why is it important to assess control before treatment

Control is a multifaceted construct. It is especially important, for assessment purposes, to be clear about which aspect of control one wishes to measure and why one wishes to do so. Most often, in health-related research, 'control' means 'perceived control' as opposed to veridical or 'actual control'.

Full Answer

Why do we need to assess the quality of treatment?

On the clinical side, treatment providers need instruments with which to assess the quality of treatment provision, as well as the progress of their clients during treatment. Their motivation is the same as that among researchers: Such instruments are seen as essential elements in the effort to improve clinical care.

Why is drug assessment important?

It is an essential part of treatment and care for people who use drugs. Assessment is the process of obtaining information about the patient's drug use and how it is affecting his or her life. It is an essential part of treatment and care for people who use drugs. NCBI Skip to main content

How is treatment provided and compliance with treatment assessed in pharmacology?

In pharmacologic studies, treatment provided and patients’ compliance with treatment are assessed in terms of medications taken.

What can be done to improve treatment and treatment processes?

New measures of treatment and treatment processes also should be developed. Better conceptualization of treatment processes should be a precursor to the development of those instruments, so that variables of the greatest relevance are focused upon.

Why is test of control important?

A test of control describes any auditing procedure used to evaluate a company's internal controls. The aim of tests of control in auditing is to determine whether these internal controls are sufficient to detect or prevent risks of material misstatements.

What is the purpose of assessing control risk?

The ultimate purpose of assessing control risk is to contribute to the auditor's evaluation of the risk that material misstatements exist in the financial statements.

Why are control procedures important?

Internal controls are processes designed to help safeguard an organization and minimize risk to its objectives. Internal controls minimize risks and protect assets, ensure accuracy of records, promote operational efficiency, and encourage adherence to policies, rules, regulations, and laws.

What is the purpose of assessing internal controls?

The objective of internal control should be to enhance operational efficiency, improve the reliability of financial reporting and comply with applicable laws.

Why is it important for the auditor to assess control risk in the planning phase of the audit?

The purpose of an entity's risk assessment is to identify, analyze, and manage risks that affect entity objectives. In a financial statement audit, the auditor assesses inherent and control risks to evaluate the likelihood that material misstatements could occur in the financial statements.

What is preliminary assessment of control risk?

The preliminary assessment of control risk is the process of evaluating the effectiveness of an entity's accounting and internal control systems in preventing or detecting and correcting material misstatements.

Why is there a need for an auditor to assess the internal control of a client?

Why do auditors ask so many questions about their clients' internal controls? Assessing internal controls is part of today's auditing requirements. It helps identify risk factors — but the requirements can sometimes be unclear.

What are the four purposes of internal control?

What are the 4 basic purposes of internal controls? safeguarding assets, Financial statement reliability, operational effieciency and compliance with management's directives.

What are the importance of the control environment in an organization?

The control environment sets the tone for the organization and influences how employees conduct their activities and carry out their control responsibilities. The control environment is the foundation for all other components of internal control and provides structure and discipline.

How do you assess controls?

How Do You Evaluate Internal Controls Deficiencies?Assess the Control Environment. ... Evaluate Risk Assessment. ... Investigate Control Activities. ... Examine Information and Communication Systems. ... Analyze Monitoring Activities. ... Index Existing Controls. ... Understand which Controls Are Relevant to the Audit.More items...•

How do you assess the effectiveness of controls?

4 Steps to Measure Controls' Effectiveness with Cyber Risk QuantificationIdentify current risk exposure.Map the control being considered to the FAIR Model.Perform a future state analysis, evaluating the effectiveness of the control.Compare the current state vs. future state to perform a cost-benefit analysis.

How do you assess control risk?

Control risk should be assessed at the maximum level for relevant assertions (1) for which controls necessary to sufficiently address the assessed risk of material misstatement in those assertions are missing or ineffective or (2) when the auditor has not obtained sufficient appropriate evidence to support a control ...

Who should conduct a drug assessment?

The person conducting the assessment should be a healthcare worker – a doctor, nurse, psychologist or other person with a health-related qualification. It is important that the information obtained in the assessment is honest and accurate. But, talking about drug use can be difficult. Patients may be reluctant to talk about their drug use.

How to explain the assessment process?

