Minnesota Department of Health Health Occupations Program P.O. Box St. Paul, MN

Transcription

1 Minnesota Department of Health Health Occupations Program P.O. Box St. Paul, MN Information for Occupational Therapy Assistant Application to be supervised in the use of PAMs in Minnesota This information sheet was developed to help the Occupational Therapy Assistant apply for PAMs use in Minnesota. Practitioners are prohibited from using physical agent modalities independently until granted written approval from the Department of Health. There is one exception to this prohibition: if a licensed practitioner completes a PAMs course that was previously reviewed and approved by the Commissioner of Health and submits the required documentation within 30 calendar days from the course date, the licensee may use PAMs under supervision of a licensed occupational therapist approved to use PAMs. State regulations also require written documentation verifying educational (theoretical) and clinical application requirements prior to use of physical agent modalities. The documentation must be submitted within two years of completing any course of study meeting the educational and clinical requirements. There are three modality areas: superficial physical agents, ultrasound and electrical stimulation device. The occupational therapy practitioner may apply for use of one, two or all three areas. The objectives listed in the Minnesota regulation for the educational and clinical requirements for each modality area are provided below. Minnesota s regulations require the Occupational Therapist to provide documentation for having met these objectives. Educational documentation must include a transcript or certificate showing successful completion of coursework that matches the objectives listed below. A copy of the course description (can be a workshop or seminar description) and that particular course s learning objectives need to be submitted along with a signed certificate of completion. In the case of clinical application objectives, teaching methods should also be documented, including actual supervised practice. Examples of clinical training that can be submitted include proficiency type checks done in the workshop setting of clinical applications done under the supervision of a qualified person (e.g. CHT, PT, or an occupational therapist who has been approved for using physical agents in Minnesota). A letter from you indicating the physical agents you have used in clinical practice along with specific listings of the type of physical agents done, verification of meeting the above goals, and a co-signature from the supervising person(s) would be appropriate. This letter can be from the person teaching the workshop or from a qualified practitioner. For your convenience, a sample letter is included at the end of these instructions. Please use this checklist to complete submission of your PAMS application: Description of workshop, course or seminar including course objectives Signed certificate of attendance/completion Content schedule of the course; and A letter evidencing that the clinical objectives have been met, signed by the applicant and a qualified, supervising person. A sample letter is included at the end of this document. Occupational Therapy Assistant Form for Notification of PAMs Supervisor Send these to the address above with attention OTA Licensing 1

2 MOST COMMON ERRORS THAT HAVE OCCURRED WITH SUBMISSIONS OF INFORMATION: There is not clear enough evidence of the clinical objectives having been met. Note the requirement of written documentation of supervised practice. This can happen at a workshop but there must be evidence of it. A letter containing the information in the sample letter (at end of this document) and signed by you and the workshop presenter, if that level of supervision and practice occurred, generally ensures clinical objectives as having been met. If the workshop does not provide clinical training or evidence the occupational therapist must supplement the workshop by finding a qualified supervisor to help meet the clinical requirements. This usually involves about 1-2 hours for each modality area provided the theoretical portion of the workshop has met the Minnesota regulations. Therapist forgets to include signed certificate of completion or send course objectives and course description. A new resident to Minnesota does not understand Minnesota regulations in comparison to other states and fails to submit the required evidence. SUPERFICIAL PHYSICAL AGENT MODALITIES OBJECTIVES: 1. Rationale and clinical indication for use of superficial physical agent modalities. 2. Physical properties and principles of superficial physical agent modalities. 3. Types of heat and cold transference. 4. Factors affecting tissue response to superficial heat and cold. 5. Biophysical effects of superficial physical agent modalities in normal and abnormal tissue. 6. Thermal conductivity of tissue, matter and air. 7. Advantages and disadvantages of superficial physical agent modalities. 8. Precautions and contraindications of superficial physical agent modalities. 1. Formulate and justify a plan for the use of superficial physical agents for treatment and appropriate to its use and simulate the treatment. 2. Evaluate biophysical effects of the superficial physical agents. 3. Identify when modifications to the treatment plan for use of superficial physical agents are needed and propose the modification plan. 4. Safely and appropriately administer superficial physical agents under the supervision of a course instructor or clinical trainer. 5. Document parameters of treatment, case example (patient) response, and recommendations for progression of treatment for the superficial physical agents; and 6. Demonstrate the ability to work competently with superficial physical agents as determined by a course instructor or clinical trainer. ELECTRICAL STIMULATION DEVICE OBJECTIVES: 1. Rationale and clinical indication of electrotherapy, including pain control, muscle dysfunction, and tissue healing; 2. Electrotherapeutic terminology and biophysical principles, including current, voltage, amplitude, and resistance (ohm s law); 3. Types of current (direct, pulsed, and alternating) used for electrical stimulation, including the description, modulations, and clinical relevance; 4. Time-dependent parameters of pulsed and alternating currents, including pulse and phase durations and intervals; 2

