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Role and Responsibilities of: The Physiotherapy Assistant, the Supervising Physiotherapist, and the Employer
New Zealand Society of Physiotherapists Inc.
PO Box 27 386, Wellington Tel: 04 801 6500 Fax: 04 801 5571 Email: email@example.com Website: www.physiotherapy.org.nz
F:\Public\1 NZSP\1.2 NZSP General\Quality improvement\Policies NZSP\The Physiotherapist Assistant NZSP Ratified05.doc Ratified at NZSP AGM 27 May 2005 Review May 2009
i Introduction 1. Definition of a Physiotherapy Assistant 2. Role and Responsibilities of the Employer 3. Role and Responsibilities of the Physiotherapy Assistant 4. Role and Responsibilities of the Supervising Physiotherapist Appendix 1: Suggested Physiotherapy Assistant Competencies
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This document is intended as a guide for use in any healthcare facility in New Zealand. It has been compiled by Maree Grbin, Professional Leader Physiotherapy Counties Manukau DHB with input from the Leaders, Advisors and Managers of Physiotherapy for District Health Boards in New Zealand and with assistance from the New Zealand Society of Physiotherapists Inc. It was ratified at the NZSP Annual General Meeting on 28 May 2005 and replaces the outdated Section IV The Physiotherapy Assistant published in the Department of Health June 1989 publication: Roles and Functions of the Physiotherapist.
Definition of a Physiotherapy Assistant
A physiotherapy assistant is a person employed to assist a physiotherapist to provide physiotherapy services in a safe effective and efficient manner. This assistance may be in the form of patient contact and/or non-clinical activities and in any setting where physiotherapy is provided (i.e. public/private hospitals, rest/convalescent homes, private practices, health centres, schools or in the community). The title physiotherapy assistant is not used for persons whose role with the physiotherapist is purely reception or clerical. Other terms that may be synonymous with physiotherapy assistant (when the person is assisting in the field of physiotherapy) are: • health assistant • health care assistant • patient care assistant • mobility assistant • therapy assistant • physiotherapy aide A physiotherapy assistant must be directed and supervised by a New Zealand registered physiotherapist with a current Annual Practising Certificate. A physiotherapy assistant must not, under any circumstances substitute for a physiotherapist. Note: An assistant may be employed across two or more disciplines and, in such cases, there may be additional responsibilities for both the assistant and the employer, and a need for flexibility to allow for cross disciplinary supervision and reporting.
Role and Responsibilities of the Employer
An organisation/practice is not able to employ a physiotherapy assistant without designating a supervising physiotherapist to direct and supervise the assistant’s programmes.
The employer organisation is responsible for ensuring the physiotherapy assistant: - Understands their boundaries and is not put in a position where they are expected to take on duties that require a registered physiotherapist. - Meets the required ethical, professional, confidentiality standards and code of conduct that apply to the physiotherapy assistant. - Has an active working knowledge of cultural safety and the principles of cultural competence. - Is clearly identifiable as a physiotherapy assistant by clients, their family/whanau and other health professionals. - Is employed to a specific job description and holds a copy of it. - Has the necessary training to meet the identified and agreed competencies for the designated role (see Appendix 1). - Is informed of who their supervising physiotherapist is at commencement in the position and subsequently any changes to this. Person specifications for a physiotherapy assistant: - emonstrates a caring attitude/disposition - Shows an ability to relate to a diverse range of people (gender, age, ethnicity). - Demonstrates effective literacy and communication skills. - Actively supports the organisation’s commitment to the Treaty of Waitangi. - Shows an understanding of the job description boundaries. - Demonstrates a positive attitude to wellness and healthy lifestyle - Is honest, responsible, efficient, reliable and will accept direction. - Will take an active part in their own ongoing professional development. - Takes responsibility for their own actions. The organisation must provide supervision for the physiotherapy assistant. Under no circumstances may a person be designated a physiotherapy assistant and provide a physiotherapy service unless a physiotherapist acts as the supervisor. Requirements to be met are: - The physiotherapy assistant is responsible to the physiotherapist at all times. - When the designated supervisor is absent or unable to provide continuous and immediate supervision, the duties of the physiotherapy assistant will be restricted to those not requiring decisions about patient care, those that the assistant has demonstrated competence in and are clearly set out in writing. An alternative contact for emergency assistance will be provided. - The physiotherapy assistant may only carry out patient programmes set down by the physiotherapist; any changes to patient programmes must be done in consultation and in agreement with the physiotherapist.
