CO Patient Safety & Risk Management 2 — Questions and Answers
Question 1: A patient with peripheral neuropathy reports no discomfort after 2 hours of wearing a new AFO, but the orthotist notices a 2 cm area of blanched skin on the fibular head. What is the most appropriate action?
- Document findings and recheck at next visit
- Immediately modify the orthosis to relieve pressure over the fibular head (Correct answer)
- Instruct the patient to wear the orthosis for shorter periods
- Apply padding to the skin before next wear
Correct answer: Immediately modify the orthosis to relieve pressure over the fibular head
Blanching over a bony prominence such as the fibular head indicates excessive pressure that can rapidly progress to a pressure ulcer, especially in neuropathic patients who cannot feel pain.
Question 2: Under HIPAA, an orthotist may share a patient's protected health information (PHI) without written authorization for which of the following purposes?
- Marketing a new orthotic product to the patient
- Treatment coordination with the referring physician (Correct answer)
- Release to the patient's employer upon request
- Publishing a case study with the patient's name
Correct answer: Treatment coordination with the referring physician
HIPAA permits disclosure of PHI for treatment, payment, and healthcare operations without specific patient authorization, including communication with other treating providers.
Question 3: When documenting a patient's informed consent for a new orthotic device, which element is MOST critical to record?
- The brand and model number of the device
- That the patient was informed of risks, benefits, and alternatives (Correct answer)
- The exact cost and insurance coverage details
- The name of the referral source
Correct answer: That the patient was informed of risks, benefits, and alternatives
Informed consent documentation must confirm that the patient received and understood information about risks, benefits, and alternatives to make an autonomous decision.
Question 4: A child patient arrives for an orthotic fitting accompanied only by an older sibling (age 16). The orthotist should:
- Proceed with fitting since a family member is present
- Reschedule and require a legal guardian to be present (Correct answer)
- Fit the device and have the sibling sign consent
- Call the child's school for permission
Correct answer: Reschedule and require a legal guardian to be present
Minors cannot provide legal consent; a parent or legal guardian must be present to authorize treatment unless an emergency exists.
Question 5: Which of the following best describes the purpose of a sentinel event review in an orthotics practice?
- To assign blame and discipline involved staff
- To analyze root causes and prevent recurrence of serious adverse events (Correct answer)
- To document events for insurance billing purposes
- To inform patients of staff performance issues
Correct answer: To analyze root causes and prevent recurrence of serious adverse events
Sentinel event reviews use root cause analysis to identify systemic factors contributing to serious incidents and implement process improvements to prevent recurrence.
Question 6: An orthotist discovers that a batch of prefabricated AFOs may have a manufacturing defect causing premature strap failure. The most appropriate first step is to:
- Wait for patient complaints before taking action
- Quarantine the affected devices and notify the manufacturer immediately (Correct answer)
- Apply extra adhesive to reinforce the straps
- Document the concern and continue using the devices
Correct answer: Quarantine the affected devices and notify the manufacturer immediately
Suspected device defects require immediate quarantine of affected products and notification to the manufacturer to prevent patient injury and initiate a formal recall if necessary.
Question 7: Which infection control measure is considered the single most effective way to prevent the spread of healthcare-associated infections in an orthotics practice?
- Wearing gowns during all patient encounters
- Proper hand hygiene before and after patient contact (Correct answer)
- Routine use of N95 respirators
- Daily sterilization of all work surfaces with bleach
Correct answer: Proper hand hygiene before and after patient contact
Proper hand hygiene—using soap and water or alcohol-based hand rub before and after patient contact—is universally recognized as the most effective infection control measure.
CO Patient Safety & Risk Management 2
A patient with peripheral neuropathy reports no discomfort after 2 hours of wearing a new AFO, but the orthotist notices a 2 cm area of blanched skin on the fibular head.
What is the most appropriate action?