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Washington Physical Therapy Supervision and Delegation

Supervision Definitions

"Close supervision" means that the supervisor has personally diagnosed the condition to be treated and has personally authorized the procedures to be performed. The supervisor is continuously on-site and physically present in the operatory while the procedures are performed and capable of responding immediately in the event of an emergency.

"Direct supervision" means the supervisor must:

    • Be continuously on-site and present in the department or facility where the person being supervised is performing services;
    • Be immediately available to assist the person being supervised in the services being performed; and
    • Maintain continued involvement in appropriate aspects of each treatment session in which a component of treatment is delegated to assistive personnel or is required to be directly supervised.

"Indirect supervision" means the supervisor is not on the premises, but has given either written or oral instructions for treatment of the patient and the patient has been examined by the physical therapist at such time as acceptable health care practice requires and consistent with the particular delegated health care task.

Responsibilities when Supervising/Delegating

Physical therapists are responsible for patient care given by assistive personnel under their supervision. A physical therapist may delegate to assistive personnel and supervise selected acts, tasks, or procedures that fall within the scope of physical therapy practice but do not exceed the education or training of the assistive personnel.

Actions that Cannot be Delegated

Regardless of the setting in which physical therapy services are provided, only the licensed physical therapist may perform the following responsibilities:

    • Interpretation of referrals;
    • Initial examination, problem identification, and diagnosis for physical therapy;
    • Development or modification of a plan of care that is based on the initial examination and includes the goals for physical therapy intervention;
    • Determination of which tasks require the expertise and decision-making capacity of the physical therapist and must be personally rendered by the physical therapist, and which tasks may be delegated;
    • Assurance of the qualifications of all assistive personnel to perform assigned tasks through written documentation of their education or training that is maintained and available at all times;
    • Delegation and instruction of the services to be rendered by the physical therapist, physical therapist assistant, or physical therapy aide including, but not limited to, specific tasks or procedures, precautions, special problems, and contraindicated procedures;
    • Timely review of documentation, reexamination of the patient, and revision of the plan of care when indicated;
    • Establishment of a discharge plan.

A physical therapist may not delegate sharp debridement to a physical therapist assistant.

Citations

RCW 18.74.010

RCW 18.74.170

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