The OTA's Guide to Writing SOAP Notes PDF Download
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Author: Sherry Borcherding
Publisher: SLACK Incorporated
ISBN: 9781556427794
Category : Medical
Languages : en
Pages : 244
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Book Description
Written specifically for occupational therapy assistants, The OTA's Guide to Writing SOAP Notes, Second Edition is updated to include new features and information. This valuable text contains the step-by-step instruction needed to learn the documentation required for reimbursement in occupational therapy. With the current changes in healthcare, proper documentation of client care is essential to meeting legal and ethical standards for reimbursement of services. Written in an easy-to-read format, this new edition by Sherry Borcherding and Marie J. Morreale will continue to aid occupational therapy assistants in learning to write SOAP notes that will be reimbursable under Medicare Part B and managed care for different areas of clinical practice. New Features in the Second Edition: - Incorporated throughout the text is the Occupational Therapy Practice Framework, along with updated AOTA documents - More examples of pediatrics, hand therapy, and mental health - Updated and additional worksheets - Review of grammar/documentation mistakes - Worksheets for deciphering physician orders, as well as expanded worksheets for medical abbreviations - Updated information on billing codes, HIPAA, management of health information, medical records, and electronic documentation - Expanded information on the OT process for the OTA to fully understand documentation and the OTA's role in all stages of treatment, including referral, evaluation, intervention plan, and discharge - Documentation of physical agent modalities With reorganized and shorter chapters, The OTA's Guide to Writing SOAP Notes, Second Edition is the essential text to providing instruction in writing SOAP notes specifically aimed at the OTA practitioner and student. This exceptional edition offers both the necessary instruction and multiple opportunities to practice, as skills are built on each other in a logical manner. Templates are provided for beginning students to use in formatting SOAP notes, and the task of documentation is broken down into small units to make learning easier. A detachable summary sheet is included that can be pulled out and carried to clinical sites as a reminder of the necessary contents for a SOAP note. Updated information, expanded discussions, and reorganized learning tools make The OTA's Guide to Writing SOAP Notes, Second Edition a must-have for all occupational therapy assistant students! This text is the essential resource needed to master professional documentation skills in today's healthcare environment.
Author: Sherry Borcherding
Publisher: SLACK Incorporated
ISBN: 9781556427794
Category : Medical
Languages : en
Pages : 244
Get Book Here
Book Description
Written specifically for occupational therapy assistants, The OTA's Guide to Writing SOAP Notes, Second Edition is updated to include new features and information. This valuable text contains the step-by-step instruction needed to learn the documentation required for reimbursement in occupational therapy. With the current changes in healthcare, proper documentation of client care is essential to meeting legal and ethical standards for reimbursement of services. Written in an easy-to-read format, this new edition by Sherry Borcherding and Marie J. Morreale will continue to aid occupational therapy assistants in learning to write SOAP notes that will be reimbursable under Medicare Part B and managed care for different areas of clinical practice. New Features in the Second Edition: - Incorporated throughout the text is the Occupational Therapy Practice Framework, along with updated AOTA documents - More examples of pediatrics, hand therapy, and mental health - Updated and additional worksheets - Review of grammar/documentation mistakes - Worksheets for deciphering physician orders, as well as expanded worksheets for medical abbreviations - Updated information on billing codes, HIPAA, management of health information, medical records, and electronic documentation - Expanded information on the OT process for the OTA to fully understand documentation and the OTA's role in all stages of treatment, including referral, evaluation, intervention plan, and discharge - Documentation of physical agent modalities With reorganized and shorter chapters, The OTA's Guide to Writing SOAP Notes, Second Edition is the essential text to providing instruction in writing SOAP notes specifically aimed at the OTA practitioner and student. This exceptional edition offers both the necessary instruction and multiple opportunities to practice, as skills are built on each other in a logical manner. Templates are provided for beginning students to use in formatting SOAP notes, and the task of documentation is broken down into small units to make learning easier. A detachable summary sheet is included that can be pulled out and carried to clinical sites as a reminder of the necessary contents for a SOAP note. Updated information, expanded discussions, and reorganized learning tools make The OTA's Guide to Writing SOAP Notes, Second Edition a must-have for all occupational therapy assistant students! This text is the essential resource needed to master professional documentation skills in today's healthcare environment.
