I argued these very things with my director but she insists that pulse ox requires a discipline specific order.
----- Original Message ----- From: Curtis Marti <[email protected]> Sent: Friday, March 20, 2009 To: [email protected] <[email protected]> Subj: [OTlist] Pulse ox use in home health CM> I know you sent your pulse ox question on 3/11/09, but I'm new to the CM> list serve, so late responding. I'm very surprised that a pulse ox CM> would be considered a modality. It is an instrument used to assess a CM> patient's vitals, similar to a blood pressure cuff. A modality, to me, CM> implies that you are administering an intervention to elicit a change CM> (i.e. increased circulation with ultrasound, etc). Using a pulse ox CM> machine does nothing to change the patient's condition, but rather, it CM> communicates what is already happening with the patient. Make sense? CM> Just my two cents. CM> Thanks, CM> Curtis CM> -----Original Message----- CM> From: [email protected] [mailto:[email protected]] On CM> Behalf Of [email protected] CM> Sent: Thursday, March 19, 2009 8:57 PM CM> To: [email protected] CM> Subject: OTlist Digest, Vol 60, Issue 1 CM> Send OTlist mailing list submissions to CM> [email protected] CM> To subscribe or unsubscribe via the World Wide Web, visit CM> http://otnow.com/mailman/listinfo/otlist_otnow.com CM> or, via email, send a message with subject or body 'help' to CM> [email protected] CM> You can reach the person managing the list at CM> [email protected] CM> When replying, please edit your Subject line so it is more specific CM> than "Re: Contents of OTlist digest..." CM> Today's Topics: CM> 1. Re: The Wack World of Home Health (Ron Carson) CM> 2. What Would YOU Do? (Sue Hossack) CM> 3. WH/WC (pat) CM> 4. Welcome to Our Newest Member(s) (Ron Carson) CM> 5. Re: Welcome to Our Newest Member(s) (Pat Ellison) CM> 6. Welcome to Our Newest Member(s) (Ron Carson) CM> 7. Remindes (Ron Carson) CM> 8. Modified Borg Scale? (Ron Carson) CM> 9. How NOT to be an OT (Ron Carson) CM> 10. Re: How NOT to be an OT ([email protected]) CM> 11. Re: How NOT to be an OT (Ron Carson) CM> 12. Re: How NOT to be an OT (R. Eren Can) CM> 13. Re: How NOT to be an OT (Ron Carson) CM> 14. Re: How NOT to be an OT (Mary Alice Cafiero) CM> ---------------------------------------------------------------------- CM> Message: 1 CM> Date: Tue, 10 Mar 2009 21:31:55 -0400 CM> From: Ron Carson <[email protected]> CM> Subject: Re: [OTlist] The Wack World of Home Health CM> To: "Lehman, David" <[email protected]> CM> Message-ID: <[email protected]> CM> Content-Type: text/plain; charset=windows-1252 CM> Hey David, I think if you are the dominant profession, and PT is CM> definitely dominant, then it probably a lot easier to not worry about CM> turf wars. OT has such a small market share that we SHOULD be worried CM> about our turf, less be gobbled up. CM> Ron CM> -- CM> Ron Carson MHS, OT CM> www.OTnow.com CM> ----- Original Message ----- CM> From: Lehman, David <[email protected]> CM> Sent: Tuesday, March 10, 2009 CM> To: [email protected] <[email protected]> CM> Subj: [OTlist] The Wack World of Home Health LD>> It is perfectly OK for both PT(A) and OT to do both. Let us LD>> remember we are all trying to do what is best for the patient and LD>> those of us more concerned with improvement in function instead of LD>> turf wars are what we need in rehab. Function>Strategy>Impairment LD>> David A. Lehman, PhD, PT LD>> Associate Professor LD>> Tennessee State University LD>> Department of Physical Therapy LD>> 3500 John A. Merritt Blvd. LD>> Nashville, TN 37209 LD>> 615-963-5946 LD>> [email protected] LD>> Visit my website: CM> http://www.tnstate.edu/interior.asp?mid=2410&ptid=1 LD>> This email and any files transmitted with it may contain LD>> confidential information and is intended solely for use by the LD>> individual to whom it is addressed. If you receive this LD>> correspondence in error, please notify the sender and delete the LD>> email from your system. Do not disclose its contents with others. LD>> ________________________________________ LD>> From: [email protected] [[email protected]] On Behalf LD>> Of Ron Carson [[email protected]] LD>> Sent: Tuesday, March 10, 2009 8:13 PM LD>> To: [email protected] LD>> Subject: [OTlist] The Wack World of Home Health LD>> Last week a PTA showed up as I was trying a patient with a cane. CM> Today, LD>> the same patient was doing some gardening when she told me the PTA CM> had LD>> done something similar the day before. LD>> Are either of these "wrong"? Is it "wrong" for OT to trial CM> patient's on LD>> different mobility