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Oregon PT Aides

What is the definition of an aide?

“Physical therapist aide” or “aide” means a person who is not licensed as a physical therapist or physical therapist assistant, who aids a physical therapist or physical therapist assistant by performing treatment-related tasks or by performing non-treatment, patient-related tasks and who works under the direct on-site supervision of a physical therapist or physical therapist assistant.  

Although they may be providing services to a patient pursuant to direction or instruction from a physical therapist or physical therapist assistant, the following persons are not considered physical therapist aides:

    • Educational or instructional aides or assistants working in a school setting; or
    • Nurses aides, restorative aides or personal care assistants. Persons performing facility maintenance, equipment assembly and maintenance, housekeeping, clerical, or other similar tasks are not considered aides.

A physical therapist aide shall:

    • Be at least 18 years of age.
    • Have received a high school diploma or equivalent.

Training Requirements

Prior to allowing a physical therapist aide to perform any treatment-related task, the supervising physical therapist shall assure that the aide has undertaken forty (40) hours of on-the-job training as follows:

    • A minimum of ten (10) hours of instruction on professional/medical ethics, patient confidentiality, universal precautions, body mechanics, physical medicine terminology and safety procedures;
    • A minimum of thirty (30) hours of instruction in the facility in areas appropriate to that particular physical therapy facility, including but not limited to precautions and contraindications for physical therapy treatments routinely provided at the facility, and supervised practical applications of appropriate treatment protocols and techniques. Changes in employment shall require another thirty (30) hours of instruction appropriate to that facility;
    • However, physical therapist or physical therapist assistant students, upon successful completion of the first year of study, may be employed as an aide with a minimum of eight (8) hours of instruction appropriate to that facility;
    • A person who has successfully completed a CAPTE accredited physical therapist or physical therapist assistant program, may be employed as an aide with a minimum of eight (8) hours of instruction appropriate to that facility.

Documentation  

The supervising physical therapist shall be responsible for documentation of the training for each aide and shall maintain this documentation at the facility for a minimum of five (5) years after termination of employment and make it available to the Board upon request. The supervising physical therapist also shall respond to any inquiry by the Board concerning the training provided to an aide. The aide training record shall include but not be limited to:

    • Aide position description;
    • Policies and procedures clearly stating the aide's duties;
    • Training schedule, which includes but is not limited to:
      • Start date for the training;
      • Activity/description of training;
      • Amount of time spent on training for each activity;
      • Date training is complete;
      • Names of instructors and aide, including signature of each instructor and aide;
      • If applicable, documentation of training received outside of the facility in the form of a letter or copies of the previous training record. Documentation must include the level of responsibility of the aide.

What can an aide do?

“Non-treatment, patient-related task” means a task related to preparation of treatment areas, transport of patients, preparation of patients for treatment and other patient-related tasks.

What is an aide expressly prohibited from doing?

A physical therapist or physical therapist assistant shall not permit an aide to perform any of the following treatment-related tasks:

    • Administer iontophoresis. However, an aide who has been trained to do so may assist with iontophoresis by applying the medication to the electrode so long as a physical therapist or physical therapist assistant administers it to the patient.
    • Administer phonophoresis. However, an aide may operate the sound head if the physical therapist or physical therapist assistant has applied the medication to the patient, determined the treatment protocols and parameters, as provided in the plan of care, and authorizes the aide to provide the treatment.
    • Administer electrotherapy. However an aide may perform this task if the physical therapist or physical therapist assistant has examined the patient in person on the day of treatment and determined the electrode placements, treatment protocols and parameters, as provided in the plan of care, and authorizes the aide to provide the treatment.
    • Administer ultrasound. However an aide may perform this task if the physical therapist or physical therapist assistant has examined the patient in person on the day of treatment and determined the treatment protocols and parameters, as provided in the plan of care, and authorizes the aide to provide the treatment.
    • Administer mechanized or manual traction.
    •  Perform manual stretching with the goal of increasing range of motion, neuro-facilitation or cardiac therapeutic exercise.
    • Perform soft tissue mobilization or massage (other than effleurage and petrissage). However, an aide who is separately licensed or registered under another Oregon statute to do so may perform these tasks if done under the direction and on-site supervision specified in OAR 848-020-0000(5)(a).
    • Wound debridement.
    • Administer tilt table or standing frame. However an aide may perform these tasks if the physical therapist or physical therapist assistant has examined the patient in person on the day of treatment and determined the treatment protocols and parameters, as provided in the plan of care, and authorizes the aide to provide the treatment.
    • Joint mobilization or manipulation.
    • Determine or modify a plan of care.
    • Initiate or administer a physical therapy intervention the first time that intervention is administered or provided to a patient. This prohibition means that a physical therapist or physical therapist assistant must provide or administer the entire specific intervention before delegating that task to an aide.
    • Independently make entries in a patient record, except for objective information about the treatment provided by the aide. The aide shall sign the record entry as provided in OAR 848-040-0150(2). A physical therapist or physical therapist assistant may also dictate information to an aide for entry into a patient medical record, so long as the physical therapist or physical therapist assistant authenticates such entries.
    • Instruct a patient or a patient's caregiver in the application of any treatment.
    • Except as required to respond to an inquiry by the Board or other person authorized to receive the information, answer or discuss any questions regarding a patient's status or treatment with anyone other than the physical therapist or physical therapist assistant.

What are the responsibilities of the PT when delegating to an aide?

Prior to allowing an aide to perform any treatment-related task:

    • The physical therapist must provide an initial evaluation of the patient and develop a plan of care;
    • The physical therapist or physical therapist assistant shall assess the competence of the aide to perform an assigned treatment-related task for that patient in a safe and effective manner;
    • The physical therapist or physical therapist assistant must assign only those tasks which are appropriate for the aide to perform for that patient based on the aide's training, experience and ability.

When a treatment-related task is performed by an aide, the supervising physical therapist or physical therapist assistant shall, at some point during each treatment, provide direct service to the patient to assess and monitor the patient's progress, and so document in the patient's record.

What type of supervision is required?

“Supervise” means to provide the amount of personal direction, assistance, advice and instruction necessary to reasonably assure that the supervisee provides the patient competent physical therapy services, given the supervisor’s actual knowledge of the supervisee’s ability, training and experiences. Additionally, supervision of:

    • A treatment-related task requires that the supervising physical therapist or physical therapist assistant be in the same building and within sight or earshot of the aide who is performing the treatment-related task, such that the supervising physical therapist or physical therapist assistant is immediately available at all times to provide in person direction, assistance, advice, or instruction to the aide or the patient. A physical therapist may delegate supervision of an aide to a physical therapist assistant;
    • A non-treatment, patient-related task requires that the supervising physical therapist or physical therapist assistant be in the building where the aide is performing the task.

What is the ratio between supervising PTs and aides?

A physical therapist or physical therapist assistant may supervise a maximum total of two physical therapist aides, when the aides are performing treatment-related tasks. In addition, a physical therapist or physical therapist assistant may supervise additional aides who are not performing treatment related tasks.

Citations

ORS 688.010

OAR 848-020-0000

OAR 848-020-0030

OAR 848-020-0040

OAR 848-020-0050

OAR 848-020-0060


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