Explain the assessment processto the patient. During an assessment, the patient may be asked to reveal very personal and private information. It is important that you explain why you are asking these questions, and what you will do with the information that the patient gives you. For example, “I'm going to ask you some questions about your drug use. We need to know this information so that we know what withdrawal symptoms to prepare you for, and also so that we can plan your treatment”. Reassure the patient that the assessment is confidential. Before you begin the assessment, ask the patient if he or she has any questions for you.

How to assess if a patient is drug dependent?

Assess whether the patient is drug dependent. This can be done using the Severity of Dependence Scale(SDS; p. 24 ). Ask the patient the SDS questions for the main drug or drugs the patient uses. If the patient equals or exceeds the shown cut-off score for a particular drug, it is likely that they are dependent on that drug. Note that the SDS is not used to assess dependence on inhalants. There are no reliable instruments for assessing inhalant dependence; rely on patient reports of previous withdrawals to guide decision-making around inhalant dependence.

What to ask a drug dependent patient about their medical history?

Introduce the medical history questions with a phrase such as “now, I'd like to ask you about any medical problems you may have had in the past, or have now. This is very important, as it will help us if you suddenly get sick or if you need medication.”

What is the responsibility of a closed setting?

Hence, if a patient discloses that they have a serious or chronic illness, it is the responsibility of the closed setting to provide treatment or care for that illness, including medication as appropriate. A drug dependent patient's withdrawal can be complicated by medical illnesses.

Why is psychosocial history important?

Psychosocial history. It is also important to obtain an understanding of how the person's drug use has affected their daily life. You might say to the patient “thank you for co-operating with the assessment so far. Now, I'd like to ask you a little bit about how drugs have affected your life.

What to do when a patient is in withdrawal?

If the patient has concerns or is in withdrawal, do your best to alleviate this. Provide accurate information about what symptoms can be expected and how long they may last. If possible, provide medication to relieve symptoms. Ask the patient if he or she has previously undergone treatment for their drug use.

Why do treatment providers need instruments?

On the clinical side, treatment providers need instruments with which to assess the quality of treatment provision, as well as the progress of their clients during treatment. Their motivation is the same as that among researchers: Such instruments are seen as essential elements in the effort to improve clinical care.

How do patient characteristics affect treatment?

Although patient characteristics (panel I in figure 1) are not components of the treatment process, they can affect access to treatment, treatment selection and treatment planning, involvement in treatment, and treatment outcomes . In addition to these direct effects, patient variables can influence or moderate the relationship between treatment and outcomes, by affecting links in the causal chain connecting treatment provision/patient involvement in treatment to proximal and ultimate outcomes (not illustrated in figure 1; see Finney 1995). For example, Smith and McCrady (1991) found that patients who scored higher on abstract reasoning ability were better able to learn coping skills during treatment than were patients with lower neuropsychological functioning. In another type of treatment, cognitive functioning might not affect what is acquired during the course of treatment. Although the treatment process cannot be considered apart from treatment recipients, the assessment of patient characteristics is not covered here, where the focus is on the assessment of treatment–related variables.

How is quality of alcohol treatment determined?

The quality of alcohol treatment is determined, not only by the therapeutic techniques applied, but also by the characteristics of individual treatment providers (panel III in figure 1). In particular, this domain of variables refers to within–program variation in provider characteristics (aggregate, program–level staff characteristics are considered in panel II). Gerstein (1991) argued that “the competence, quality, and continuity of individual caregivers are likely to be critical elements in explaining the differential effectiveness of [substance abuse] treatment programs” (p. 139). In the alcohol treatment field, the few studies that have been conducted (e.g., W.R. Miller et al. 1980; Valle 1981; McLellan et al. 1988; Sanchez–Craig et al. 1991; Project MATCH Research Group 1998; for reviews, see Najavits and Weiss 1994; Najavits et al. 2000) indicate that therapist characteristics play an important role in determining clients’ treatment retention and outcomes.

What are the five treatment approaches?

2001#N#Description: This multidimensional instrument assesses five treatment approaches: psychodynamic or interpersonal, cognitive–behavioral, family systems or dynamics, 12–step, and case management. For each of the first four modalities, items assess beliefs underlying the approach, practices appropriate in individual therapy, and practices appropriate in group therapy. Case management is an individual approach, so no group practices items were included. In addition, items were developed to tap general “group techniques” (e.g., “encouraging peer social support”) and “practical counseling” (e.g.,“developing rapport and trust”). The instrument consists of 48 items that assess 14 subscales. Construct validity was supported by the results of a confirmatory factor analysis in which subscale items loaded on the factor they were intended to assess, but not on other factors. Corresponding belief and practice subscales correlated highly, except for case management. Cronbach alphas for all subscales except psychodynamic and family systems beliefs were above 0.50 and most were over 0.70 (Kasarabada et al. 2001, p. 287). The fact that some of the subscales consist of only three items contributed to low internal consistency estimates.

