36C25519Q0482-007.doc

Self-Assessment Skills Checklist Occupational therapist Name: _______________________________

Date: _______________________________

Signature:

Self-Rating Definitions

1. No Experience, Not competent

2. Novice Practitioner: performs as entry level graduate; tends to be rule or “recipe” driven; collects facts and performs procedural interventions but has difficulty filtering, prioritizing, and synthesizing patient data to grasp the big picture; use of analytical reasoning to link cause and effect in a concrete manner;

3. Advanced Beginner: beginning to use past experiences to recognize patterns and filter irrelevant information; broadened analytical reasoning enables resident to summarize data in a clinically meaningful way;

4. Competent: accepts full responsibility for delivering virtuous physical therapy care; readily identifies patterns in patient data or responses based on past experiences; challenged by complexity, unfamiliarity, or limited information; reverts to more methodical, analytical decision-making approach when faced with these situations;

5. Proficient: beginning to adopt a more intuitive approach to decision-making; beginning to tolerate ambiguity and anxiety; still using a methodical, analytical approach when intuition is inadequate to solve a problem;

6. Advanced Practitioner: readily identifies clinical presentations or responses that are inconsistent with a specific clinical pattern; consistently integrates knowledge from interdisciplinary sources and research evidence to optimize clinical practice; demonstrates strong commitment to advancing one’s own practice; at the most advanced levels, this practitioner uses clinical / research knowledge and skill consistently, efficiently, and effectively across a wide spectrum of patients; tolerates uncertainty; manages ambiguity; able to make sound decisions based on limited information; adept at using reflection in action to alter decision-making; attentive to the multidimensional factors influencing an episode of care.

Please use the space at the end of this document to any other clinical competencies, advanced skills, strengths/weakness that you wish to highlight

Comprehensive, Evidence-based Occupational Therapy Evaluation in the following clinical settings:

Outpatient ages 18+

Acute Care Inpatient Hospital

Comprehensive Rehabilitation Inpatient

Skilled Nursing / Extended Care

Home Care

Comprehensive, Evidence-based Occupational Therapy Treatments in the following clinical settings:

Outpatient ages 18+

Acute Care Inpatient Hospital

Comprehensive Rehabilitation Inpatient

Skilled Nursing / Extended Care

Home Care

VITAL SIGNS/BP & PULSE

a. Demonstration of BP & Pulse testing

b. Verbalization of alternate measure placements

c. Pulse Ox reading

d. Indications for taking vital signs

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. Verbalize 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. Examples of testing balance (e.g.5 Time Sit to Stand, Functional Reach, FIST)

b. Verbalization and examples of functional progressive balance exercises

COORDINATION

a. Examples of coordination/gross motor function tests (finger to nose, heel to shin, heel to toes, alternating rapid movement, cross body movement)

b. Fine motor-functional dressing (button/zipper), self-cares, 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 (Increased, Decreased, Flaccid, Paresis, Paralysis, Paresthesia, Hyperesthesia, Kynesthesia)

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

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

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. Function: how can strength be functional?

HOYER/OVERHEAD LIFT

a. Verbalizes safe use of hoyer and/or overhead lift systems, sling sizes, adjustment/fixation to lift/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 in to account)

c. Proper fitting of cushion and indication for different cushion types

ORTHOTICS/PROSTHETICS

a. Indication and types of hand splints, prosthetics, slings-based on prognosis, dysfunction

b. Indication and types of bracing

c. Make appropriate recommendations based on physical presentation of the patient

c. Education on splint wearing schedule

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. Proper 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 x 4

b. Patient’s current level of alertness, orientation, comprehension, concentration, and immediate memory for simple commands.

d. Examples of cognitive assessments (MOCA, Short Blessed, TMYB)

HOME SAFETY/ENVIRONMENTAL ADAPTATIONS

a. Evaluation and adaptation of environmental barriers in bathroom, bedroom, kitchen, entrance/exit

b. Suggestive adaptive equipment/durable medical equipment

FUNCTIONAL MOBILITY

a. Demonstrate, assess and teach

1. Bed mobility

2. Transfers

3. Ambulation

4. Wheelchair management

ADLS

a. Assess and teach basic toileting, dressing, grooming and bathing

b. Assess and teach advanced meal prep, housekeeping, laundry

c. Assess medication management and strategies

INTEGUMENTARY

a. Identification of impaired integumentary system

b. Treatment ideas and referral indications

c. Recognize signs and symptoms of infection

USE OF PHYSICAL AGENTS

Ultrasound

Electrical Stimulation – TENS, FES, Neuromuscular, Transcutaneous

Cryotherapy – cold packs, ice massage, hydrotherapy

Thermotherapy – dry heat, hot packs, paraffin, hydrotherapy

CARDIO-PULMONARY

a. Identify indications for pulm exercise and postural drainage

e. Teach Caregiver/Patient energy conservation

DME

a. Patient and caregiver training

b. Measuring and sizing

d. Verbalize ordering process

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

Below please describe any other clinical competencies, advanced skills, strengths/weakness that you wish to highlight.

Comments: _____________________________________________________________________