3 5. Amplitude-dependent characteristics of pulsed and alternating currents; 6. Neurophysiology and the properties of excitable tissue (nerve and muscle); 7. Nerve and muscle response from externally applied electrical stimulation, including tissue healing; 8. Electrotherapeutic effects and the response of nerve, denervated and innervated muscle, and other soft tissue; 9. Precautions and contraindications of electrotherapy, including considerations regarding pathology of nerve and muscle tissue. 1. Formulate and justify a plan for the use of electrical stimulation devices for treatment appropriate to its use and simulate the treatment; 2. Evaluate biophysical effects of the electrical stimulation; 3. Identify when modifications to the treatment plan using electrical stimulation are needed and propose the modification plan; 4. Safely and appropriately administer electrical stimulation under the supervision of a course instructor or clinical trainer; 5. Document the parameters of treatment, case example (patient) response, and recommendations for progression of treatment for electrical stimulation; and 6. Demonstrate the ability to work competently with electrical stimulation as determined by a course instructor or clinical trainer. ULTRASOUND OBJECTIVES: 1. Rationale and clinical indications for use of ultrasound, including anticipated physiological responses of the treated area; 2. Biophysical thermal and nonthermal effects of ultrasound on normal and abnormal tissue; 3. Physical principles of ultrasound, including wavelength, frequency, attenuation, velocity and intensity; 4. The mechanism and generation of ultrasound and energy transmission through physical matter; 5. Precautions and contraindications regarding the use of ultrasound devices. 1. Formulate and justify a plan for the use of ultrasound for treatment appropriate to its use and simulate the treatment; 2. Evaluate biophysical effects of ultrasound; 3. Identify when modifications to the treatment plan for use of ultrasound are needed and propose the modification plan; 4. Safely and appropriately administer ultrasound under the supervision of a course instructor or clinical trainer; 5. Document parameters of treatment, case example (patient) response, and recommendations for progression of treatment for ultrasound; and 6. Demonstrate the ability to work competently with ultrasound as determined by a course instructor or clinical trainer. THE SAMPLE LETTER ON THE FOLLOWING PAGE CAN BE USED IF THE WORKSHOPS YOU HAVE ATTENDED ONLY MEET THEORETICAL REQUIREMENTS. THIS LETTER DOCUMENTS THAT A PRACTITIONER HAS MET THE CLINICAL APPLICATION OBJECTIVES. 3

4 SAMPLE LETTER Minnesota Department of Health Health Occupations Program P.O. Box St. Paul, MN Date Applicant Name Address City State Zip MN OTA License # Occupational Therapy Advisory Council: I have completed theoretical training for the physical agent modalities of superficial physical agents, ultrasound, and electrotherapy. The clinical application training has included competency checks in the areas of: Hot packs Ice massage Cold packs Paraffin Contrast baths Ultrasound TENS Iontophoresis FES electrotherapy applications Interferential Current For all clinical application areas, I have been required Explain rationale and the clinical implications for what I am doing Devise a treatment plan Incorporate the physical agent into the overall occupational therapy plan of care Evaluate the positioning and patient education needs Apply the technique appropriately (see proficiency checks attached) Modify the procedure as needed Document the treatment, patient response, and overall appropriateness of the plan. For each physical agent and electrotherapy device used, I have reviewed indications, precautions, and contraindications. I have discussed advantages and disadvantages of each modality as plans of care were developed for the various cases presented to me. My certificate of attendance is enclosed along with the course brochure giving descriptions and objectives. I have also included a copy of the proficiency checks on the various modalities. I am hopeful this information will meet the criteria for me to practice with physical agents, ultrasound, and electrotherapy as an occupational therapy assistant in the state of Minnesota. Please contact me if further information is required. Sincerely, Signature of PAMs Applicant Date I certify the above information is accurate. Signature of CHT, approved OT, or PT who can attest to the above competencies. 4

5 OCCUPATIONAL THERAPY ASSISTANT FORM FOR NOTIFICATION OF PAMS SUPERVISOR Applicant Name MN OTA License # Applicant Address City State Zip PHYSICAL AGENT MODALITIES The Commissioner is required by Minnesota Statutes , Subd. 1 (c), to maintain a roster of licensees using physical agent modalities. Please indicate below whether you will use any physical agent modality and, if so, the type (superficial, electrical stimulation or ultrasound). Prior to use of physical agent modalities, you must submit to the Commissioner documentation verifying that you have met the educational requirements described in Minnesota Statutes , Subds. 3 to 5, and have been granted approval as provided in subdivision 7. Minnesota Statutes , Subd. 1 (b), requires that physical agent modalities be provided only under a physician s order. Superficial physical agent modalities are therapeutic media which produce a temperature change in skin and underlying subcutaneous tissues within a depth of 0-3 centimeters for the purposes of rehabilitation of neuromusculoskeletal dysfunction. Superficial physical agent modalities may include, but are not limited paraffin baths, hot packs, cold packs, fluidotherapy,, contrast baths, and whirlpool baths. Superficial physical agent modalities do not include the use of electrical stimulation devices, ultrasound or quick icing. Electrotherapy means the use of electrical stimulation devices for a therapeutic purpose. Ultrasound means a device intended to generate and emit high frequency acoustic vibrational energy for the purposes of rehabilitation of neuromusculoskeletal dysfunction. PHYSICAL AGENT MODALITIES STATEMENT Please check the type of modality used in practice and whether the modality will be used in practice as an occupational therapy assistant. If you are using physical agent modalities as an occupational therapy assistant, please provide the name and MN credential number of your supervising occupational therapist to practice as an independent practitioner. Please use one page for each Supervisor. SUPERFICIAL PHYSICAL AGENT MODALITY ULTRASOUND ELECTROTHERAPEUTIC DEVICES Applicants MN work location: Employment Name Employment Address City State Zip Applicant Employment Phone Number Date I started employment at this facility (Day/Mon/Yr): Supervisor MN work location: Employment Name Employment Address City State Zip Supervisor Employment Phone Number Date I started employment at this facility (Day/Mon/Yr): 5