devices? Is it "wrong" for PT to have CM> patient's LD>> gardening? LD>> It's a wacky world!! <smile> LD>> Ron LD>> -- LD>> Ron Carson MHS, OT LD>> www.OTnow.com LD>> -- LD>> Options? LD>> www.otnow.com/mailman/options/otlist_otnow.com LD>> Archive? LD>> www.mail-archive.com/[email protected] LD>> -- LD>> Options? LD>> www.otnow.com/mailman/options/otlist_otnow.com LD>> Archive? LD>> www.mail-archive.com/[email protected] CM> ------------------------------ CM> Message: 2 CM> Date: Wed, 11 Mar 2009 07:41:41 -0500 CM> From: Sue Hossack <[email protected]> CM> Subject: [OTlist] What Would YOU Do? CM> To: [email protected] CM> Message-ID: <[email protected]> CM> Content-Type: text/plain; charset=ISO-8859-1; format=flowed CM> I would like to clarify the issue regarding pulse Ox. In Home Health it CM> is *required* to have a doctors order for any modality. That includes CM> monitoring oxygen stats, hot packs, ice packs.We all think it's silly, CM> but that is the regulation. What I do is always put "Monitor O2 Sats CM> PRN" on my initial order - In our agency we have a checklist sheet that CM> goes to the doctor for signature, I added a check box for this and check CM> it when necessary. I also include it when writing continuation orders. CM> Medicare will cite this as an issue during an audit. Just as you must CM> have doctors orders for any visit, you must have orders for O2. CM> I use my pulse ox when working with a patient on O2 to make sure I am CM> not stressing the patient, I use it to show the patient when teaching CM> pursed-lip breathing so they can see the increase - sort of CM> bio-feedback. If Oxgyen drops too low too often I would inform the CM> doctor. In the home health setting you must inform the doctor of any CM> changes, issues, such as a patient not taking meds, or not using O2 as CM> specified by doctor. CM> This is one of many differences between in-patient and home health CM> -don't assume that because you did it in the SNF you can do it in the CM> home the same way :-) CM> Sue CM> -- CM> Sue Hossack MOT, OTR/L, ATP CM> Occupational Therapist CM> http://www.ot-care.com CM> ------------------------------ CM> Message: 3 CM> Date: Thu, 12 Mar 2009 12:34:19 -0600 (GMT-06:00) CM> From: pat <[email protected]> CM> Subject: [OTlist] WH/WC CM> To: [email protected] CM> Message-ID: CM> CM> <20336428.1236882859833.javamail.r...@elwamui-royal.atl.sa.earthlink.net >> CM> CM> Content-Type: text/plain; charset=UTF-8 CM> I used to work in a work hardening/work conditioning program several CM> years ago, and now my current employer wants me to start up a similar CM> program. I have been unable to find the criteria for those programs. CM> Also, I would need to create whatever forms we use for documentation. I CM> remember there were several forms that both I and the participants in CM> the program completed, but don't remember the specifics of them. Can CM> anyone in the group point me in the right direction or to someone who CM> can help me with this? CM> Thanks! CM> Pat CM> ------------------------------ CM> Message: 4 CM> Date: Fri, 13 Mar 2009 06:47:44 -0400 CM> From: Ron Carson <[email protected]> CM> Subject: [OTlist] Welcome to Our Newest Member(s) CM> To: [email protected] CM> Message-ID: <[email protected]> CM> Content-Type: text/plain; charset=windows-1252 CM> Welcome to our newest member(s): CM> ##################################### CM> ahava <[email protected]> CM> sandra <[email protected]> CM> "D Caldwell, OTR/L" <[email protected]> CM> Trish <[email protected]> CM> Laura Templeton <[email protected]> CM> Alayna <[email protected]> CM> ##################################### CM> Welcome everyone and feel free to join in the "ruckus" <smile>. And CM> please, everyone keep spreading the word, it's the only way we can grow CM> as a community!! CM> Ron CM> -- CM> Ron Carson MHS, OT CM> www.OTnow.com CM> ------------------------------ CM> Message: 5 CM> Date: Fri, 13 Mar 2009 05:34:19 -0600 CM> From: Pat Ellison <[email protected]> CM> Subject: Re: [OTlist] Welcome to Our Newest Member(s) CM> To: [email protected] CM> Message-ID: CM> CM> <20090313113729.dzlb26568.hrndva-omta02.mail.rr....