STANDARDS OF PRACTICE
I. STANDARDS OF PRACTICE
II. INTERPRETING ETHICAL PRINCIPLES
III. CODE OF ETHICS
IV. JOB DESCRIPTION
STANDARDS OF PRACTICE
This document is intended to serve Orthopaedic Technologists (OTs) who are members of the National Association of Orthopaedic Technologists (NAOT) in interpreting the standards of practice and matters of professional conduct. These guidelines are subject to change as the dynamics of the profession change, and as new patterns of health care delivery are developed and accepted by the professional community and the public. The Standards of Practice are subject to monitoring and revision by the Executive Board of the Association.
INTERPRETING ETHICAL PRINCIPLES
The interpretations expressed herein are not to be considered all inclusive of situations that could evolve under specific Articles of the Standards of Practice, but reflect the opinions, decisions, and advice of the Executive Board of the Association. While the statements of ethical principles apply universally, specific circumstances determine their appropriate application. Input related to current interpretations or situations requiring interpretation is encouraged from Association members.
Article I
Principle
Orthopaedic Technologists respect the rights and dignity of all individuals.
IA. Attitudes of Orthopaedic Technologists
1. The Orthopaedic Technologist (OT) shall recognize that each individual is different from other individuals and shall respect and be responsive to those differences.
2. OTs are to be guided at all times by concern for the physical, psychological, socio-economic welfare of those individuals entrusted to their care.
3. OTs shall be responsive to and mutually supportive of colleagues and associates.
IB. Confidential Information
1. Information relating to the Orthopaedic Technologists/Patient relationship is confidential and may not be communicated to a third party not involved in that patient’s care without the prior written consent of the subject, according to applicable law.
2. Information derived from a competent-sponsored peer review shall be held confidential by the reviewer unless written permission to release the information is obtained from the Orthopaedic Technologist who was reviewed.
3. Information derived from the working relationships of Orthopaedic Technologists shall be held confidential by all parties.
4. Information may be disclosed to appropriate authorities when it is necessary to protect the welfare of an individual or the community. Such discloses shall be in accordance with applicable law.
Article II
Compliance with Rules and Regulations
The Orthopaedic Technologist is to comply with the laws and regulations governing the practice of orthopaedic technology.
IIA. Professional Practice
1. The Orthopaedic Technologist shall provide consultation, evaluation, treatment, and preventative care in accordance with the laws and regulations of the jurisdiction (s) in which they practice.
Article III.
Responsibility
Orthopaedic Technologists accept the responsibility for exercise of sound judgment.
IIIA. Acceptance of Responsibility
1. Upon accepting an individual for orthopaedic services, the Orthopaedic Technologist shall assume the responsibility of evaluating that individual; planning, implementing, and supervising the treatment; reevaluating and changing that treatment; and maintaining adequate records of the case, including progress notes.
2. When the individual’s needs are beyond the scope of the Orthopaedic Technologist’s expertise, the individual shall be so informed and assisted in identifying a qualified person to provide the necessary services.
3. When the Orthopaedic Technologist judges that benefit can no longer be obtained by their services, they shall so inform the individual receiving the service. It is unethical to initiate or continue services that, in the technologist’s judgment, either cannot result in a beneficial outcome or are contradicted.
IIIB. Delegation of Responsibility
1. The Orthopaedic Technologist shall not delegate to a less qualified person any activity, which requires the unique skill, knowledge, and judgment of the Orthopaedic Technologist.
2. The primary responsibility for orthopaedic care rendered by supportive personnel rests with the Supervising Orthopaedic Technologist. Adequate supervision requires, at a minimum, that a Supervising Orthopaedic Technologist perform the following activities:
a. Designate or establish channels of written and oral communication.
b. Interpret available information concerning the individual under care.
c. Provide initial evaluation
d. Develop a plan of care, including short and long term goal.
e. Assess competence of supportive personnel to perform assigned tasks.
f. Direct and supervise supportive personnel in delegated tasks
g. Identify and document pre-cautions, special problems, contradiction, goals and plans for re-evaluation.
h. Reevaluate and adjust plan of care when necessary; perform final evaluation and establish a follow up plan.
