Organizing & Administering an Athletic Training Program Mrs. Marr Sports Med I Topics of Discussion Student shall: 1. Describe a well- designed athletic training facility 2. Identify the rules of operation that should be enforces in an AT facility 3. Explain budgetary concerns for ordering supplies and equipment 4. Explain the importance of the pre- participation physical exam 5. Identify the necessary records that must be maintained by the Athletic Trainer What is a well- designed Athletic Training facility? What is a well- designed Athletic Training facility? How much money? How much room? How many student- athletes? Needs vs. Wants Accessible/ location Other Planning a Training Room Proposed uses of facility Type of sports to be served # staff members # patients served Placement of facility (exits, locker rooms, easy access, male/female access) Traffic flow patterns Hours of use Other functions Classes/labs Planning a Training Room Intended Space Allocation Offices & Record Keeping - confidentiality Evaluation & Treatment Rehabilitation Taping – waste buckets, sink, flooring Storage - shelving Drug screening – separate bathroom, privacy Exam room Teaching room/lab What type of equipment? Size (2-3 sq. ft./person during peak loads – square footage occupied by equipment) + others in area at time (AT, Dr.) (ideal is 1000-1200 sq. ft) Location compared to other facilities Planning a Training Room Intended space allocation Specific space allocation Electrical Plumbing Ventilation (hydrotherapy) Telephone, computer, communication systems, stereo systems Ceiling type & height – tall athletes Door width & height - Cabinetry, workstations Flooring type – non-slip, industrial grade Carpet vs. tile Planning a Training Room Wall covering – sound absorbers Colors – White – safe, cleanliness, sanitary Black – strong accent color, use in small quantities Reds – exciting, stimulation, unpleasant tensions Orange – similar to reds, but not as great an extent Yellow (creams, beiges) – humor, cheery, decrease tensions Green – calm, restful Blue – rest, calm, overuse = depression Violet – rest, calm, uncertainty, depression, tension Neutrals (gray, brown, tan) – grays – good background w/ other colors, browns/tans – homelike = lighter tones; masculine = heavier tones Lighting – 4-5 ft. off ground GFIC, 20-50 foot candles of illumination 4’ above floor for taping, rehab 50-100 foot candles – facial expressions, skin color Windows – more calming effect Planning a Training Room Application of Title III from ADA Installing ramps Making curbs cut in sidewalks/entrances Repositioning telephones Adding raised markings on elevator control buttons Installing flashing alarm lights Widening doors Installing accessible door hardware Installing grab bars in toilet stalls Rearranging toilet partitions to increase maneuvering space Repositioning paper towel dispenser in bathroom Installing paper cup dispenser at water fountains Removing high-pile, low-density carpeting Designing a Facility - Area Construction Considerations Program areas General facility considerations Taping area Treatment area Rehabilitation area Hydrotherapy area Office area Exam room area Pharmacy area Storage area Specialty pad & Orthotic work area Locker room, lavatory, & shower Janitorial storage & closet Conference room or library Rehabilitation pool X-ray room Special Service Areas Treatment Area: area that accommodates 4-6 adjustable treatment tables, 3-4 stools, and hydrocollator and ice machine accessibility Electrotherapy Area: area that houses ultrasound, diathermy, electrical stim units, storage units, grounded outlets, treatment tables and wooden chairs, under constant supervision Hydrotherapy Area: area with centrally sloping floor to drain, equipped with 2-3 whirlpools, shelving and storage space and outlets 5 feet above the floor Exercise Rehabilitation Area: area that provides adequate space and equipment to perform reconditioning of injuries Taping, Bandaging & Orthotic Area: 3-4 taping tables and storage cabinets to treat athletes with proximity to a sink Physician’s Exam Room: space for physician to work which may hold exam table, lockable storage, sink, telephone, refrigerator Records Area: space devoted to record keeping which may include filing system or computer based database, that allows access only to medical personnel Storage Facilities Training rooms often lack ample storage space Storage in training room that holds general supplies and special equipment Large walk-in storage cabinet for bulk supplies Refrigerator for equipment, ice cups, medicine and additional supplies Athletic Trainer’s Office Space at least 10x12 feet is ample All areas of training room should be supervised without leaving office space (glass partitions) Equipment should include, desk, chair, tack board, telephone, computer (if necessary) and independent locking system Additional Areas (college/ Pro teams) Pharmacy Area: separate room that can be secured for storing