Self Assessment
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Do you have any experience with this skill?
Are you competent performing the following?
Competency for the Physical Therapist Assistant
Proficiency Required
Evaluation Method
Competency Validation Indicated by PT Supervisor Initials and Date
Yes
No
Yes
No
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Demonstrates ability to process paperwork and associated functions necessary to facilitate :
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1. Knowledge of Assessment Process :

a. Assesses response to treatment

b. Other :

2. Documentation Skills: (accurate, legible, timely, and complete) :

a. Progress Notes, flow charts

b. Incident/Variance reporting

c. Other :

3. Adheres to Plan of Care (POC) :

a. Reviews POC prior to care

b. Performs services as ordered

c. Documents according to POC

d. Communicates/coordinates as appropriate

e. Other :

4. Knowledge of Medicare/State Guidelines :

a. Criteria for participation

b. Skilled reimbursable visit

c. Other :

5. Reports and documents key information to Physician, Discharge Planner, Other Clinicians, Supervisors (Administrator and Physical Therapist)

6. Participates as team member

7. Submits written summary reports as indicated

8. Attends/participates in case conferences as required

9. Supply/HME requisition and management

10. Infection Control Practices :

a. Hand washing

b. Personal protective equipment

c. Exposure control plan

d. Equipment care, as appropriate

e. Other :

11. Patient home safety

12. Other :

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B. Patient Education
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1. Develops/implements teaching plan

2. Evaluates effectiveness of teaching

3. Documents patient response

4. Other :

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C. Clinical Skills – General
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1. Vital Signs/I & O

2. Other :

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D. Skilled Treatments/Interventions
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1. Perform therapeutic exercises :

a. Active

b. Passive

c. Strengthening and endurance

d. Other

2. Transfer Activities

3. Mobilization :

a. Bed mobility

b. Gait training

c. Other :

4. Use of Physical Agents :

a. Ultrasound

b. Hot/cold packs

c. TENS\FES

d. Massage

e. Other :

5. Prosthetic Training

a. Care of prosthesis

b. Stump conditioning

c. Other :

6. Assistive Devices

a. Fit/adjustment

b. Gait training

c. Safety

d. Other :

7. Fabricates orthotic device, instructs in use

8. Other :