IIIC. Provision of Services
1. The Orthopaedic Technologist’s professional practices and their adherence to ethical principles of the Association shall take preference over individual business interests. Provision of services for personal financial gain, rather than the need of the individual receiving the services, is unethical.
2. If the Orthopaedic Technologist’s services are misused, the technologist(s) involved must accept responsibility for the misuse.
IIID. Practice Arrangements
1. Participation in a business, partnership, corporation, or other entity shall not exempt the Orthopaedic Technologist, whether employer, partner, or stockholder, either individually or collectively, from the obligation of promoting and maintaining the ethical principles of the Association.
Article IV
Promotion of High Standards
Orthopaedic Technologists maintain and promote high standards in the provision of Orthopaedic Technology services.
IVA. Continued Education
1. The Orthopaedic Technologist shall participate in educational activities, which enhance their basic knowledge and provide new knowledge.
IVB. Review and Self-Assessment
1. The Orthopaedic Technologist shall provide for utilization review of their services.
2. The Orthopaedic Technologist shall demonstrate their commitment to quality assurance by peer review and self-assessment.
IVC. Research and Education
1. Whenever possible, Orthopaedic Technologists shall participate and support others in the conduct and communication of research and in educational activities that may contribute knowledge for improved patient care and patient or student education and for the growth of Orthopaedic Technology as a profession.
2. When Orthopaedic Technologists are researchers or educators, they are responsible to the research subjects, students, colleges, institutions, facilities, funding agencies, the profession, and society for maintaining and promoting ethical conduct in research and educational activities.
Article V
Endorsement of Equipment
VA. The Orthopaedic Technologist shall not influence upon individuals under their care or their families for utilization of products and equipment based upon the direct or indirect financial interest of the Orthopaedic Technologist(s). While it cannot be considered unethical for Orthopaedic Technologists to own or have financial interest in products or equipment companies, they must act in accordance with law and make full disclosure of their interest whenever such companies become the source of products or equipment for individuals under their care.
VB. In endorsing or advertising products or equipment, the Orthopaedic Technologist shall use sound professional judgment and shall not give the appearance of an Association endorsement.
Article VI.
Provide Accurate Information
Orthopaedic Technologists shall endeavor to educate the public to an awareness of the Orthopaedic Technology profession through such means as publication of articles and participation in seminars, lectures, and civic programs.
Article VII.
Protection of Profession
Orthopaedic Technologists shall accept responsibility to protect the public and the profession from unethical, incompetent, or illegal acts.
VIIA. Consumer Protection
1. The Orthopaedic Technologist shall report any conduct, which appears to be unethical, incompetent or illegal.
CODE OF ETHICS
PREAMBLE
This Code of Ethics sets forth ethical principles for the Orthopaedic Technology profession. Members of this profession are responsible for maintaining and promoting ethical practices. This Code of Ethics, adopted by the National Association of Orthopaedic Technologists, shall be binding on the Orthopaedic Technologists who are members of the Association.
Principle I
Orthopaedic Technologists respect the right and dignity of all individuals.
Principle II
Orthopaedic Technologists comply with the laws and regulations governing the practice of Orthopaedic Technology.
Principle III
Orthopaedic Technologists accept responsibility for the exercise of sound judgment.
Principles IV
Orthopaedic Technologists maintain and promote high standards in the provision of Orthopaedic Technology services.
Principles V
Orthopaedic Technologists provide accurate information to the consumer about the profession and about services they provide.
Principles VI
Orthopaedic Technologists accept the responsibility to protect the public and profession from unethical, incompetent or illegal acts.
Principles VII
Orthopaedic Technologists participate in efforts to address the health needs of the public.
JOB DESCRIPTION
I. Definition
The Orthopaedic Technologist is a paramedically trained member of the orthopaedic team who works with all health care professionals in delivering patient care and assuming appropriate responsibilities concerning all surgical and non-surgical procedures.