and administrating medications (records must be maintained concerning administration) Rehabilitation Pool: if space permits, must be accessible to individuals with various injuries, with graduated depth and non-slip surface X-Ray Room: separate room with lead shielding in walls, large enough to house necessary equipment Floor plans Communicate with the Architect Concept Plans What you want in the facility (wants vs. needs) Preliminary Drawing Look at the plans & review: Space allocation Traffic flow Electrical, Plumbing, Lighting, Ventilation, Heating & Cooling Walls & floors Door placements Final Drawing Review everything again! Last chance to change things Remodeling an Existing Facility What do you want to change? How can you change it? What is cost effective? Can those walls be moved? Plumbing? Are there more headaches than would be if a new facility was made? Athletic Training Facilities http://www.lsusports.net/ViewArticle.dbml?DB_OEM_ID=5200&ATCLID=1772 77 http://www.adrian.edu/academics/ESPE/athletic_training/facilities.php http://www.omavs.com/sports/2008/6/5/training_room.aspx http://www.rolltide.com/sports-med/medicine-facilities.html http://bus.collins.utulsa.edu/atrg/donald_w.asp http://www.niuhuskies.com/ot/training-facilities.html http://www.csmfoundation.org/Division_Facilities.html http://www.uni.edu/athtrn/pages/uniathletictraining/facilities.shtml http://www.aggieathletics.com/ath-training/tam-ath-training-facilities.html http://utepathletics.cstv.com/athletic-training/utep-athletic-training.html http://www.uhcougars.com/facilities/hou-aac.html http://www.ci.bryanisd.org/athtrain/ http://www.nkschools.org/1600206484550160/blank/browse.asp?a=383&BM DRN=2000&BCOB=0&c=59055&1600206484550160Nav=|&NodeID=148 Assignment 1: Part A: Design your own Training Room Part B: Remodel the Klein Collins Training Room. Identify the rules of operation that should be enforces in an AT facility Identify the rules of operation that should be enforces in an AT facility What kinds of rules should you have? Safety 1st Paperwork issues Educational considerations Schedules Title IX issues (Co-Ed facilities) Consistency Klein Collins AT Rules Hygiene & Sanitation Rules Athletic Training Facility Rules Rules concerning room cleanliness and sanitation must be set and made known to population using facility Examples No equipment/cleats in training room Shoes off treatment tables Shower prior to treatment No roughhousing or profanity No food or smokeless tobacco Hygiene & Sanitation Rules Athlete Rules Promotion of good health and hygiene is critical Athlete clearance to participate Prompt injury and illness reporting Follow good living habits Avoid sharing clothes and towels Exhibitgood hygiene practices Avoid common drinking sources Other AT facility rules: http://web.uccs.edu/sports_medicine/Rules%20and%20Regs%20Page%20new.htm http://blogs.westmont.edu/athletics/athletic-training/athletic-training-rules/ http://www.ehc.edu/athletics/pdfs/ATR.pdf http://www.jccc.edu/home/handbook/athletic.php/train_room http://buhuskies.com/sports/2010/3/15/athletic_training.aspx http://cruathletics.com/news/2010/9/7/WVB_0907101410.aspx?path=wvball http://www.nevadawolfpack.com/ViewArticle.dbml?DB_OEM_ID=10000&ATCLID=1567810 http://trainer.lufkin.high.schoolfusion.us/modules/groups/group_pages.phtml?gid=425936&nid=32635&sessionid =90bf0905ad20494142a586f01ac41095&sessionid=90bf0905ad20494142a586f01ac41095 http://www.butlersports.com/information/sports_medicine/sports-medicine SAT Guidelines (Handbook): http://www.utpabroncs.com/ath-training/SATmanual.html http://www.edb.utexas.edu/atep/content/ACI%20handbook%206-27-06.pdf Assignment 2: Develop your own Training Room Rules (be able to justify!) Budgetary concerns (ordering supplies and equipment) What is a budget? “…a strategic plan for how the sports medicine unit will function over a given period and an operational plan for how it will accomplish its goals” (Ray, 117). “…a financial plan of operation that commits resources for projects, programs, or activities and specifies the services to be provided and the resources that must be spent to achieve these service deliveries” (Rankin, 125). MONEY!- the amount of money you can spend. Use it or lose it! Budgetary Concerns Size of budget?? Different settings = different size budgets and space allocations Equipment needs and supplies vary depending on the setting (college vs. high school) Continuous planning and prioritizing is necessary to effectively manage monetary allocations to meet programmatic goals Types of Budgets Zero-based budgeting Lump-sum budgeting Line-item budgeting Zero-based Budgeting Prioritizes services & goods needed What is necessary to provide care? How important is each good/service? New budget each year Budget based on program goals Need documentation ATC needs to justify and evaluate all expenses Why?? Line-Item Budgeting Expenses are broken down into… Classes, subclasses Expendable supplies Permanent