Assignment 3 – Supervision Scenarios
Case #1: A patient underwent an uncemented total hip arthroplasty. After an unremarkable
stay at an acute care hospital, she was discharged to home. The surgeon sent a referral for
home PT specifying “toe touch weight bearing.” The D/C note was sent to the home health care
agency but was incorrectly transcribed as “weight bearing as tolerated.” A PT completed an
initial examination and evaluation of the patient and developed a plan of care. The PT directed
a physical therapist assistant (PTA) to carry out the therapy interventions for the patient. The
PT did not document whether the hip prosthesis was cemented or uncemented, nor did it
record specific limitations to the patient’s weight bearing status. Because the plan of care
contained no information about the type of prosthesis used, the PTA started the patient at toe
touch weight bearing on the affected lower extremity and over the next 3 weeks she
progressed the patient to minimal and then partial weight bearing. By the end of the first 6
weeks of therapy, the PTA had progressed the patient to full weight bearing without an
assistive device and had her performing pivot transfers. In total, the PTA saw the patient in her
home 3 times a week for 3 months. Although the patient complained of continuous soreness
and swelling during that period, there was no documentation that the PTA discussed the
patient’s care or status with the supervising PT or that the PT reassessed the patient after the
initial visit. The patient was discharged by the PTA with a home exercise program. Six months
later, the patient had to undergo a second arthroplasty due to nonadherence of the prosthesis.
Case #2: A 35-year-old male patient with a history of traumatic brain injury was receiving twice
a week out-patient physical therapy including aquatic therapy. The physical therapist (PT)
typically worked with the patient individually and then had him to walk on his own along the
pool wall holding the handrail. The patient had been seen for several weeks and was showing
improvement. One day, after working with the patient, the PT left the pool area to attend to
another patient in the gym. An athletic trainer (ATC) employed by the clinic was instructed to
monitor the patient while he did his usual walking along the pool wall. The ATC was distracted
by a call on his cell phone for about 5 minutes. During the time he was not observed, the
patient became submerged under the water. The ATC pulled the patient from the water and
initiated cardiopulmonary resuscitation (CPR) until emergency personnel arrived. The patient
survived but had acute respiratory distress syndrome and aspiration pneumonia requiring
several weeks in a hospital followed by an extensive stay at a rehabilitation facility.eview APTA guidelines for supervision of support personnel at: http://www.apta.org / Practice & Patient Care / Practice Administration / Supervision & Teamwork. Review state requirements for supervision of support personnel for the state you intend to seek licensure. Links to each state’s practice act are available at: https://www.fsbpt.org/Free-Resources/Licensing-Authorities-Contact-Information or by going directly to the state’s website. Analyze the two supervision scenarios provided (See Resources). Cite a specific state PT practice act and APTA supervision guidelines in your analyses. Submit both analyses as one document.
this is for new york state Physical therapy license please