Author: Kathlyn L. Reed
Publisher:
ISBN: 9780944480809
Category : Occupational therapy
Languages : en
Pages : 0
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Book Description
Author: Amy J Mahle
Publisher: F.A. Davis
ISBN: 0803689802
Category : Medical
Languages : en
Pages : 1087
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Book Description
The go-to text/reference for class, clinical, and practice! A who’s who of experts and educators brings you practical, in-depth coverage of the most common adult conditions and the corresponding evidence-based occupational therapy interventions. Written for OTAs to meet their unique needs, this approach combines theory with the practical, evidence-based functional content that develops the critical-thinking and clinical-reasoning skills that are the foundation for professional, knowledgeable, creative, and competent practice.
Author: Marie J. Morreale
Publisher: Slack
ISBN: 9781617110825
Category : Allied health personnel
Languages : en
Pages : 0
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Book Description
Rev. ed. of: The OTA's guide to writing SOAP notes. 2nd ed. 2007.
Author: Gary Kielhofner
Publisher: F.A. Davis
ISBN: 0803623488
Category : Medical
Languages : en
Pages : 331
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Book Description
PREPARE YOUR OT STUDENTS TO BECOME OT THINKERS. Thoroughly revised and updated, the 4th Edition of this groundbreaking text traces the historical development of the foundations of modern occupational therapy theory; examines its status today; and looks to its future. Dr. Kielhofner compares and contrasts eight well-known models, using diagrams to illustrate their practical applications and to highlight their similarities and differences. Well organized chapters are supported by extensive references.
Author: Mia Erickson
Publisher: Routledge
ISBN: 9781630916268
Category : Medical
Languages : en
Pages : 0
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Book Description
Newly updated and revised, Physical Therapy Documentation: From Examination to Outcome, Third Edition provides physical therapy students, educators, and clinicians with essential information on documentation for contemporary physical therapy practice. Complete and accurate documentation is one of the most essential skills for physical therapists. In this text, authors Mia L. Erickson, Rebecca McKnight, and Ralph Utzman teach the knowledge and skills necessary for correct documentation of physical therapy services, provide guidance for readers in their ethical responsibility to quality record-keeping, and deliver the mechanics of note writing in a friendly, approachable tone. Featuring the most up-to-date information on proper documentation and using the International Classification of Functioning, Disabilities, and Health (ICF) model as a foundation for terminology, the Third Edition includes expanded examples across a variety of practice settings as well as new chapters on: Health informatics Electronic medical records Rules governing paper and electronic records Billing, coding, and outcomes measures Instructors in educational settings can visit www.efacultylounge.com for additional materials to be used for teaching in the classroom. An invaluable reference in keeping with basic documentation structure, Physical Therapy Documentation: From Examination to Outcome, Third Edition is a necessity for both new and seasoned physical therapy practitioners.