equipment Maintenance & repair Salaries & benefits Professional organization memberships Physician involvement Line-item Budgeting Allows parent organization greater monetary control Advantage: Breakdown of categories=easy comprehension Disadvantage: “Mid-year financial crisis” Funds cannot be interchanged between classes. Lump-sum Budgeting ATC is given a “lump-sum” of money Uses where and when needed Spending freedom Athletic trainer held accountable for spent money By administrators Budget Settings College/University Traditional (High School) Professional athletics Industrial Rehabilitation Remember- Choose budgeting type that fits employment setting (if you can) Meets the program needs (college vs. pro) Consider past budgets when creating a new one. Documentation! Effectively communicate program needs Less money for more sports… Think outside the box & be creative! Remember the Trainers Lament! The Trainer's Lament WE THE WILLING LED BY THE UNKNOWING ARE DOING THE IMPOSSIBLE FOR THE UNGRATEFUL WE HAVE DONE SO MUCH FOR SO LONG WITH SO LITTLE- WE ARE NOW QUALIFIED TO DO ANYTHING WITH NOTHING! Supplies Expendable (supplies that cannot be reused- first aid and injury prevention supplies) Non-expendable (re-useable supplies -ace wraps, scissors…etc) Yearly inventory and records must be maintained in both areas Equipment Items that can be used for a number of years Fixed (remain in the training room- ice machine, tables) Non-fixed (crutches, coolers, training kits) Purchasing Systems Direct buy vs. competitive bidding Lease alternative Additional Budget Considerations Telephone and postage expenses Contracts for outside services Purchases relative to liability insurance and professional development Assignment 3: Use the catalogs provided, internet and any other resources to order athletic training supplies for Klein Collins HS. The importance of the pre- participation physical exam The importance of the pre- participation physical exam Every year thousands of athletes undergo a pre- participation physical evaluation. Physicals can identify an athlete who may be at risk for injury before he or she participates in a sport. The physical can reveal conditions that can warrant disqualification from participation in all or certain sports or it could warrant the use of special equipment such as a brace or eye glasses. The physical evaluation also sets a baseline in case of injury. This allows the athletic trainer to help the athlete get back to or as close to his or her original physical condition after an injury. Pre-participation physical exam The pre-participation physical evaluation is administered by a family physician or by a group of individuals who work together with physicians and are trained in assessing the health of an athlete such as a Certified Athletic Trainer. Most often, an athlete’s annual physical evaluation is completed by a medical doctor in a private-practice setting. If the physician is the athlete’s primary-care physician then the doctor is more familiar with the medical history and the past health conditions of the athlete. Another system of administering pre- participation evaluations is a station evaluation Seen in HS Settings Pre-participation physical exam The station evaluation can handle a large number of athletes at the same time and it is organized by stations using a group of individuals in the medical profession. Volunteers who help administer the evaluations at each station include medical doctors, dentists, certified athletic trainers, physical therapists, physician assistants, nurses, and other allied-health personnel. Parents and coaches also assist in making these screenings possible. The evaluations include a medical history, height, weight, blood pressure, pulse rate, dental screening (college), vision screening, general medical screening, musculoskeletal exam, orthopedic screening, body composition, and a number of fitness assessments. After all the screenings are complete, then a physician will determine whether the athlete can participate in athletics or if there are any limitations for the athlete. Pre-participation physical exam The following sections are included in the station pre-participation physical evaluation: Medical History (MOST IMPORTANT!) Cardiovascular: Family history of sudden death under the age of 50, Prior heart disease in family, heart murmur, exertional shortness of breath or chest pain, fainting during or following exertion, high blood pressure, excessive fatigue, palpitations (skipped, irregular, or racing heart beats) Orthopedic: Recent or significant musculoskeletal injuries, neck injuries, unexplained hip or knee pain, dislocations, broken bones Neurologic: Seizure history, concussion history Pulmonary: Asthma history Gastrointestinal: Spleen or liver enlargement Menstrual History: Absence or irregular periods, stress fractures, disordered eating Medical Illnesses: Infectious mononucleosis, hepatitis, sickle cell trait, HIV, diabetes, heat