Functional mobility Personal device care Personal hygiene and grooming Sexual activity Rest and Sleep Rest Sleep preparation Sleep participation Financial management Health management and maintenance Home establishment and management Meal preparation and up Religious / spiritual activities and expression Safety and emergency maintenance Shopping Work Employment interests and pursuits Employment seeking and acquisition Job performance Retirement preparation and adjustment Volunteer exploration Volunteer participation Play Leisure Social Participation Play exploration Play participation Leisure exploration Leisure participation Community Family Peer/friend Activities: Designed and selected to support the development of skills, performance patterns, roles, habits, and routines that enhance occupational engagement Practicing an activity Simulation of activity Role play Examples: Preparatory Methods and Tasks: Methods, adaptations and techniques that prepare the client for occupational performance Preparatory Exercises Physical agent modalities Splinting Assistive technology Wheelchair mobility Examples: Education: describe Training: describe Advocacy: describe Group Interventions: describe Method of Intervention Direct Services/Caseload for OT One-to-one: Small group(s): Large group: Discharge/Outcomes of Clients (% clients) Home Another medical facility Home health Outcomes of Intervention Occupational performance improvement and/or enhancement Health and Wellness Prevention Quality of life Role competence Participation OT Intervention Approaches Create, promote health/habits Establish, restore, remediate Maintain Modify, facilitate compensation, adaptation Prevent disability Theory/Frames of Reference/Models of Practice Acquisitional Biomechanical Cognitive/Behavioral Coping Developmental Ecology of Performance of Human Occupation (MOHO) Occupational Adaptation Occupational Performance Person-Environment-Occupation (PEO) Person-Environment-Occupational Performance (PEOP) Psychosocial Rehabilitation frames of reference Sensory Integration Other (please list): Please list the most common screenings and evaluations used in your setting: Identify safety precautions important at your FW site Medications Postsurgical (list procedures) Contact guard for ambulation Fall risk Other (describe): Swallowing/choking risks Behavioral system/ privilege level (locked areas, grounds) Sharps count 1 to 1 safety/suicide precautions Performance skills, patterns, contexts and client factors addressed in this setting (check all that apply): ACOTE Standard C. 1.12
Performance Skills: Motor skills Process skills Social interaction skills Performance Patterns: Person: Habits Routines Rituals Roles or Population: Habits Routines Rituals Roles Client Factors: Values Beliefs Spirituality Mental functions (affective, cognitive, perceptual) Sensory functions Neuromusculoskeletal and movement-related functions Muscle functions Movement functions Cardiovascular, hematological, immunological, and respiratory system functions Voice and speech functions; digestive, metabolic, and endocrine system functions; Skin and related-structure functions Context(s): Cultural Personal Temporal Virtual Environment: Physical Social Most common services priorities (check all that apply): Direct service Discharge planning Evaluation Meetings (team, department, family) Client education Intervention Consultation In-service training Billing Documentation Target caseload/productivity for fieldwork students: Documentation: Frequency/Format (briefly describe) : Productivity ( %) per 40-hour work week: Caseload expectation at end of FW: Productivity (%) per 8-hour day: Number groups per day expected at end of FW: Handwritten documentation: Computerized medical records: Time frame requirements to complete documentation: Administrative/Management Duties or Responsibilities of the OT/OTA Student: Student Assignments. Students will be expected to successfully complete: Schedule own clients Supervision of others (Level I students, aides, OTA, volunteers) Budgeting Procuring supplies (shopping for cooking groups, items) Participating in supply or environmental maintenance Other: Research/EBP/Literature review In-service Case study In-service participation/grand rounds Fieldwork project (describe): Field visits/rotations to other areas of service Observation of other units/disciplines Other assignments (please list): OPTIONAL DATA COLLECTION: The question includes in this section may be used by academic programs to demonstrate compliance with the Accreditation Council for Occupational Therapy Education Standards documentation for fieldwork.