Author: Marie Morreale
Publisher: Taylor & Francis
ISBN: 1040141935
Category : Medical
Languages : en
Pages : 354
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Book Description
The bestselling, newly updated occupational therapy assistant (OTA) textbook, The OTA’s Guide to Documentation: Writing SOAP Notes, Fifth Edition explains the critical skill of documentation while offering multiple opportunities for OTA students to practice documentation through learning activities, worksheets, and bonus videos. The Fifth Edition contains step-by-step instruction on occupational therapy documentation and the legal, ethical, and professional documentation standards required for clinical practice and reimbursement of services. Students and professors alike can expect the same easy-to-read format from previous editions to aid OTAs in learning the purpose and standards of documentation throughout all stages of the occupational therapy process and different areas of clinical practice. Essentials of documentation, reimbursement, and best practice are reflected in the many examples presented throughout the text. Worksheets and learning activities provide the reader with multiple opportunities to practice observation skills and clinical reasoning, learn documentation methods, create occupation-based goals, and develop a repertoire of professional language. Templates are provided to assist beginning OTA students in formatting occupation-based SOAP notes, and the task of documentation is broken down into smaller units to make learning easier. Other formats and methods of recording client care are also explained, such as the use of electronic health records and narrative notes. This text also presents an overview of the initial evaluation process delineating the roles of the OT and OTA and guidelines for implementing appropriate interventions. New in the Fifth Edition: Incorporation of the Occupational Therapy Practice Framework: Domain and Process, Fourth Edition and other updated American Occupational Therapy Association documents Updated information to meet Medicare Part B and other third-party payer requirements Revised clinical terminology on par with current trends Added examples from emerging practice areas Expanded tables along with new worksheets and learning activities Included with the text are online supplemental materials for faculty use in the classroom, this includes: access to supplemental website worksheets, learning activities, and scenario-based videos to practice the documentation process.
Author: Hazel M. Clarkson
Publisher: Lippincott Williams & Wilkins
ISBN: 9780683303841
Category : Medical
Languages : en
Pages : 476
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Book Description
Completely revised and updated, this edition presents the principles and methodology of assessing both joint range of motion (ROM)/goniometry and manual muscle strength for the head, neck, trunk, and extremities. Each chapter is devoted to a separate anatomical region and provides knowledge of pertinent surface anatomy and deep anatomy. Excellent photography and illustrations enhance comprehension of techniques and serve as a self-learning tool. New to this edition: New vertical format; second-color added to line art; 200 new photographs; detailed coverage of ROM and muscle length assessment and measurement for each body region; comprehensive coverage of end feels for each joint motion; and chapter relating assessment methods to treatment techniques and activities of daily living. A useful resource for assessment and treatment!
Author: Sherry Borcherding
Publisher: Slack Incorporated
ISBN: 9781556427190
Category : Medical
Languages : en
Pages : 236
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Book Description
Manual focusing on documenting the occupational therapy process. Each skill is broken down into small steps and taught individually. Includes a template for writing problems, goals, and each section of the SOAP note. Also includes practice worksheets and detachable checklist and summary.
Author: Aota
Publisher: AOTA Press
ISBN: 9781569003619
Category : Medical
Languages : en
Pages : 51
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Book Description
As occupational therapy celebrates its centennial in 2017, attention returns to the profession's founding belief in the value of therapeutic occupations as a way to remediate illness and maintain health. The founders emphasized the importance of establishing a therapeutic relationship with each client and designing an intervention plan based on the knowledge about a client's context and environment, values, goals, and needs. Using today's lexicon, the profession's founders proposed a vision for the profession that was occupation based, client centered, and evidence based--the vision articulated in the third edition of the Occupational Therapy Practice Framework: Domain and Process. The Framework is a must-have official document from the American Occupational Therapy Association. Intended for occupational therapy practitioners and students, other health care professionals, educators, researchers, payers, and consumers, the Framework summarizes the interrelated constructs that describe occupational therapy practice. In addition to the creation of a new preface to set the tone for the work, this new edition includes the following highlights: a redefinition of the overarching statement describing occupational therapy's domain; a new definition of clients that includes persons, groups, and populations; further delineation of the profession's relationship to organizations; inclusion of activity demands as part of the process; and even more up-to-date analysis and guidance for today's occupational therapy practitioners. Achieving health, well-being, and participation in life through engagement in occupation is the overarching statement that describes the domain and process of occupational therapy in the fullest sense. The Framework can provide the structure and guidance that practitioners can use to meet this important goal.
