Standard Operating Procedure for Ward Based Therapy AssistantsReporting Structure:
Designated Therapy Manager
Senior Physiotherapist/Occupational Therapist/Speech and Language Therapist/Dietician
Allocation of Duties: The TA is responsible for completing prescribed therapy tasks only, as designated by PT/OT/SLT/Dietician.
They will not provide any additional intervention on request of any other discipline.
Location of Duties: Across the acute wards
Timetable: 5/7 shift pattern across all wards.
Allocation of caseload discussed daily at team huddle post Red2Green meetings
Bleep: The therapy assistant will be available via bleep.
Therapy Assistant Roles & Responsibilities:
General Roles & Responsibilities:
The TA will access regular supervision from a designated PT / OT / Dietitian / SLT
The TA will complete the NGH Therapy Assistant Shared Competency Document
The TA will complete all Mandatory Training as required
The TA will be responsible for managing their own caseload as assigned to the TA by the PT/OT/SLT/Dietician.
The TA will complete the safety checklist prior to intervention with each patient (see appendix i) This is to ensure the patient is medically stable to receive intervention as prescribed
From Monday – Friday, the TA must report any concerns regarding the assigned patient to the treating therapist e.g. deterioration in medical status, suitability for rehabilitation
On a weekend, the TA must immediately report any concerns regarding the assigned patient to the ward nurse in charge
If the TA/Nurse has any concerns regarding the patient suitability for intervention, they must not proceed.
The TA will document (in the medical chart) the patient status, reason for not proceeding, and who they escalated concerns to,
The TA will complete tasks from therapy assistant on each ward as appropriate throughout the day
Record Keeping:
TA sticker should be used Documentation should follow a SOAP format:
Subjective: 'What the patient tells you' e.g. Consent gained
Objective: Observations, patient position, intervention carried out.
Analysis: of the intervention
Plan: for future sessions
Recording Statistics:
Statistics including how many daily patient contacts for each discipline, a record of the number of doubles and single patient reviews assessed and how long spent in direct contact and in-direct contact (admin) should be recorded on the TA excel spreadsheet.
Stats should be recorded on the x-drive and completed at the end of each working day.
Cleaning of Equipment:
Equipment used, wheelchairs and anything that has come into contact with a patient should be cleaned using tristel solution after a patient intervention.
In some cases, depending on infectious status, other solutions may be used to clean equipment e.g. acticlor to ensure there is no spread of infection.
Training/Mentorship:
Shared Competency Framework for Therapy Assistants, supported by senior PT/OT/SLT/Dietician
Therapy Assistant in service training (as identified via a learning needs assessment)
Attendance at relevant in-service training at department level
Peer learning
1. Physiotherapy Roles & Responsibilities:
Peer learning
1. Physiotherapy Roles & Responsibilities
The TA will assist patients with established rehabilitation activities such as mobility and strengthening exercises, balance and mobility programs.
The TA will prepare the client and the environment for treatment as directed by the therapist(s).
The TA will organise and supervise therapeutic activities, with individual clients/groups as directed by the therapist and carry out one to one interventions under the direction of the therapist.
The TA should ensure mobility sheets are present at each patient's bedside and update them accordingly depending on the patients' current mobility status.
The TA should provide exercise programmes as prescribed by the physiotherapist and educate patients on same.
The TA will collaborate with patients, family, carers and other staff in treatment/intervention and in the provision of rehabilitation and exercise support
The TA will contact families/carers and ask them to bring in appropriate clothing to support rehabilitation and the concept of 'Get Up, Get Dressed, Get Moving' The TA will encourage families/carers to continue rehabilitation exercises with the patient and follow the mobility status information at the patient's bedside
2. Occupational Therapy Roles & Responsibilities
The TA will organise and supervise therapeutic activities, with individual clients/groups as directed by the therapist and carry out one to one interventions under the direction of the therapist.
The TA will assist patients with their rehabilitation goals and intervention as outlined by the OT such as transfer, PADL and DADL practice and cognitive rehabilitation.
The TA will provide and demonstrate use of equipment and small aids which are prescribed by the OT.
The TA will assist the OT in ensuring patients are in appropriate seating, have appropriate pressure relief cushions and seating care plans are being followed.
The TA will provide information leaflets and packs as appropriate and directed by the OT
3. Speech and Language Therapy Roles & Responsibilities
The TA will observe the general performance, behaviour and ability of individuals during therapeutic interventions.
The TA will record intervention observations and outcomes as appropriate and report outcomes to the SLT on the day intervention or within 24 hours.
The TA will collaborate with patients, family, carers and other staff in treatment/intervention and in the provision of support and advice as prescribed by SLT.
The TA will complete dysphagia and communication rehabilitation as prescribed by the treating SLT.
The TA will conduct thorough mealtime observations for patients with known or suspected dysphagia, identify and document any signs or symptoms of dysphagia.
The TA must report signs of dysphagia or concerns regarding swallowing immediately or as soon as possible to the SLT.
The TA will ensure bedside swallow care plans (if required) are present and accurate at each patient's bedside.
The TA will participate in SLT team based development, education, training and learning as deemed beneficial for the TA role by the SLT supervisor.
4. Dietetic Roles & Responsibilities
The TA will complete mealtime observations and filling in of food record charts as directed by the dietitian and feedback promptly to dietitian.
The TA will assist, prompt and encourage with meals, snacks and oral nutritional supplements as directed by the dietitian and feedback promptly to dietitian.
Under the direction of a dietitian, the TA will recheck a weight where there is an anomaly in the recent weight recorded and weighing the patient requires assist of two (i.e. where the dietitian cannot do independently).
For patients seen by TA, feedback to the dietitian should occur the same day or at least within 24 hours.Weekend Roles and Responsibilities
Weekend Roles and Responsibilities
The TA's caseload will be assigned by the supervising PT/OT/SLT/Dietician in advance of the weekend.
The caseload list of patients to be seen is saved on one drive (Title: TA Weekend Caseload Planning Sheet)
The TA will document all patients for intervention on their caseload planner
Only patients assigned to the TA by the supervising PT/OT/SLT/Dietician can be seen at the weekend
On arrival on the ward the TA will introduce themselves to the nurse in charge and run through the list of patients for intervention ascertaining an update on the patient and confirming that the patient is medically well for intervention
If the TA/Nurse has any concerns regarding the patient suitability for intervention, the TA must not proceed.
The TA will document (in the medical chart) the patient status, reason for not proceeding, and who they escalated concerns to.
As required following/during treatment the TA must immediately report any concerns regarding the assigned patient to the ward nurse in charge
On Monday the TA will clinically update the supervising PT/OT/SLT/Dietician on the outcome of the weekend treatment
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