@xp-8ddd72eec76f.eart hlink.net>> CM> CM> Content-Type: text/plain; charset="us-ascii"; format=flowed CM> Wow... the group is really growing! Welcome to all the newest CM> members, and the ones I missed welcoming also! I hope you will all CM> jump in with any questions, answers, suggestions, or comments... it's CM> what keeps the group alive! CM> Pat CM> At 04:47 AM 3/13/2009, you wrote: >>Welcome to our newest member(s): >> >>##################################### >> >> ahava <[email protected]> >> >> sandra <[email protected]> >> >> "D Caldwell, OTR/L" <[email protected]> >> >> Trish <[email protected]> >> >> Laura Templeton <[email protected]> >> >> Alayna <[email protected]> >> >>##################################### >> >> >>Welcome everyone and feel free to join in the "ruckus" <smile>. CM> And >>please, everyone keep spreading the word, it's the only way we can CM> grow >>as a community!! >> >>Ron >> >>-- >>Ron Carson MHS, OT >>www.OTnow.com >> >> >>-- >>Options? >>www.otnow.com/mailman/options/otlist_otnow.com >> >>Archive? >>www.mail-archive.com/[email protected] CM> ------------------------------ CM> Message: 6 CM> Date: Mon, 16 Mar 2009 21:27:59 -0400 CM> From: Ron Carson <[email protected]> CM> Subject: [OTlist] Welcome to Our Newest Member(s) CM> To: [email protected] CM> Message-ID: <[email protected]> CM> Content-Type: text/plain; charset=windows-1252 CM> Welcome to our newest member(s): CM> ##################################### CM> Laura Templeton <[email protected]> CM> Tara <[email protected]> CM> dee salz <[email protected]> CM> Colette Warren <[email protected]> CM> Robert <[email protected]> CM> Jackie Reasor <[email protected]> CM> Sherri <[email protected]> CM> Curtis Marti <[email protected]> CM> ##################################### CM> WELCOME! to all the new members.... Please make your presence known... CM> Thanks, CM> Ron CM> -- CM> Ron Carson MHS, OT CM> www.OTnow.com CM> ------------------------------ CM> Message: 7 CM> Date: Mon, 16 Mar 2009 21:47:09 -0400 CM> From: Ron Carson <[email protected]> CM> Subject: [OTlist] Remindes CM> To: [email protected] CM> Message-ID: <[email protected]> CM> Content-Type: text/plain; charset=windows-1252 CM> Hello All: CM> With the recent influx of new members, I want to post a couple CM> reminders: CM> 1. This is a members only list, however, ALL messages are archived and CM> may be easily browsed on the Internet by anyone. So, don't post any CM> information that you do not want to become public knowledge. CM> 2. Trim messages so that replies contain only the most recent CM> information. Heavy traffic threads become very lengthy unless they are CM> trimmed. CM> 3. IF you reply to a message that is received in digest format, PLEASE CM> do two things: CM> a. Change the subject line so that it matches the topic CM> b. Delete all unrelated messages from the reply CM> 4. The list is open to ANY topic relating to occupation and/or the CM> practice of occupation therapy. Unfortunately, my topics tend to CM> dominate the traffic on this site, but that's ONLY because members CM> choose to not post other topics. CM> 5. Most members are on moderation. However, after a "reasonable" number CM> of messages are successfully posted, members' moderation flag is CM> removed. This is ONLY done to reduce the risk of SPAM and ensure members CM> are joining to contribute and learn and not for marketing. CM> 6. Speaking of that, marketing messages (i.e. job recruiters) are CM> generally not permitted. CM> 7. Please promote the OTnow.com site and this list to your peers. There CM> is no promotion other than word of mouth, so we need everyone's help in CM> this matter. CM> 8. Lastly, some of the topics can "step on a nerve", in this cases, try CM> to keep conversations about topic and not the person. CM> This is YOUR list and YOU get out of it what YOU put in!!!! CM> Thanks and again, welcome to all the new members!!!! CM> Ron CM> -- CM> Ron Carson MHS, OT CM> www.OTnow.com CM> ------------------------------ CM> Message: 8 CM> Date: Tue, 17 Mar 2009 08:45:52 -0400 CM> From: Ron Carson <[email protected]> CM> Subject: [OTlist] Modified Borg Scale? CM> To: [email protected] CM> Message-ID: <[email protected]> CM> Content-Type: text/plain; charset=windows-1252 CM> Is the Modified Borg Scale scored by the patient or the therapist? CM> Thanks, CM> Ron CM> -- CM> Ron Carson MHS, OT CM> www.OTnow.com CM> ------------------------------ CM> Message: 9 CM> Date: Thu, 19 Mar 2009 08:04:48 -0400 CM> From: Ron Carson <[email protected]> CM> Subject: [OTlist] How NOT to be an OT CM> To: [email protected] CM> Message-ID: <[email protected]> CM> Content-Type: text/plain; charset=windows-1252 CM> For our new members, let me explain that I like highlighting the CM> "stupid" OT experiences that I run across. What follows are two such CM> examples: CM> 1. Patient comes home from rehab after a fall with resultant hip CM> pinning. I asked him about what OT did for him in rehab. He comments CM> that they had him working on his arms and doing things like pegs, CM> sander, and shoulder arc, etc. Now, here's the catch, the patient can CM> NOT dress his affected LE and is too scared to take a shower. Now, I'm CM> not saying that his OT's didn't address these issues but the impression CM> the patient walked away with are the "stupid" toys that many OT's play CM> with. I ask, did these OT's do BEST practice? Did they provide SKILLED, CM> medically necessary therapy services? Did they address the patient's CM> most important goals? CM> 2. Another patient, just out of rehab. 