While I was in Physical Therapy (PT) school I was taught that patients who did not wear gait belts during gait or balance exercises, any slips, trips and falls resulting in personal injury could be a medical malpractice/negligence claim and is an issue of ethics. And, if the personal injury does result in a lawsuit, you — the PT — lose.
Please note that when using a gait belt there needs to be contact (or very close) supervision. (If there’s no supervision, then why the gait belt?) The level of supervision needs to be documented in the chart, as well as the use of the gait belt. In this BLOG, whenever the term “gait belt” is used, please assume the level of supervision was either contact or close.
Recently I’ve visited various outpatient clinics and rehabilitation facilities. I made it a point to ask the PTs whether they used gait belts when treating patients with balance/gait deficits that could result in slips, trips and falls. And I noted the type of business of employment.
This led to some very interesting discussions, so I decided to include YOU in the discussion. The following is a four-question quiz for those of you working with patients, and after that is a one-question quiz for those working in academia. I am quite interested in hearing from you — both in the quiz and in the comments. I will let you know the results of the quiz in a subsequent BLOG.
Questions for clinicians
Question for academics
In a medical malpractice/medical negligence case, it will be important to know whether a gait belt owned by the owner of the rehabilitation business was on the premises at the time of the bodily injury. Also, it will be important to know whether the use of gait belts is appropriately in the Policy and Procedure manual. If the rehabilitation business does not have a gait belt on the premises, the rehabilitation facility may be liable for not providing a safe environment.
The bottom line is that every physical therapy place of business should have functional gait belt(s) on the premises, and the use of the gait belt needs to be in the Policy/Procedure manual.
The above two paragraphs are only about legal ramifications around the gait belt. Let’s now look at the ramifications around ethics.
The American Physical Therapy Association has identified eight principles around the core values of ethics: Accountability, Compassion, Professional Duty, Social Responsibility, Altruism, Compassion/Caring, Excellence, and Integrity. It is the professional duty of a PT to cause no harm (i.e., no personal injury) to the patient. Also, if the patient falls, the question of “excellence of care” arises.
So, if the PT does not use a gait belt and personal injury ensues, the PT or the employer must ask the questions of ethics:
- Did the PT have a professional duty to the patient?
- Did the PT act in manner providing excellence of care?
So, let’s use that gait belt.
Now it is your turn! Please share your thoughts about gait belts below — and if you haven’t taken them yet, take a look at our courses related to balance and falls.