Poster Sessions - 2018 Research Day

Event Title

Exploration of the Decision-Making Process for Physical Therapist to Physical Therapist Assistant Delegation in the Acute Care Setting: A Retrospective Case Report

Location

Hall of Governors

Start Date

4-6-2018 4:00 PM

End Date

4-6-2018 5:30 PM

Abstract

Background/purpose: Guidelines for PT to PTA delegation are vague. Coupled with decision-making processes for delegation not being well-defined in the literature and limited published research on this topic, PTs may find themselves in the midst of an ethical dilemma. The purpose of this case report is to explore and describe the decision-making process behind PT to PTA delegation of a medically complex patient with congestive heart failure (CHF) in the acute care setting to further the discussion of appropriate delegation practices within the physical therapy profession.

Case Description: An 88-year-old African American male recently admitted to an acute care facility with acute on chronic diastolic and systolic CHF. The therapy team that provided acute rehabilitative services consisted of two PTs and one PTA. PT to PTA delegation practices at this hospital were primarily determined by census and patient need for skilled services.

Outcomes: The patient was seen by an SPT for a total of four visits. Despite discharge recommendations to receive more care at a skilled nursing facility, the patient chose to return to his assisted living facility housing.

Discussion: Delegation practices in acute care are often based on hospital census, caseload demands, productivity, and services required without full consideration of ethical best practice. Renewed focus on a patient-centered approach is needed when making delegation decisions in the acute care setting. Patient factors, interventions within the plan of care, scope of practice, risk management, and the code of ethics should be considered prior to delegating patient care to a PTA in this setting.

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Research was supported by GSU Office of Student Life

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Apr 6th, 4:00 PM Apr 6th, 5:30 PM

Exploration of the Decision-Making Process for Physical Therapist to Physical Therapist Assistant Delegation in the Acute Care Setting: A Retrospective Case Report

Hall of Governors

Background/purpose: Guidelines for PT to PTA delegation are vague. Coupled with decision-making processes for delegation not being well-defined in the literature and limited published research on this topic, PTs may find themselves in the midst of an ethical dilemma. The purpose of this case report is to explore and describe the decision-making process behind PT to PTA delegation of a medically complex patient with congestive heart failure (CHF) in the acute care setting to further the discussion of appropriate delegation practices within the physical therapy profession.

Case Description: An 88-year-old African American male recently admitted to an acute care facility with acute on chronic diastolic and systolic CHF. The therapy team that provided acute rehabilitative services consisted of two PTs and one PTA. PT to PTA delegation practices at this hospital were primarily determined by census and patient need for skilled services.

Outcomes: The patient was seen by an SPT for a total of four visits. Despite discharge recommendations to receive more care at a skilled nursing facility, the patient chose to return to his assisted living facility housing.

Discussion: Delegation practices in acute care are often based on hospital census, caseload demands, productivity, and services required without full consideration of ethical best practice. Renewed focus on a patient-centered approach is needed when making delegation decisions in the acute care setting. Patient factors, interventions within the plan of care, scope of practice, risk management, and the code of ethics should be considered prior to delegating patient care to a PTA in this setting.