90 years old, previously living CM> alone and now temporarily living with her son. During my home health CM> eval, I explained to the patient/son that as an OT, I am there to teach CM> the patient how to be safe and independent in their home. I went on to CM> explain that this may include everything from car transfer to cooking CM> and that what I do is based on the needs/desires of the patient. The CM> son, who was very nice, immediately said, "Mom can do those things like CM> folding clothes". Now, I never mentioned folding clothes but I do know CM> that MANY rehab OT's do have patients standing at a table folding CM> clothes. Did this man get the impression that OT is about teaching CM> people to "fold clothes"? If so, what a SAD statement about our CM> profession. CM> Thanks, CM> Ron CM> ------------------------------ CM> Message: 10 CM> Date: Thu, 19 Mar 2009 12:54:24 +0000 (UTC) CM> From: [email protected] CM> Subject: Re: [OTlist] How NOT to be an OT CM> To: [email protected] CM> Message-ID: CM> CM> <1063158434.8815851237467264976.javamail.r...@sz0012a.emeryville.ca.mail .comcast.net>> CM> CM> Content-Type: text/plain; charset=utf-8 CM> Wow...as a graduate student in the OT profession I find myself appauled CM> at the below comments.? Too many times we are not identifying with the CM> patient on their needs, this is found through an easy interview or needs CM> assessment.? I have recently done a project with the ALC here in CM> stillwater, and the site is planning on implementing the program based CM> on our practice of addressing the needs of the site, the needs of the CM> community as well as the needs and desires of the students.? I do not CM> want to graduate with this degree with an image such as the one below. CM> and i will fight to change that.? I am fortunate to have worked and CM> study under some wonderful OT's! Lets hope that the therapists talked CM> about below realize their failures and make the necessary changes to CM> embrace what OT is really for and how it is incredibly beneficial to the CM> patient.? sincerely, sarah croft CM> ----- Original Message ----- CM> From: "Ron Carson" <[email protected]> CM> To: [email protected] CM> Sent: Thursday, March 19, 2009 7:04:48 AM GMT -06:00 US/Canada Central CM> Subject: [OTlist] How NOT to be an OT CM> For ?our ?new ?members, ?let ?me ?explain ?that ?I like highlighting the CM> "stupid" ?OT ?experiences ?that ?I run across. What follows are two such CM> examples: CM> 1. ?Patient ?comes ?home ?from ?rehab ?after ?a ?fall with resultant hip CM> pinning. ?I ?asked ?him ?about what OT did for him in rehab. He comments CM> that ?they ?had ?him ?working ?on ?his ?arms and doing things like pegs, CM> sander, ?and ?shoulder ?arc, etc. Now, here's the catch, the patient can CM> NOT ?dress ?his affected LE and is too scared to take a shower. Now, I'm CM> not ?saying that his OT's didn't address these issues but the impression CM> the ?patient ?walked away with are the "stupid" toys that many OT's play CM> with. ?I ask, did these OT's do BEST practice? Did they provide SKILLED, CM> medically ?necessary ?therapy ?services? ?Did they address the patient's CM> most important goals? CM> 2. ?Another ?patient, just out of rehab. 90 years old, previously living CM> alone ?and ?now ?temporarily ?living with her son. During my home health CM> eval, ?I explained to the patient/son that as an OT, I am there to teach CM> the ?patient ?how to be safe and independent in their home. I went on to CM> explain ?that ?this ?may include everything from car transfer to cooking CM> and ?that ?what ?I ?do is based on the needs/desires of the patient. The CM> son, ?who was very nice, immediately said, "Mom can do those things like CM> folding ?clothes". ?Now, I never mentioned folding clothes but I do know CM> that ?MANY ?rehab ?OT's ?do ?have ?patients ?standing at a table folding CM> clothes. ?Did ?this ?man ?get ?the ?impression that OT is about teaching CM> people ?to ?"fold ?clothes"? ?If ?so, ?what ?a ?SAD ?statement about our CM> profession. CM> Thanks, CM> Ron -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