What is possible to assess in panel VI?

In addition to determining what has been provided to patients, it is also possible to ascertain to what extent patients have been involved in treatment (panel VI). For example, instead of simply determining the number of group therapy sessions a patient attended, it is possible to assess such constructs as the patient’s contributions to group discussions. Presumably, patient involvement in treatment would be more strongly associated with proximal and ultimate outcomes (see figure 1) than the treatment offered to individual patients.

What is alcohol treatment?

Alcohol treatment programs typically provide psychosocial and/or pharmacologic interventions to patients. To the extent that it is constant across all patients, treatment provided is a program–level characteristic (panel II in figure 1). In most programs, however, the treatment provided varies across patients (panel V).

What are the factors that affect the impact of alcohol treatment?

Therapeutic Alliance. One of the key factors affecting the impact of alcohol treatment, especially psychosocial treatments, is the quality of the alliance or relationship that is developed between the therapist and client (panel IV in figure 1).

What is an assessment for a therapist?

Assessment allows your therapist to track changes in your symptoms, so they can adjust their treatment plan as you heal. An assessment allows for a specialized and targeted treatment; this does more than just soothe your symptoms and allows for lasting results, including decreased pain and increased range of motion.

What is an assessment for massage therapy?

Assessment may include verbal consultation, range of motion testing, manual resistance and other special testing, and may be done before your therapist starts your massage, or as part of your massage treatment. Assessment allows your therapist to track changes in your symptoms, so they can adjust their treatment plan as you heal.

Does Anatomica have an assessment?

At Anatomica, every treatment includes an assessment – no matter if it’s your first or your fifteenth visit. The reason for this is to help your RMT best understand your condition, and any changes to your condition, in order to provide the most effective treatment.

Is orthopaedic assessment a diagnosis?

An orthopaedic assessment is not a diagnosis, it is an evaluation of soft tissue and the implications this has for posture and function of muscle and joints. Assessment really is a process that allows each client to receive the treatment that they need and deserve.

Why is comprehensive assessment important?

I have been promoting the importance of comprehensive assessment for 30 years. Accurate and efficient clinical reasoning with these tests takes you to the primary tissues involved and helps illustrate the likely nature of the injury. It is through orthopedic assessment that we gain a better understanding of the physiological, biomechanical, and psychosocial factors that may be playing a role in a client’s complaint. Accurate, informed understanding of your client’s problem, the tissues involved, the nature of the condition, and other critical factors are what lead to successful treatments.

What is initial assessment?

Initial assessment steps will help you figure out first if the condition is even something in your scope of practice and second, if massage is the best treatment solution. If not on either, referral is warranted. The basics – history, observation, and palpation – give you a roadmap for choosing which physical examination methods will elicit the most information. Clearly, no client will have the patience for or enjoy the practitioner simply running through an A to Z list of tests with them. We determine which tests are appropriate with information gained from the early steps in the process.

What are the limitations of a special test?

However, they come with limitations. The first is sensitivity, which means how accurate the test is at picking up everyone who has a specific condition. If the test is not very sensitive it may not give accurate information about a condition’s presence when the client has it. The second important factor is specific city, which refers to how accurate the test is at ruling out people that don’t have a specific condition. A test might be great at producing positive results indicating when a condition is present, but if it also gives positive results when the client doesn’t have the condition, it is less beneficial.

Why not jump to a special test?

Jumping to special tests is jumping to conclusions , rather than gathering information. Sure, they will tell you something, but they often do not provide the level and detail of information you can elicit from doing range-of-motion and muscle-resistance testing thoroughly and accurately first. In addition, without having first performed some of the range-of-motion tests you may inaccurately interpret the special tests.

Is an orthopedic assessment good?

Learning just the basics of orthopedic assessment will nearly guarantee better results with more satisfied and happier clients. Sounds like a sales pitch. It’s not. Good assessment drives your treatment decisions and when your treatment protocols are specific and targeted to the client’s issue, superior results follow. And I am not referring to the most complicated assessment process. Sometimes it’s a simple range- of-motion test done at the right time, with a few select questions that help effectively resolve a client’s problem.

