N.H. Admin. Code § Phy 404.11

Current through Register No. 49, December 5, 2024

Section Phy 404.11 - Skills To Be Determined for Physical Therapists Holding Conditionally Reinstated Licenses

The supervisor of a physical therapist holding a conditionally reinstated license shall, in the course of supervision, determine whether and to what extent the physical therapist has the following skills:

(a) Evaluation skills, including:

(1) Screening using procedures to determine the effectiveness of, and need for, physical therapy services, including:

a. Identifying critical signs and symptoms that signal appropriateness for physical therapy examination;

b. Selecting appropriate screening procedures;

c. Conducting physical therapy screening in a technically competent manner;

d. Interpreting screening findings; and

e. Determining, based on the screening, the client's appropriateness for physical therapy or referral to other providers;

(2) Examination skills, including:

a. Selection of reliable and valid physical therapy examination methods relevant to the client's complaint, the screening results, and the client's history;

b. Obtaining accurate information by performing the selected examination methods;

c. Performing them while minimizing risk to the patient and to the conditional licensee; and

d. Performing them in a technically competent manner; and

(3) Skills in using the clinical findings to determine physical therapy diagnoses and outcomes of care, including:

a. Synthesizing the examination data to complete the physical therapy evaluation;

b. Interpreting clinical findings to establish a physical therapy diagnosis;

c. Explaining to the client the influence of pathological, abnormal physiological, and pharmacological processes on the patient's movement system;

d. Using clinical findings and a medical or a physical therapy diagnosis to establish a physical therapy prognosis;

e. Performing regular re-examinations of the client's status;

f. Performing regular evaluations of the effectiveness of the client's treatment; and

g. Evaluating changes in the client's status;

(b) Treatment skills, including:

(1) Practicing in a manner that minimizes risk to the patient, to the physical therapist, and to others including, but not limited to:

a. Observing universal precautions and any health and safety regulations of the worksite;

b. Maintaining a safe working environment;

c. Recognizing physiological and psychological changes in the client and adjusting treatment accordingly;

d. Being aware of contraindications and precautions of treatment;

e. Requesting assistance when necessary; and

f. Using techniques designed for safety in the handling of patients;

(2) Applying the principles of logic and the scientific method to the practice of physical therapy, including:

a. Presenting a cogent rationale for clinical decisions;

b. Making clinical decisions within the context of the ethical practice set forth in Phy 500;

c. Making clinical decisions regarding therapy goals and the plan of care with the patient's informed consent and in accordance with RSA 328-A:15, III., IV. and V.;

d. Utilizing information from multiple data sources to make clinical decisions;

e. Distinguishing practices based on traditional beliefs from practices that are scientifically based; and

f. Using appropriate outcome measures in the delivery and assessment of ongoing patient care;

(3) Designing a physical therapy plan of care:

a. In collaboration with the patient;

b. Consistent with the patient's examination and evaluation;

c. Integrating goals, treatment, functional outcomes and a discharge plan;

d. Specifying the expected time durations for the goals and functional outcomes;

e. Adjusted in response to changes in the patient's status; and

f.. Establishing a plan for timely patient discharge; and

(4) Performing physical therapy interventions in a competent manner, including:

a. Selecting interventions designed to achieve the desired outcomes;

b. Performing effective, efficient, and coordinated movements in providing technically competent interventions;

c. Performing interventions consistent with the plan of care;

d. Providing interventions in a manner minimizing risk to the physical therapist and the patient; and

e. Using intervention time efficiently and effectively;

(c) Management skills, including:

(1) Producing documentation to support the delivery of physical therapy services, including:

a. Selecting relevant information to document the delivery of care;

b. Documenting all aspects of physical therapy care, including screenings, examination, evaluation, plan of care, treatment(s), response to treatment(s), discharge planning, family conferences, and communications with others involved in the delivery of care;

c. Producing documentation that follows the guidelines and format required by the practice setting;

d. Documenting patient care consistent with the board's rules and the requirements of third party payers; and

e. Producing documentation that is accurate, concise, timely, and legible;

(2) Participating in activities addressing quality of service delivery, including:

a. Seeking information regarding the quality of care he or she renders;

b. Following the protocols established by the prescribing physician, the practice setting, and the employer; and

c. Participating in quality assurance activities, peer reviews, and review of utilization of services;

(3) Addressing any needs of the patient for services other than physical therapy, including:

a. Determining the needs of, and available resources for, the patient;

b. Recommending referral(s) based on the expertise and effectiveness of provider(s);

c. Advocating for appropriate patient services and resources; and

d. Assisting patients in accessing resources; and

(4) Managing time, space, and equipment to achieve the goals of the practice site or practice setting, including:

a. Incorporating, through accurate and timely billing and otherwise, an understanding of economic factors in the delivery of physical therapy services;

b. Using time effectively;

c. Adhering to reimbursement guidelines established by payers for physical therapy services; and

d. The scheduling of patients, equipment and space; and

(d) Professional interaction skills, including:

(1) Presenting oneself in a professional manner, including:

a. Accepting responsibility for one's own actions;

b. Being punctual and dependable;

c. Completing scheduled assignments in a timely manner;

d. Wearing attire consistent with the expectations of the practice site or setting;

e. Abiding by policies and procedures of the practice site or setting; and

f. Adapting to changes in schedule, patient population, treatment location, and other changes similarly not within the control of the holder of the conditionally renewed license;

(2) Behaving professionally in interactions with others, including:

a. Maintaining productive working relationships with patients, the families of patients, and others;

b. Contributing to a positive work environment by treating others with positive regard, dignity, respect, and compassion;

c. Accepting criticism without defensiveness;

d. Managing conflict in positive ways; and

e. Maintaining patients' privacy and modesty;

(3) Adhering to ethical practice, including:

a. Complying with Phy 500;

b. Identifying situations in which ethical questions are present; and

c. Reporting to the employer and the board violations of ethical practice;

(4) Adhering to legal practice standards, including:

a. Abiding by applicable state and federal law, including RSA 328-A, RSA 328-F, and the rules of the board; and

b. Identifying situations in which legal questions are present;

(5) Communicating in ways that are congruent with situational needs, including:

a. Communicating verbally and nonverbally in a professional and timely manner;

b. Initiating communication in difficult situations;

c. Selecting the most appropriate person(s) with whom to communicate;

d. Listening actively and attentively to understand what is being communicated by others;

e. Using professionally and technically correct language;

f. Communicating using nonverbal methods that are consistent with the intended message;

g. Interpreting and responding to the nonverbal communication of others; and

h. Evaluating the effectiveness of his or her own communication and modifying communication accordingly;

(6) Adapting delivery of physical therapy care to reflect respect for, and sensitivity to, individual differences, including exhibiting sensitivity to differences in race, creed, color, gender, age, national or ethnic origin, sexual orientation, and disability or health status when:

a. Communicating with others;

b. Developing plans of care; and

c. Implementing plans of care; and

(7) Educating patients, the families of patients, other caregivers, other staff at the care site or in the care setting, students, and other health care providers, using relevant and effective teaching methods, including:

a. Identifying and establishing priorities for educational needs;

b. Designing education activities to address identified needs;

c. Conducting educational activities using a variety of instructional strategies; and

d. Evaluating one's own educational activities for effectiveness and modifying them accordingly.

N.H. Admin. Code § Phy 404.11

#9431, eff 3-19-09

Amended by Volume XXXVII Number 6, Filed February 9, 2017, Proposed by #12088, Effective 1/20/2017, Expires 1/20/2027.