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This article, found on AOTA's website, discussed an ethical issue that we, as practitioners, will face that I hadn't really thought about. As therapists we will be faced with the issue of treating two individuals who have the same diagnosis and prognosis, but have different insurances! One individual will more than likely get more minutes and resources based on their insurance compared to the other. This is definitely an ethical dilemma I hadn't thought about.

This article, written by the American Occupational Therapy Association, outlines various ethical issues concerning payment for services occupational therapy practitioners may face. For instance, occupational therapy practitioners may encounter situations where two individuals have the same diagnosis but are entitled by differing insurance plans to varying levels of services at different levels of reimbursement. Sadly, differences in insurance plans can pose inevitable differences in patients' care. I have been able to witness this scenario first hand, as some insurance companies will only pay a flat rate for 30 minutes of occupational therapy services for a skilled patient versus another insurance company allowing a patient to receive ninety minutes of skilled occupational therapy services per day, when both patients have the same diagnosis and deficits. It stands to reason that individuals who are able to receive more intensive services will receive a higher level of care as more time can be devoted to addressing deficits. All of the issues presented in this document can pose potential ethical dilemmas for occupational therapy practitioners; however, utilizing the AOTA Code of Ethics can enable practitioners to make effective, ethical decisions in the best interest of their patients.

This article is a great article about professionalism during an interview for an occupational therapy position. Although this article is not about clinical professionalism I thought it would be great to share as it gives great advise to us students about obtaining an occupational therapist position after we graduate. The article gives tips and advise to new grads on how to present your self when applying for a position. the article also gives potential questions to ask the employers and potential questions that will be asked of you. The article mentions how you should act in the room and how you should dress to portray a professional demeanor. The article is extremely relevant to us students as we will have to go through the process of obtaining an OT position in a couple of months.

With the increasing age of the baby boomer generation, it is expected that the number of individuals in long-term care facilities will increase. This article was written to help healthcare professionals anticipate the psychosocial needs that the baby boomer generation will have when residing in a long-term care facility. The author defines ten potential factors to look for when working within long-term care settings. For instance, the first psychosocial need the author anticipates the baby boomer generation will have is a desire for social connectedness with others. By anticipating these needs, occupational therapists will be better prepared to help the baby boomers smoothly transition into long-term care facilities.

Information on Medicare and Medicaid Services.

This article is great for people to read who are going to be working in nursing homes. It focuses on the psychosocial needs of the baby boomers as they move into nursing home care.

Within the last decade there has been a substantial push for healthcare professionals, including occupational therapists, to utilize evidence-based practice. This article outlines some of the many initiatives that have been developed in order to encourage occupational therapy practitioners to use evidence-base practice. While significant strides have been made in order to utilize evidence in everyday practice, there is still a great room for improvement within this arena. The goal for the future is that evidence-based practice will be so commonplace that the phrase will not be prominent; instead it will simply become an everyday part of practice.

This PowerPoint presentation discusses and defines the importance of conscious decision making in occupational therapy. The Ontario College of Occupational Therapists define a consciously competent practitioner as one who knows his or her strengths and limits; knows the standards, guidelines and rules, and the values behind them; makes good choices consciously and deliberately; and is able to explain why he or she took a particular course of action. The presentations discusses that as clinicians we will encounter numerous situations that will us to make conscious decisions and, more often than not, the situation will involve an ethical dilemma. The Ontario College provided easy to follow steps to get rid of that uneasy or hesitant feeling as a therapist facing an ethical dilemma. Step 1) Describe the situation. Step 2) Identify the principles related to the situation. Step 3) Identify the relevant resources to assist with the decision-making. Step 4) Consider if you need further information or clarification. Step 5) Identify the options. Step 6) Choose the best option. Step 7) Take action. Step 8) Evaluate the decision.

This website summarizes the benefits of implementing evidence-based practice in the healthcare setting. This process may involve conducting research within the healthcare setting but it does not necessarily mean a healthcare professional has to be directly involved in conducting research. It can also mean to understand the latest evidence from research and use it to guide patient care to provide the best possible outcomes. Some of the benefits include a higher quality care that is supported by evidence and improved healthcare outcomes. This article also reports that healthcare professionals will also have increased confidence when making decisions and using critical thinking because their decisions will be supported. Using EBP may also reduce costs in healthcare because it is more effective and efficient. Insurance companies are also more likely to support practices that are evidence-based. It is important to understand the benefits of implementing EBP in occupational therapy because practitioners will be more likely to implement these supported practices if they understand the benefits.

The scope of this handout created by North Carolina Department of Public Instruction is a guide for school based therapist when determining if a child is in need of services in the school. This document states that if the child cannot have access to their education or will not experience educational benefit then occupational therapy services are relevant and could be necessary in order to enhance the child's educational success. Alternatively, this handout also addresses when occupational therapy services are not warranted. Some indicators to know when services are not needed include 1) the needs can be addressed by a special educator or school faculty 2) can needs be addressed during non school hours and/or 3) will providing services lead to an unnecessary gaps or contraindications with other necessary services. These simple guidelines can help the therapist to clinically reason if the student requires services and why or why not. Another great piece of this handout is discussing when occupational therapy services can be discontinued. This section helps the therapist walk through the necessary step in order to accurately determine if services are still needed.