II. Education
Minimum requirements: high school graduate or equivalent.
III. Credentials
A. Entry Level (Level I)
1. Training in one or all of the items listed below:
a. At least one year full-time work experience in either a hospital, clinic or office setting, working directly in the treatment of the orthopaedic patient(s).
b. High school graduate or equivalent.
2. Skills
a. Ability to articulate descriptions of orthopaedic conditions based upon a basic understanding of anatomical structures and their relationship with one another.
b. Ability to apply upper and remove upper and lower extremity casts.
c. Understanding of theory and application of skin and skeletal traction.
d. Understanding of the proper application of aseptic techniques in dressing change and in setting up surgical fields.
B. Certified Level (Level II)
1. Training in at least one of the following categories must be met:
a. At least two (2) years full-time work experience in a hospital, clinic, or office, or as an independent contractor working directly in the care of the orthopaedic patient, and certification by The National Board of Certification for Orthopaedic Technologists (NBCOT).
b. Completion of an orthopaedic technology training program and certification by NBCOT.
c. Completion of a related allied health program (i.e. RN, PA, LVN, LPN, Surgical Technologist, Radiology Technologist) with at least one-year full-time work in either a hospital, clinic, office setting, or as an independent contractor, working directly in the treatment of the orthopaedic patient, and certification by NBCOT.
2. Skills
a. Ability to articulate descriptions of orthopaedic conditions based on the understanding of anatomical structures and their relationship with one another.
b. Ability to apply, adjust, and remove all common orthopaedic devices, using a manual or standard practice as a guide.
c. Knowledge of theory and application of skin or skeletal traction.
d. Knowledge of the proper application of aseptic techniques in dressing change, removal of sutures or staples and in setting up surgical fields.
e. Ability to interpret simple fractures and dislocations on X-ray films.
f. Ability to perform in an operating room environment as first and second assistant or scrub technician under the direct supervision of a surgeon.
g. Ability to supervise and train other certified, eligible Orthopaedic Technologists.
C. Advanced Certified Level (Level III)
1. Training in at least one of the following categories must be met:
a. At least eight (8) years full-time work experience in a hospital, clinic or office setting, or as an independent contractor working directly in the care of orthopaedic patients and certification by NBCOT for no fewer than three (3) years.
b. Completion of an orthopaedic technology training program, and at least eight (8) years full-time work experience in a hospital, clinic or office setting, or as an independent contractor working directly in the care of the orthopaedic patient, and certification by NBCOT for no fewer than three (3) years.
c. Completion of a related allied health program with at least four (4) years full-time work in either a hospital, clinic or office setting, or as an independent contractor working directly in the care of the orthopaedic patient, and certification by NBCOT for no fewer than three (3) years.
2. Skills
a. Ability to articulate descriptions of orthopaedic conditions based on advanced understanding of anatomical structures and their relationships with one another.
b. Ability to apply, adjust, and remove all common and difficult orthopaedic devices.
c. Advanced knowledge of theory and application of skin, skeletal and manual tractions.
d. Expert knowledge of the proper application of aseptic techniques in dressing change, removal of sutures, staples, Steinman pins, K-wires, and in setting up surgical fields and draping in the operating room.
e. Ability to interpret most fractures and dislocations on X-ray films.
f. Ability to perform in an operating room environment in an expert manner as a first and second assistant or scrub technician under the direct supervision of a surgeon.
g. Ability to supervise and train other no-certified Orthopaedic Technologists.
IV. Goals
1. Application of knowledge of the basic concepts necessary for the performance of the duties expected of certified Orthopaedic Technologists.
2. Development of ideas and professional attitude that will promote responsibility as an individual health care professional and as a member of the health care team.
3. Coordination of team efforts to offer the most qualified support team to the patient, physician and other allied health care professionals.
4. Awareness of the patient as an individual, with specific physical, psychological and spiritual needs.
5. Adherence to the Standards of Practice and Code of Ethics of the National Association of Orthopaedic Technologists that will reflect the ethical, legal an moral responsibilities of the Orthopaedic Technologist.
