. . Estimate a reasonable length of stay based on the client’s pre- morbid status, current functional status and disposition. 17. Documents the results of the evaluation process that demonstrates objective measurement of client’s occupational performance. The student will: . Accurately report performance according to the Functional Independence Measure (FIM) and provide comments as necessary. . Utilize appropriate documentation/forms according to treatment unit/program. . Recognize the need for additional documentation/forms (e.g. addendums) based on evaluation results. . Utilize acceptable hospital abbreviations.

III. INTERVENTION

18. Articulates a clear and logical rationale for the intervention process. The student will: . Explain the rationale for OT intervention based on the recipient’s level of understanding. 19. Utilizes evidence from published research and relevant resources to make informed intervention decisions. The student will:  Demonstrate the ability to interpret evidence for use in assigned practice setting.  Demonstrate the ability to determine appropriate treatment when lack of evidence exists. 20. Chooses occupations that motivate and challenge clients. The student will: . Collaborate with the client to identify meaningful and challenging activity related to their pre-morbid occupational roles. 21. Selects relevant occupations to facilitate clients meeting established goals. The student will: . Demonstrate functional-based interventions for self-care performance areas. . Utilize group treatment as appropriate. . Participate in community re-entry outings as able. . Collaborate with other disciplines to provide relevant occupation-based treatment. 22. Implements intervention plans that are client-centered. The student will: . Incorporate the patient’s input into the intervention plan. . Recognize the need for family/caregiver’s input into the treatment plan. . Re-assess the intervention plan with the patient and/or family on a regular basis. 23. Implements intervention plans that are occupation-based. The student will: . Implement intervention plans based on the patient’s pre-morbid and present occupational roles. 24. Modifies task approach, occupations, and the environment to maximize client performance. The student will: . Demonstrate the ability to readily upgrade or downgrade an activity based on the patient’s performance. . Recognize the need to change an activity based on the patient’s participation and/or behavior. . Recognize the need to alter the environment based on the patient’s participation and/or behavior. 25. Updates, modifies or terminates the intervention plan based upon careful monitoring of the client’s status. The student will: . Alter the intervention plan based on the changes in the patient’s functional performance, taking into account specific changes in physical, cognitive and behavioral status. . Adjust the intervention plan according to changes in disposition and/or family/caregiver support. 26. Documents client’s response to services in a manner that demonstrates the efficacy of interventions. The student will: . Document appropriate subjective material related to treatment intervention. . Document according to FIM providing sufficient comment to recognize the patient’s response and the efficacy of interventions.

V. MANAGEMENT OF OCCUPATIONAL THERAPY SERVICES

27. Demonstrates through practice or discussion the ability to assign appropriate responsibilities to the occupational therapy assistant and occupational therapy aide. The student will: . Utilize the assistants and aides to provide effective patient treatment. . Provide adequate instruction to the aide in how to assist during treatment sessions. . Demonstrate the ability to delegate responsibilities to the aides for effective time management. 28. Demonstrates through practice or discussion the ability to actively collaborate with the COTA. The student will: . Discuss or demonstrate how to assign appropriate patients to the COTA and monitor progress, making modifications to the treatment plan as appropriate. . Recognize differences in the supervision needs of each COTA and adjust collaboration as appropriate. 29. Demonstrates understanding of the costs and funding related to occupational services at this site. The student will: . Bill for services according to the policies and procedures of the facility and/or unit. . Ensure that both direct and indirect patient care is used productively. . Demonstrate awareness of the cost of adaptive equipment/DME and issue it to clients appropriately. . Take initiative to learn about changing regulations and laws regarding reimbursement specific to the unit/facility. . Consider insurance regulations/coverage with regards to DME recommendations and continuation of OT services. . Understand the various levels of OT service delivery within the network and make appropriate referrals. 30. Accomplishes organizational goals by establishing priorities, developing strategies and meeting deadlines. The student will: . Demonstrate punctuality for all scheduled treatment sessions and meetings. . Demonstrate the ability to problem-solve and prioritize patient needs, family training, rounds and meetings. . Demonstrate flexibility in scheduling based on patient/department need. . Complete assignments by scheduled deadlines. 31. Produces the volume of work required in the expected time frame. The student will: . Meet the caseload expectations of a level II student specific to their program/unit and complete assignments accordingly. . Complete all necessary documentation according to policy.

VI. COMMUNICATION

32. Clearly and effectively communicates verbally and nonverbally with clients, families, significant others, colleagues, service providers and the public. The student will: . Present self in a professional manner to clients, families, significant others and colleagues. . Demonstrate therapeutic use of self to achieve maximum outcomes in treatment. . Arrange for interpreter services when necessary and demonstrate the ability to effectively use the interpreter during treatment sessions. . Utilize knowledge of practice framework terminology and collaborate with colleagues as needed. . Present a relevant in-service/project to colleagues. 33. Produces clear and accurate documentation according to site requirements. The student will: . Follow documentation policies and procedures according to the specific unit/program. . Utilize professional language in accordance with the uniform terminology of the facility. 34. All written communication is legible, using proper spelling, punctuation and grammar. The student will: . Seek assistance for alternative methods of written communication as needed. . Utilize available resources to ensure proper spelling, punctuation and grammar. 35. Uses language appropriate to the recipient of the information, including but not limited to funding agencies and regulatory agencies. The student will: . Demonstrate the ability to write a letter of medical necessity as needed.

VII. PROFESSIONAL BEHAVIORS

36. Collaborates with supervisor(s) to maximize the learning experience. The student will: . Attend supervisory meetings as scheduled by the supervisor and program coordinator, demonstrating an active role and preparedness. . Understand his/her learning style (Learning Style Inventory) and that of the supervisor and how it affects the supervisory process. 37. Takes responsibility for attaining professional competence by seeking out learning opportunities with supervisor(s) and others. The student will: . Demonstrate self-motivation in attending facility-run in- services, meetings and rounds as able. . Seek out interdisciplinary team members to gain competence in discipline-specific treatment areas that affect occupational therapy goals. . Seek out senior staff members and other disciplines for learning opportunities. . Take initiative to observe other units/programs within the network. . Demonstrate the ability to generalize information learned from specific situations into novel situations. 38. Responds constructively to feedback. The student will: . Provide feedback to the supervisor and program coordinator as appropriate and receive feedback in a constructive manner. . Incorporate feedback into practice in a timely manner. 39. Demonstrates consistent work behaviors including initiative, preparedness, dependability and work site maintenance. The student will: . Adhere to a consistent work schedule within the policy of the program/unit. . Follow program/unit policy and procedures for scheduling and billing. . Demonstrate adequate preparedness for all team rounds and family meetings as scheduled. . Arrange for caseload coverage for time-off according to program/unit policy. 40. Demonstrates effective time management. The student will: . Attend all scheduled meetings and in-services while managing his/her caseload. . Utilize available resources/tools for effective time management. 41. Demonstrates positive interpersonal skills, including but not limited to cooperation, flexibility, tact, and empathy. The student will: . Demonstrate effective interpersonal skills when working with patient’s, family members, team members, vendors and insurance companies. 42. Demonstrates respect for diversity factors of others including but not limited to socio-cultural, socioeconomic, spiritual and lifestyle choices.

Updated 2/08