What is the purpose of a screen and are there any practice tips for success when performing a rehab screen?
Answer
The purpose of a rehab screen is for the therapist to attempt to identify clients' needs and possible rehab potential. A screen may not result in a therapy evaluation. It does not require a physician order. The screen is used to support and provide additional documentation on the evaluation findings to support medical necessity. No recommendations can be made other than evaluation or no evaluation. It is a hands-off review to ID those needing therapy intervention.
Screening should focus on screening clients with a change in function and when appropriate these clients should be referred to therapy.
For best practices,
Screen will determine if an evaluation is needed
Evaluation will determine if further rehab potential and goals can be established
Use clinical reasoning skills to determine if the client warrants a skilled plan of care
Tips for success:
Effective communication between nursing and therapy
Regular meetings with the nursing staff
Utilize a nursing referral form
Supportive documentation is present
Provide in-services to the multidisciplinary team
Obtain info from various sources
A screening chart review should include:
Nurses notes-daily nursing documentation may illustrate a pattern which warrants a screen
MD notes
CNA flow sheets
Restorative nursing notes
Previous therapy notes and discharge summary
Example of clients to be screened are those who have:
Had a fall
Abnormal posture
Poor head, neck, or trunk control
Contractures
Problems with edema
Decreased safety awareness
Decreased transfer ability
Decreased ability to re-position self
Poor supported sitting balance
Poor skin integrity
Pressure injuries
Difficulty eating or swallowing
Decreased participation in ADL
Complaints of pain
Decreased ability to self-propel wheelchair
Difficulty breathing
Decreased socialization due to poor position
Difficulty maneuvering wheelchair in environment
Difficulty using motorized wheelchair or scooter
Neely Sullivan, MPT, CLT-LANA, CDP
Neely Sullivan, PT, CLT-LANA, has worked with diverse client populations ranging from pediatric to geriatric in a variety of clinical settings. These experiences and multiple courses on the topic have allowed her to treat and develop client care programs for clients living with lymphedema and wounds. She has served in multiple levels of regional and corporate management positions. In these positions, Neely has developed policies and worked closely with interdisciplinary teams to ensure that clients living with lymphedema and/or wounds have the opportunity to attain their highest level of function and quality of life. She is a certified lymphedema therapist and has most recently been responsible for the identification, implementation, and evaluation of clinical programs in long-term care settings. Neely currently provides educational support to 13,000+ therapists nationwide as an Education Specialist for Select Rehabilitation. Neely has lectured nationally and at the state level on the topics of Lymphedema and Wound Care Management. She has authored publications focusing on edema and lymphedema management.
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'This presenter does an excellent job informing and communicating what is necessary for good wound treatment beyond just treating the wound'Read Reviews
A systematic approach to wound care staff training can result in a positive outcome for therapists, staff, their clinic, and most importantly, their clients. Using multiple examples, this course examines key elements (role of multidisciplinary team, documentation and reimbursement, prevention, wound assessment, and wound treatment) of effective education and introduces strategies for making wound care learning engaging and fun to support delivered wound care services. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.