illness, allergic reactions, other chronic illnesses, drug or other allergies Use of glasses, contact lenses, hearing aids Medication Use: Including nutritional supplements Pre-participation physical exam All parts of the pre-participation physical evaluation come together to assess the athlete’s overall health level. Clearance is made at the end of the screening by a state licensed physician who has reviewed the athlete’s history and has performed the general examination. Often, for those who are not cleared, there are certain criteria that have to be met before they can be cleared. In rare cases, it is found that playing sports could endanger or threaten the health of the athlete. If this happens, the athlete is denied participation or another sport is recommended. No matter the outcome, the pre-participation evaluation is one of the best tools to help prevent athletic injuries. Assignment 4: Use the internet, UIL website or any other resource to determine 3 reasons why an athlete may NOT be cleared for participation Identify the necessary records that must be maintained by the Athletic Trainer Identify the necessary records that must be maintained by the Athletic Trainer -Record Keeping Paperwork, Paperwork, Paperwork! Major responsibility Rule not the exception Must be accurate and up-to-date Medical records, injury reports, insurance information, injury evaluations, progress notes, equipment inventories, annual reports Injury Reports and Injury Disposition Injury reports serve as future references Reports can shed light on events that may be hazy following an incident Necessary in case of litigation All reports should be filed in the athletic training room Injury Evaluation and Progress Notes Injuries and progress should be monitored by the athletic trainer and recorded SOAP note format S: Subjective (history of injury/illness) O: Objective (information gathered during eval) A: Assessment (opinion of injury based on information gained during evaluation) P: Plan (short and long term goals of rehabilitation) HOPS evaluation format Treatment Log Sign-in to keep track of services Daily treatments can be recorded Can be used as legal documentation in instances of litigation Personal Information Card- Emergency Card Contains contact information for family, physician, insurance information and Past Medical History (PMHx) Supplies and Equipment Inventory Managing budget and equipment/supplies is critically important Document every penny! Inventory must be taken yearly in order to effectively replenish supplies End of sport season Annual Report Summary of athletic training room functioning Can be used to evaluate recommend potential changes for program Includes number and types of injuries seen/treated Release of Medical Records Written consent is required Waiver must be signed for any release (include specifics of information to be released and to whom) Buckley Amendment HIPPA Computer as Tool for Athletic Trainer Indispensable tool Can make the job more efficient with appropriate software Must maintain security Can also be used for other administrative tasks SportsWare/ RankOne Collecting Injury Data Accident - unplanned event resulting in loss of time, property damage, injury or death Injury- damage to the body restricting activity Case study- looks at specific incident of injury Injury study falls under numerous categories Age, gender, body part, occurrence in different sports Contact vs. non-contact sports Catastrophic Injuries 98% of injuries requiring hospital emergencies are treat and release relative to sport Sports deaths (struck with object, heat stroke) Catastrophic injuries also include spinal cord trauma, cardiorespiratory injuries/problems Most injuries are related to appendages sprains, contusions, fractures, Strains, abrasions Current National Injury Data- Gathering Systems State of the art injury surveillance is still developing Ideal situation Epidemiological approach that studies relationship of various factors that influence frequency and distribution of injury in sport Extrinsic factors (activity, exposure, equipment) Intrinsic factors (age, gender, neuromuscular aspects, structural aspects….etc) Number of different surveillance systems in place Surveillance Systems National Safety Council (general sports injury data) Annual Survey of Football Injury Research (public school, college, professional, sandlot football injury data) National Center of Catastrophic Sport Injury Research (Tracks catastrophic injuries in all levels of sports) NCAA Injury Surveillance System (data collected on most major sports- ATC data collection) Surveillance Systems cont’d National Electronic Injury Surveillance System (Monitor injuries relative to different products --consumer safety, determine if products are hazardous or defective) National High School Sports Injury Registry (tracks injuries in specific sports at 150-200 high schools) QUESTIONS / COMMENTS?
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