Theraputic relations ch. 12&13

universal percautions
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universal percautions
- hand washing
-protective barriers
-infection control such as:
daily disinfection of tables and counters
maintence of cleaning supplies
availability of gloves, bandages, and first aide kits
maintaing a safe enviornemnt includes:
- keeping track of your keys
-dont take restricted items to wards
-have everything ready before patient arrives
-use shatterproof mirrors
- organize tools to permit quick accurate counts of potentially dangerous items.
-alerting consumers to potential dangers
- follow safty percautions for toxins
-knowing and using proper safty equiptment
- observing the local fire code
- pay attention to the condition of the floor
- eleminating electrical hazards
- observing food and fire safty guidelines in the kitchen
applying and teaching positiong techniques
provid increased structre when necessary
medical emergencies and first aide:
include: fainting, seizures, minor cuts, burns, contusions, serious wounds, fractors, poisoning, choking, cardiac arrest and strokes

Most common:
- seizures: patient may become rigid and then exhibit jerking motions, may also void urine or feces or stop breathing. follow first aide techniques as instructed
- bleeding: minor cuts may be managed by the OTA; sever wounds will require intervention by hospital staff. universal percautions should be followed at all times
- burns: minor first degree butns are treated with basic first aide. OTA should seek assistance in treating any burns with blistering or charred skin
- sunburn: photosensitivity is a side effect of some medications. prevenions includes applying sunscreen prior to outdoor activities
- strains, sprains, contusions: minor bumps and bruises are treated witg RICE( rest, ice, compression, elevation)
phychiatric emergencies:
more common in a inpatient setting but can happen anywhere
- suicide: prevention involves keeping the sucidal patient away from hazardous objects and far from windows or access to building roofs
-assult: OT is not approiate for person to likely commin assult. if assult happens, call for help and remove others from the area.
-eleopment: refers to running away from a facility. secure doors and windows to reduce likelihood of occurance

SIGNS OF SUICIDE:
- talking about killing themselves
-reacent acqusition( buying a gun)
-making a will or taking out life insurance
-giving away personal belongings
- seeking promises that someone else will take care of pets if anything happens to me
-passive suicidal behavior: not eating, drinking too much
risk factors
risk: factors that increase likelihood of self harm

-biopsychosocial: depression, hopelessness, trauma, abuse, major physical illness
- enviornmental: job or financial loss, incarceration, firearms in home
- sociocultural: lack of social support, barriers to health care, culture
protective factors:
preventative in nature, impact positively on risk.

- easy access to HC and support
- strong connections to family and community support
- identify and practice strategies to decrease thoughts and behaviors that can lead to self injurious behavior
educating consumers about safty
- OTAs are effective at educating consumers
- knowledge of household safty hazzards
- application of basic first aide

HANDWASHING, DISINFECTING CUTS, AND APPLYING BANDAGES.

-dialing 911
-obtain emergency medical care
chapter 13
...
purpose of group treatment:
it is a planned process for creating changes in individuals by bringing them together for this purpose

benefits:
- ability to treat multiple patients at the same time
-group members learn from eachother as well as from the therapist

good candidates:
- patients with a greater potential for problem solving
- patients who need oppertunities for reality testing
- patients who have adequate trust in others
group dynamics:
groups that work well sahre the following characteristics:
- cohesiveness: a sense of solidarity among members
- shared goals and norms: members feel that their needs as well as the needs of others can be met through group treatment
- established functional roles: there is clearly a leader in the group, and there are distinct roles group members can fulfill. members can occupy roles such as:

--task roles
-- group maintence roles
--antigroup/egocentric roles
anne mosey establised 5 levels of group skill, or the ability to be successful navigating group dynamics1. parallel: ability to work and play in the presence of others ( 18 months to 2 years) 2. project: ability to share a short term task with one or two others people ( 2 to 4 years) 3.egocentric-cooperative: awareness of group norms and willingness to abide by them ( 5 to 7 years) task role development 4. cooperative: ability to express feelings as well as be aware of and respond to others feelings in a group (9 to 12 years) maintence role development 5. mature: ability to take on various group roles, such as a task and group maintence ( 15 to 18 years)leader role in an activity grouptherapy groups are formed around many different goals, as an OTA you are most likely to lead ACTIVITY groups. - leaders assign offical roles, and must be aware of how these role designations will affect the individual and the group dynamic - leaders redirect group energies toward common goals characteristics of leader behavior includes: -consistancy - autonomy - nurturing - interpersonal learning leader may need to faciliate interaction in group establishing leadership requires participation: (4) - knowledge -space -materials -paperwork developing a group session plan can help you define group goals as well as anticipate challenges that may arise during group pay particular attention to the beginning and completion of each group session, as these set the tone for present and future group sessions the beginning of the session sets the stage for how the session will progress - if new members are present or group meets infrequently, introductions can foster a sense of welcoming. - identify the days activity and goal can give the group a sense of shared direction the completion of group allows members to reflect on their activity and look ahead to future groups - clean up gives members time to chat infomally - wrap-up discussions let members share their feelings and discoveries made during groupprogram developmentconsidertions while planning an activity group: - members - needs and skill level - rules and resources - focus and goals considerations when writing a group protocol - purpose - format group protocol format elements: -name -description -structure -behavioral objectives -referral criteria -methodology -method -role of leader -evaluation -exit critera -reason for discontinuation -resources/referencesprogram evaluation- procedure for measuring whether a program has been effective - part of the total quality measurment apprach ( TQM) - evaluation focuses on whether participation in the group resulted in behavioral changes specified in the goals evaluation procedues include: - pretest/posttest evaluation: members are evaluated before and after therapy; any changes are noted -posttest evaluation; members are evaluated after therapy; results are compared to norms of behavior if therapy had not been attempted