Occupational Therapy

Occupational Therapy Clinic Policy and Procedures

Documentation

Each student is responsible for the documentation associated with his/her client. After each treatment session, students are required to document the client's performance and progress on the established goals. Students will use the documentation forms and document in a manner that is consistent with your documentation course.

Client Records

The file established on the client is considered a personal and confidential document. It cannot leave the treatment area. Students are expected to review the file and complete their documentation in the established documentation area. Be sure to keep the file organized with the most recent information at the top.

Client Safety

Remember first and foremost the client's safety during their time at the clinic. It is your responsibility to always know the whereabouts of your client and to keep him/her safe.

Precautions: Ask parent/caregiver/ct. about any precautions (i.e. cardiac conditions, seizure disorders, respiratory problems, etc.) that may be of concern.

Environmental safety: Ensure the environment is free of clutter, in order to decrease the chance of tripping or falling in clinic, kitchen, or simulated apartment settings.

Wheelchair safety: Always lock wheelchair brakes when in stationary position.

Injury: If a client. has sustained an injury during his or her time at the clinic, be sure to notify the OT supervisor and document the accident/injury on an accident report form. Ensure all clients use proper body mechanics when engaging in any therapeutic activity.

Sharp object: Ensure to supervise ct. when using sharp objects such as scissors, knives, needles, etc

Food Safety: Ensure to use proper food handling procedures, as well as, to ensure that all food supplies do not exceed expiration dates.

Child Safety

• Swing Safety - Be sure to double-check the swing attachments to be sure they are secured and hooked up appropriately. Be sure that there are mats underneath the swing and mats protecting the child from other equipment and walls if necessary. Carefully monitor the child's reaction when using the swing in a rotary fashion. Watch for paling and any signs of respiratory distress, as well as indications the child may be having a seizure.

• Outlet Safety - Be sure the outlet covers are replaced if you have plugged in an electric device.

• Choking Hazards - Be sure to carefully monitor the children around toys or activities that have small parts

• Climbing Equipment - Be sure the floor underneath where the child is climbing is free obstacles and that there are mats placed under the equipment.

Student Safety

Body Mechanics - Remember to use appropriate body mechanics when working with the children in the clinic.

Transferring clients - Be sure to use a transfer belt when moving clients who cannot safely transfer themselves.

•Universal Precautions

All students are expected to follow the Universal Precaution protocol that is presented in September at the start of classes. Students will use the universal precautions when handling any body fluids. This includes oral-motor stimulation techniques. Latex free gloves are provided.

Equipment Maintenance

All students are expected to clean the mats and equipment after clients have used them. This should be done even if the client has not obviously soiled them. There is spray cleaner available under the sink in supply room between 3115 and 3113 for use on mats and other large equipment. All toys should be washed in warm soapy water and then returned the cabinets from which they were taken. Any toys and all feeding/eating supplies should be washed in the dishwasher. If you place items in the dishwasher to be washed be sure to let Karen know that a load needs to be run. After your treatment session, please wash the toys in the kitchen. Towels and blankets should be placed in the washing machine. Please let the Administrative Assistant know when a load of laundry is being run.

First Aid Kit

There is a first aid kit available in the therapy room. It is located above the sink. If you take items from the kit, please be sure to let the supervisor know so the items can be replaced. There are ice packs located in the freezer in the room between the therapy room and the kitchen.

Accident Report

- If a client has sustained an injury during the time at the clinic, please be sure to document the accident on the accident report form. This and other forms are located in the conference room in the file box marked "clinic forms". Students are responsible for alerting the supervising therapist of the incident and for discussing the incident with the parent.

Personal Appearance of Student Interns

The personal appearance of all occupational therapy students and observers must be appropriate to the professional atmosphere of the Clinic. Clothing should be neat and clean and should allow freedom of movement. Also, please remember there will usually be family, student, or clinical supervisors observing your sessions from the observation window. Student interns are not allowed to chew gum, drink beverages or eat during management sessions, except if this is part of planned therapy activities for that session. All students should wear their nametags during treatment sessions.

Mandated Reporter Responsibilities /Procedures

Student interns and the supervising therapist are considered mandated reporters of abuse by Minnesota State Statutes. If a client is reporting abuse or if the student intern or clinical supervisor suspects abuse, it must be reported. Students must report any suspicions or reports of abuse to the supervising therapist, who will make the mandated report call. The report must be documented in the client's folder.