I am posting this article on the signs of elder abuse as it will be our ethical responsibility to report abuse if we see these signs in the workplace. The article is easy to read and quick to point out 5 types of abuse and what to look for in each type. The fist is physical abuse and the signs for these are bruises, broken bones, burns, abrasions, pressure marks, and odd explanations of injuries from staff or caregivers. The next type of abuse is neglect and the signs for this are dirty cloths, soiled diapers, bedsores, unusual weight loss, unusually messy home that wasn't before, and lack of DME. The next type of abuse is verbal or emotional abuse and the warning signs associated include, withdrawal, unusual behavior, nervous behavior around caregiver, strained or tense relationship with caregiver or staff, forced isolation from family or caregiver, and caregivers or staff that snap or yell. The article also describes signs of sexual abuse and signs of financial exploitation. As OTs it will be our duty and ethical responsibility to report elder abuse. Home health and SNF are probably the two most prominent areas of practice that might see this problem.

This article examines ethical issues in long-term care. One key component of solving ethical issues in long-term care settings is continually reexamining the beliefs and assumptions of the elderly in this setting and how occupational therapy services will affect them. One area that we must consider to make ethical decisions is the changes in medical technology and the demographics of the residents in these long-term care settings. The next point the article discusses is the concept of autonomy and how the current autonomy paradigm is poorly suited to guide occupational therapy's decisions regarding older adults in long-term care. The concepts of autonomy inadequately describe the realities of aging populations according to this article. The third concept is to create a new approach of autonomy by consulting the individual and taking into account the elderly's freedoms while they are residing in long-term care facilities. Another model that must be incorporated into developing ethical guidelines for long-term care settings is the partnership model, which states that family and important resources should be included in the daily living activities and critical health care decisions of the residents. Approaching occupational therapy with these concepts in mind will allow for better quality of care and increased ethical guidance.

Documentation is extremely important in the OT profession, and is necessary whenever professional services are provided to a client. The AOTA standard's of practice state that, "an OT practitioner should document OT services and abide by the time frames, format, and standards established by practice settings, governmental agencies, payers, AOTA documents, and external accreditation agencies." This document is based on the AOTA framework and describes and defines the various components of documentation so that OT practitioners have a clearer idea of what documents are and how they can be used to document client services. I believe this document will be beneficial to us as we begin to start our jobs as practitioners and will assist us in the documentation process.

This article aims to use a qualitative descriptive study to describe occupational therapists experiences and improvements in work after adopting the Occupational Therapy Intervention Process Model (OTIPM). The OTIPM is a client-centered, top down, occupation-focused OT model of practice. The assumptions of the model are that every person is unique, has the will to engage in meaningful occupations, occupations are the primary therapeutic means and engagement in occupations in the central focus in OT. The study was conducted in an acute care hospital in Sweden starting in 2001. They were selected because the therapists wanted to improve OT services and promote evidence-practice in their hospital. The participants participated in a total of six semi-structured focus interviews in which the occupational therapists were asked to describe their experiences of the long-term improvements in work, attitudes toward improvements work and thoughts on how this improved work impacts the goal to change to a more sustainable and evidence-based OT practice in their setting. The first three interviews were in 2006 and the last three were in 2011. The interviews were analyzed and broken down into common themes among therapists. The first theme is that the therapists found their thoughts and actions were transformed on an individual and group level after adopting the OTIPM. The second theme discovered how the therapists dealt with conflicting feelings and attitudes toward change. The final theme describes a shared professional culture. In conclusion, the investigators discovered from the 10-year study and testimonies of Swedish therapists that the use of OTIPM can lead to the integration of evidence-based knowledge that has long-lasting achievements in practice.

http://www.tandfonline.com/doi/abs/10.3109/11038128.2013.872183?journalCode=iocc20 I found the article through a SSU library search. The content may not show up on this site, but if you log into the library and search the article you will have access. Here is another resource as well.

AOTA. Occupational Therapy Assistant Supervision Requirements. This AOTA document summarizes laws for supervision of COTAs by state. I compared some of the supervision laws of Ohio and Kentucky because I will most likely be working in one or both of these states. As I read through the specific laws for each of these states, I was surprised by the differences. For practitioners living near the border of multiple states, being well-versed in specific state laws will be essential for protecting our licensure. I summarized just a couple specific laws of these two states to give you a better idea of how they may differ state to state. This is a very important document to keep handy, and it goes into much more detail than what I've provided here. In Kentucky, supervising OTs must provide no less than 4 hours per month of general supervision for each COTA, which must include no less than 2 hours per month of face-to-face supervision. This law is more specific in Ohio. In Ohio, OTs must provide supervision at least once a week for all COTAs who are in their first year of practice. The OT must provide supervision at least once a month for COTAs beyond their first year of practice. Ohio law specifies that co-signing client documentation alone does not meet the minimum level of supervision. Supervision is specified as an interactive process that includes review of the following: client assessment, client reassessment, treatment/intervention plan, intervention, and discontinuation of treatment/intervention plan. In Kentucky, OTs may not have more than the equivalent of 3 full time COTAs under supervision at any 1 time. In Ohio, the number of COTAs an OT can supervise varies based upon the OTs job duties. If the OT performs evaluations, direct treatment, and supervision of OT personally, an OT may supervise up to 4 COTAs. However, if the OT does NOT provide direct treatment, the OT may supervise up to 6 COTAs.

These are just short little statements regarding the effectiveness that OT has in acute care settings with different diagnoses. Alot of my patient recently have questioned what I can actually help them do in a few short days. This is just a tool I will probably pull out to prove that OT does help!