6. Education of the general public regarding the Orthopaedic Technologist and what his/her specific duties on the health care team entail.
V. Objectives
1. Respect the patient’s inherent right to privacy, dignity and confidentiality.
2. Recognize the importance of teamwork, consideration and cooperation.
3. Function efficiently and in a professional manner in all aspects of patient treatment.
4. Apply the principles of asepsis in a knowledgeable manner to provide optimum patient care.
5. Prepare and know the specific uses of all equipment and supplies used for orthopaedic procedures.
6. Differentiate sterilization materials and techniques required for specific instruments and procedures.
7. Demonstrate knowledge of the step-by-step progress of specific orthopaedic procedures and display dexterity in the use of the required instrumentation and equipment.
8. Develop and improve skills in the organization of work and in assisting the physician for economy in time, motion and materials.
9. Identify emergency situations and use sound judgment in instituting established procedures to respond to emergencies in a calm and efficient manner.
10. Understand that each Orthopaedic Technologist is individually responsible for his or her own actions and recognizes legal and policy limits of individual responsibility.
11. Understand and establish policy and procedure directives.
VI. Job Knowledge
A. General
1. Anatomy, physiology and medical terminology
2. Fracture healing and complications
3. Wound healing and complications
4. Principles of aseptic techniques
5. Environmental safety and precautions
6. Application and use of orthopaedic equipment and supplies
7. Maintenance and ordering of orthopaedic equipment and supplies
8. Legal, moral and ethical responsibilities of an Orthopaedic Technologist.
9. Effective communication skills.
10. Implementation of cost containment measures.
11. Adherence to and implementation of established hospital polices and procedures of the work place.
B. Hospital Orthopaedic Technologists
1. Fabricate, adjust and remove orthopaedic devices.
2. Apply mobilization and immobilization devices.
3. Apply skin, skeletal and manual traction.
4. Make rounds on all orthopaedic patients
5. Serve as technical advisor to the hospital personnel in matters pertaining to orthopaedic devices and equipment.
6. Assist orthopaedic surgeons in operating room as first and second assistants or scrub technician.
7. Represent the Orthopaedic Technologists at medical, nursing and administrative meetings.
8. Record in patient’s chart, condition, progress and assessment for review by the Orthopaedic Surgeon.
9. Adhere to and implement established hospital policies and procedures of the work place.
C. Clinic/Office Technologists
1. Order orthopaedic equipment and supplies
2. Take necessary measurements (i.e. grip strength, leg lengths).
3. Remove sutures, staples, Steinman pins and K-wires
4. Change dressing and care for wounds.
5. Apply, adjust and remove casts.
6. Draw up injections
7. Record patient’s blood pressure, pulse and weight.
8. Phone and chart medication ordered by the physician.
9. Assist Orthopaedic Surgeon in reduction of fractures.
10. Write standard admitting and pre-op instructions for patients having surgery.
11. Assist in making follow-up appointments and consultation appointments with other specialists for patients.
12. Measure and fit patients for braces and other orthopaedic devices.
13. Instruct patient in pre and post-operative care.
14. Instruct patient in proper care of cast.
15. Clean and stock patient exam and treatment rooms.
16. Adhere to established clinic/office policy and procedure directives.
D. Health Care Agency/ Independent Contractor
1. Perform all of the duties of a hospital-based Orthopaedic Technologist.
2. Perform all of the duties of a clinic/office-based Orthopaedic Technologist.
3. Serve as a technical expert to hospitals, orthopaedic surgeons and other Orthopaedic Technologists in matters pertaining to orthopaedic devices and techniques.
4. Set up and fit patients at home with orthopaedic devices and equipment.
5. Instruct others in the practice of orthopaedic technology.
6. Educate the public about the role of an Orthopaedic Technologist on a team of health care providers.
Disclaimer
This information is made available by the Standards of Practice/Job Description Committee of the National Association of Orthopaedic Technologists for reference purposes only. This information is not intended to represent the only, nor necessarily the best information on the Standards of Practice or Job Description for Orthopaedic Technologists.
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