Role and Responsibilities of the Physiotherapy Assistant
While the supervising physiotherapist is responsible for the physiotherapy programme, the assistant is accountable for their own performance. 3.1 Standards: The physiotherapy assistant will at all times comply with the Health and Disability Sector Standards and all other relevant standards and legislation including those related to: - Privacy - Occupational health and safety - Infection control - Hazard identification - Treaty of Waitangi Reporting: The physiotherapy assistant will report each working day to their supervising physiotherapist and on additional occasions when there are any changes to their existing programme. - The physiotherapy assistant will be required to document patient activities carried out and comment on how the patient managed these activities (whether this is recorded in the patient record may depend on the policy of the employing organisation) - It is the responsibility of the physiotherapy assistant to notify the physiotherapist of any concerns the assistant has related to carrying out their designated programme ie. due to observed changes in patient’s presentation, or in skill level of the assistant. Professional development: The physiotherapy assistant will take part in designated professional development activities relevant to their role. - The physiotherapy assistant will have a performance development plan which will be reviewed annually. - The physiotherapy assistant will receive regular constructive feedback on their performance. Designated tasks: Tasks will be designated by the employer at the time of appointment and subject to the assistant demonstrating competence. - Reception, clerical and housekeeping duties may be included in the role. - Activities related to patient care but not part of physiotherapy interventions eg escorting patients, preparing patients for treatment, dressing, preparing files. - Assisting the physiotherapist with patient therapy eg moving and handling, bilateral limb movements, 2 person gait training, hydrotherapy, group activity. - Carry out planned therapy programmes following specific instruction from the physiotherapist eg supervise existing exercise programmes, apply equipment for patients to continue their specified exercise programmes, facilitate patients practicing functional activities. - Carry out programmes that carers would be expected to do eg passive and assisted range of movement activities, application of orthosis. - Measure and instruct in the use of simple mobility aids eg walking sticks.
- Prepare and apply the following physiotherapy adjuncts following physiotherapist instructions. § Wax baths § Hydrocollator packs § Ice packs § Heated wheat bags § CPM machines § TENS § Exercise equipment § Assist with tilt table, treadmill harness and hoist. § Group work e.g. exercise programmes; walking groups 3.4 Tasks excluded from physiotherapy assistant duties: The following tasks must not be undertaken by a physiotherapy assistant at any time as they are deemed core physiotherapy activities that are required to be undertaken by a registered physiotherapist: - Interpreting referrals - Assessing clients - Interpreting findings - Making a diagnosis - Planning and initiating physiotherapy programme - Progressing or changing a care plan - Discharge planning - Discussing aspects of the client’s medical condition or possible future care with other health professionals or family/whanau. - Administering of electrotherapeutic modalities that are connected to mains supply e.g. ultrasound
Role and Responsibilities of the Supervising Physiotherapist
The designated physiotherapist is responsible for the provision of physiotherapy services and consequently any clinical activities the assistant is involved in and therefore must: - Take responsibility to instruct, delegate and evaluate the implementation of delegated tasks with supervision as necessary. - Promote appropriate professional development for the physiotherapy assistant. - Recognise the background knowledge, skills and attitudes the physiotherapy assistant brings to the role and understand the impact this will have on carrying out their duties. - Ensure the physiotherapy assistant: § has a good understanding of their role and its limitations § demonstrates competence in their delegated activities § can access the supervising physiotherapist readily § has a plan for their personal development
Appendix 1 Suggested Physiotherapy Assistant Competencies
Provides safe and effective client care: - Treat individuals with respect - Ensures patient safety, privacy and comfort are maintained at all times - Contributes to the achievement of client focussed goals - Demonstrates safe manual handling skills - Demonstrates competence in delegated tasks - Demonstrates an understanding of wellness - Demonstrates safe use of therapy equipment - Able to identify deterioration in the patient - Able to initiate an appropriate alert in an emergency Communicates effectively: - Is aware of and meets the requirements of the Health Information Privacy Code 1994 - Communicates clearly and appropriately with client and family/whanau members - Is able to communicate patient responses or changes clearly to other health professionals - Recognises conflict situations and seeks appropriate assistance. - Can follow instructions accurately - Knows when to seek clarification - Communicates any concerns re workload - Complies with organisation documentation policy - Contributes to effective working relationships - Can record tasks undertaken and responses observed in writing Contributes to a safe working environment: - Keeps her/himself safe - Identifies and responds appropriately to faulty equipment - Complies with infection control standards - Identifies and reports health and safety risks Demonstrates individual responsibility and accountability - Able to plan efficient use of time - Follows appropriate procedures for managing planned and unplanned leave - Knows role boundaries - Identifies own learning needs and plans to achieve these - Contributes to the effectiveness of the team.
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