When selecting a sedation scale for prevention of opioid-induced respiratory depression, care must be taken to be sure?

When selecting a sedation scale for prevention of opioid-induced respiratory depression, care must be taken to be sure that the selected scale matches the intended purpose. For example, the Ramsey is appropriate for monitoring the patient’s tolerance for ventilation in the ICU, but is not intended for use in prevention of opioid-induced respiratory depression. It contains irrelevant items, such as agitation, which have nothing to do with opioid-induced respiratory depression.

What is the clinical practice guideline for acute pain management?

22 This guideline outlines a comprehensive pain evaluation that would be most useful when obtained prior to the surgical procedure. In the pain history, the nurse identifies the patient’s attitudes, beliefs, level of knowledge, and previous experiences with pain. Expectations of patient and family members for pain control postsurgically will uncover unrealistic expectations that can be addressed before surgery. This comprehensive pain history lays the foundation for the plan for pain management following surgery, which is completed collaboratively by the clinicians (physician and nurse), the patient, and his or her family.

What is the Joint Commission's pain assessment?

The Joint Commission developed pain standards for assessment and treatment based upon the recommendations in the Acute Pain Clinical Practice Guideline. The Joint Commission requires that hospitals select and use the same pain assessment tools across all departments. This standard suggests providing options among scales such as the NRS, the Wong-Baker FACES scale, and a verbal descriptor scale.

When was the Pain Management Guideline released?

Pain management guideline; developed by the Health Care Association of New Jersey; released July 2006. This guideline includes definitions of pain (acute and chronic); clear direction for assessment and treatment with pharmacological and nonpharmacological interventions (including physical and occupational therapy); policies for pain education for staff, patients, and families; and direction for quality monitoring. The guideline is applicable to pain management in acute care and long-term care nursing facilities. Web site: http://www.guidelines.gov/summary/summary.aspx?doc_id=5526&nbr=003757&string=pain+and+assessment+and+nursing

What is pain performance improvement plan?

Establishing and maintaining an institutional pain performance improvement plan is a Joint Commission requirement. 5 Institutions should develop interdisciplinary approaches to acute pain management with clear lines of responsibility for achieving good acute pain control. 5, 22, 24 This interdisciplinary approach includes an individualized plan of care for pain control, developed in collaboration with the patient and family. Systems should be in place to monitor pain management that alerts the clinician when pain is poorly managed. For example, in an institution with a computerized documentation system, an alert may pop up when a patient’s pain exceeds a threshold. The threshold may be set individually by patient and clinician or institutionally. A reasonable threshold might be moderate to severe pain, which means a pain score of greater than 4 on a 0–10 scale. 31 The plan of care provides the basis for monitoring the quality of acute pain management provided.

Is pain management a quality indicator?

Although satisfaction with pain management currently is used as a measure of institutional quality, satisfaction with pain management is no longer recommended as a quality indicator for pain control. 24, 32 This is because patient satisfaction findings are difficult to interpret. In their review of 20 quality improvement studies conducted between 1992 and 2001, Gordon and colleagues 32 noted 15 studies reported high satisfaction with pain management despite many patients experiencing moderate to severe pain during hospitalization. Thus, patient satisfaction data should be cautiously interpreted and, if used, used in conjunction with other quality indicators. Because of the current focus on report cards for health care organizations, patient satisfaction data are routinely collected and easily obtained for review.

Why is it important to assess a patient's ambulatory capabilities before applying bandages?

It is important to assess a patient’s ambulatory capabilities before applying the bandages to ensure that the therapy is appropriate for the individual (Charles and Lindsay, 2004). An ambulatory assessment chart has been devised although, as yet, it is not widely available (Lindsay et al, 2003). Practitioners should use their trust assessment form as a basis for obtaining the required information.

What is compression therapy?

Compression therapy involves the deliberate application of pressure to the body and is most frequently used in treating venous disorders of the lower limb, for example venous ulceration, varicose eczema, oedema and varicose veins (Charles and Lindsay, 2004). It is also used in the maintenance phase of treating lymphoedema.

Why is compression used in venous disorders?

Compression is used for patients with venous disorders to help reduce blood pressure in the superficial venous system and to promote venous return by increasing blood flow in the deep veins. The reduction in pressure differences between capillaries and tissues also helps to reduce oedema (Dowsett, 2004). Thus, in a patient with lymphoedema, ...

Why do you put extra padding on bony prominences?

