ASHA Risk Management & Mitigation 2 — Questions and Answers
Question 1: An SLP suspects a patient with dysphagia is silently aspirating during a clinical swallow evaluation. What is the most appropriate immediate risk mitigation step?
- Continue oral feeding and monitor symptoms for 48 hours
- Recommend modified diet textures and refer for instrumental assessment (Correct answer)
- Discontinue all oral intake and place an NG tube without further evaluation
- Document the suspicion and wait for the next scheduled appointment
Correct answer: Recommend modified diet textures and refer for instrumental assessment
Recommending modified diet textures immediately reduces aspiration risk while an instrumental assessment (MBSS or FEES) provides definitive information.
Question 2: Under ASHA's Code of Ethics, an SLP is ethically obligated to do which of the following when a risk to a client's welfare is identified?
- Inform the client's insurance provider before the client
- Take immediate action to protect the client and report concerns through appropriate channels (Correct answer)
- Avoid documentation to protect the clinician from liability
- Defer to the physician and take no independent action
Correct answer: Take immediate action to protect the client and report concerns through appropriate channels
ASHA's Code of Ethics Principle I requires SLPs to act in the best interest of clients and report welfare concerns through appropriate channels.
Question 3: Which factor most significantly increases fall risk for elderly patients receiving speech-language pathology services in a skilled nursing facility?
- Mild expressive aphasia
- Cognitive impairment combined with impulsivity (Correct answer)
- Mild articulation disorder
- Presbycusis without balance involvement
Correct answer: Cognitive impairment combined with impulsivity
Cognitive impairment with impulsivity leads to unsafe independent transfers and ambulation, dramatically increasing fall risk.
Question 4: When an SLP identifies that a supervisee has been providing services beyond their competency level, what is the supervisor's primary risk mitigation responsibility?
- Ignore the issue if no client harm has yet occurred
- Immediately reassign affected clients and provide remedial training or supervision (Correct answer)
- Report the supervisee to ASHA before addressing the issue internally
- Allow the supervisee to self-correct without intervention
Correct answer: Immediately reassign affected clients and provide remedial training or supervision
The supervisor must immediately act to protect clients and provide remediation, as supervisors are accountable for the quality of services their supervisees provide.
Question 5: A client with severe TBI demonstrates agitation and combative behavior during speech therapy. Which risk mitigation strategy is most appropriate?
- Restrain the client to continue the session
- End the session, ensure safety, and consult with the interdisciplinary team (Correct answer)
- Administer a calming verbal prompt and continue therapy
- Document the behavior and proceed with the planned session
Correct answer: End the session, ensure safety, and consult with the interdisciplinary team
Ensuring physical safety by ending the session and consulting the IDT is the priority when a client exhibits combative behavior.
Question 6: Which of the following best describes a 'near miss' in the context of healthcare risk management for SLPs?
- A documented adverse event that caused measurable client harm
- An event that could have caused harm but was caught before reaching the client (Correct answer)
- A minor error that caused temporary discomfort
- A scheduling conflict that delayed treatment by one session
Correct answer: An event that could have caused harm but was caught before reaching the client
A near miss is an unplanned event that had the potential to cause harm but did not, often due to chance or timely intervention.
Question 7: An SLP working in a school setting discovers a student has disclosed abuse during a therapy session. What is the most critical risk management action?
- Maintain confidentiality and document only in clinical notes
- Report the disclosure to Child Protective Services as mandated by law (Correct answer)
- Notify the student's parents before contacting authorities
- Consult with a colleague before deciding whether to report
Correct answer: Report the disclosure to Child Protective Services as mandated by law
SLPs are mandated reporters under state law and must report suspected child abuse immediately to the appropriate authorities regardless of other considerations.
ASHA Risk Management & Mitigation 2
An SLP suspects a patient with dysphagia is silently aspirating during a clinical swallow evaluation.
What is the most appropriate immediate risk mitigation step?