Supervision, Delegation, and Utilization of PTAs, Students, and Unlicensed Personnel
Supervision levels
Kansas regulations distinguish direct supervision-the supervising PT is physically present and immediately available-from general supervision, where the PT is available by telecommunication but not on site. The plan of care and Board rules determine which level applies to a given PTA task and patient condition.
What a PTA may do
A PTA implements selected interventions within the PT’s plan of care, documents treatment, and reports changes. A PTA may not perform the initial examination or evaluation, establish a diagnosis or prognosis, develop or significantly alter the plan of care, or make the discharge decision. The PT must re-evaluate at required intervals and when the patient’s condition changes.
Unlicensed personnel
Aides may perform non-skilled tasks such as clerical work, equipment cleaning, transport, and setup. They may not apply modalities, perform therapeutic exercise, interpret responses, or provide patient education that requires clinical judgment.
Students
Students may participate in patient care as part of an accredited educational program. The supervising PT remains responsible for the patient and must ensure the student’s level of supervision matches the student’s competence and the facility’s policy.
Worked example
A PTA wants to increase resistance during a strengthening session. The plan of care authorizes progression based on tolerance, and the PT is available by phone. The PTA may progress within the documented parameters and must document the change. If the patient’s pain pattern changes or the PTA wants to change goals, the PT must re-evaluate.
Traps that cost marks
Having an aide apply ultrasound; allowing a PTA to perform the initial evaluation; and assuming “general supervision” means no supervision at all.