This workshop aims to analyze the handling skills required for delegated therapeutic tasks, identify existing staff skills, and devise alternative strategies if necessary. The document provides guidance for physical therapists and occupational therapists on delegation, treatment handling, and ensuring staff and patient safety. It discusses levels of competence, possible alternatives if staff skills are insufficient, and factors like child size and levels of functioning that influence handling and delegation.

1. Auckland Conference 2012
Challenging workplace
boundaries
Pat Alexander
MSc PGDip PGCE MCSP CMIOSH MIfL

2. Aims of workshop
 Analyse handling skills required for
delegated therapeutic tasks
 Identify existing staff skills
 Devise alternative strategies if necessary

3. UK Physio Guidance on
Treatment handling
(2008)
 physios must not use or condone
unsafe systems of work- extra staff or
equipment must be considered
 treatment goals must be realistic and
achievable or may need to be
reconsidered
 management responsibility to ensure
staff safety is compatible with patient
progress and support staff in
rehabilitation issues

4. UK Physio Guidance on
delegation (2008)
 physio must be clear if it is delegation or
guidance
 principles of duty of care and risk
assessment apply in
 physio must be working within
professional scope to be covered by
Public liability insurance
 physios have duty of care to
assistants/others as well as patients
 physio must ensure they are up to date
with current good practice

5. UK Physio – guidance
Delegation, guidance and
advice (cont)
 no profession can dictate to another
person how they must handle a patient
 aim must be to prevent harm to
handlers whilst ensuring best possible
outcome for patient
 giving advice and delegating tasks is
normal/essential part of physio. Clarity
about position of physio should make
this easier.

6. UK OT - Delegation and
guidance to others (2006)
 Does person have sufficient skill/
knowledge of manual handling
 respect other person’s policy
 guidance to formal/paid carers (not
training - this is employer’s
responsibility)
 guidance to supervisor of team
 capability of family/unpaid carer
 OTs are not able to “dictate” method of
handling to other professions-but allow
balance where rehabilitation can
progress, even with use of equipment

7. Benner levels of competence
 Novice- adheres to rules, little
experience, inflexible behaviour

 Adv. beginner- limited perception, place advice
in context
 Competent- gaining perspective, standardised
procedures
 Proficient- holistic view, faster decision
making, uses deviations from norm
 Expert- no longer needs to analyse, enormous
experience, intuitive grasp, advanced problem
solving

8. Possible alternatives
 The task could be simplified/altered to suit
the competence of available staff
 Other staff could be found who possess the
correct level of expertise
 The therapist could educate the available
staff to enable them to function at higher
level
 The therapist could visit the child more
often

9. Child size
 A Babies and very small children
0-2 years, estimated weight range 3-10 kg
 B Pre-school
2-4 years, estimated 11-20 kg
 C Young Children
4-7 years, estimated 21- 25 kg
 D Older children
7-12 years, estimated 26-35 kg
 E Teenagers
3-16 years, estimated 36-40 kg
 F Almost Adults
16-18 years, estimated 41+ kg

10. Levels of Functioning (from FIM)
7 Complete Independence (timely, safely)
6 Modified Independence (extra time, devices)
5 Supervision (cueing, coaxing, prompting)
4 Minimal Assistance (performs 75% or more of
task)
3 Moderate Assistance (performs 50-74% of task)
2 Maximal Assistance (performs 25-49% of task)
1 Total Assistance (performs less than 25% of
task)