Extra padding should be applied to bony prominences to reduce sub-bandage pressure and the risk of local tissue damage or necrosis (Mear and Moffatt, 2002).

Why do we need initial pain assessments?

Initial assessments will cover a lot of ground because they are used as part of a much wider exercise designed to help health professionals understand why patients are seeking treatment, what treatment and interventions have been tried, and their understanding of their current situation. Pain assessments after this point may focus on a smaller range of the pain experience to monitor treatment, the patient’s recovery or the course of the disease.

Why is it important to assess pain in adults?

Pain affects patients physically and emotionally, so successful ly managing the pain they experience is a key component of their recovery. This third article in a series on pain looks at why it is important to assess pain in adults and how this can best be done. The causes and symptoms of chronic and acute pain are detailed, along with the different assessment tools that can be used and for which patients they are suitable.

How to assess pain in nursing?

Patients vary in their ability to lead or participate in discussions about their pain and it is important for nurses to consider this before choosing the most appropriate assessment strategy. Self-report of pain using a guided question set is the best way to assess pain (MacIntyre and Schug, 2014). When patients cannot verbally report pain, there are a range of other options, including pain rating scales, to which the patient can point if able to do so. The Wong-Baker FACES Pain Scale has been endorsed by many groups as an effective tool for use in people with mild-to-moderate cognitive impairment (Scherder et al, 2009), even though it is better known as a tool used with children.

What is pain assessment?

A pain assessment is conducted to: Detect and describe pain to help in the diagnostic process; Understand the cause of the pain to help determine the best treatment; Monitor the pain to determine whether the underlying disease or disorder is improving or deteriorating, and whether the pain treatment is working.

Why is it easier to locate pain?

Pain is usually easier to locate accurately when it is acute and somatic - that is, related to some sort of superficial tissue damage. Deeper pain and chronic pain tend to be harder to pinpoint.

Why do health professionals want to understand patients' pain?

Health professionals want to understand patients’ pain because that will help them to diagnose the problem, select an effective treatment programme and monitor their progress. Purpose of pain assessment. A pain assessment is conducted to: Detect and describe pain to help in the diagnostic process;

Can a patient participate in pain assessment?

Health professionals should not assume that a patient cannot participate in a pain assessment. People with dementia can often use self-report pain scales but they may need to be re-taught how to do so each time (Kaasalainen et al, 2013). Almost universally, patients change their “normal” behaviour when they are in pain, so knowing individual patients and their normal demeanour is vital.

Why is it important to do a patient assessment?

It is important to perform a history and do a focused physical exam to be sure that there aren't any medical risks that would predispose the patient to a medical emergency during the actual procedure. It is also important to talk to the patient to get a feel for the patient's psychological state.

How to know if a patient has a good history?

A good history is merely confirmed by the physical examination. Begin with the basic vital signs including blood pressure, heart rate, respirator y rate, and record the height and weight of the patient.

What is risk assessment?

Risk Assessment. In order to answer these questions, a risk assessment is performed, which requires taking a medical history and performing a physical examination. Most of the information obtained in the medical history will be the basis for the risk assessment and it is important for the clinician to spend time talking with the patient.

What is an ASA 3 patient?

Patients classified as ASA 1 or 2 do not require any modifications to the sedative technique. An ASA 3 patient requires more caution; modifications might be needed, such as lighter sedation or treatment in a hospital setting. An ASA 4 patient should only be treated in a hospital dental facility, and should generally undergo emergency and palliative care only.

Understanding Your Personal Circumstances

• As well as collecting personal information, such as your name, address and date of birth, your therapist will ask questions relating to lifestyle, fitness, exercise routine, nutrition, work-life balance, what your occupation is and a number of questions to gain enough information to help …

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Helping to Address Problem Areas

How Long Does An Assessment take?

Patient Characteristics

Program–Level Characteristics

Provider Characteristics

Therapeutic Alliance

Treatment Provided/Treatment Involvement

Proximal Outcomes

Ultimate Outcomes

Table 1.—Measures of General Program–Level Characteristics

Table 2.—Measures of Treatment Orientation

Treatment Provided/Patient Involvement in Treatment

• In pharmacologic studies, treatment provided and patients’ compliance with treatment are assessed in terms of medications taken. Developments such as Medication Event Monitoring System (MEMS) vials that record the dates and times they are opened (e.g., Namkoong et al. 1999; Krystal et al. 2001) can yield more accurate compliance data than patient r...

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