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Practice Analysis of ABC Certified Mastectomy Fitters

January 2019


Appendix B

New Test Specifications

2019 Mastectomy Fitter Domain Test Specifications

Task Statements
 1. Patient Assessment 29%
1Review patient's prescription/referral
2Obtain relevant patient medical history, including previous use of post-mastectomy items, diagnosis and activities of daily living (ADL)
3Discuss patient's expectations and goals
4Perform a diagnosis-specific functional clinical examination that includes observation of chest wall and evaluation of range of motion, manual dexterity, skin integrity and shape/physical characteristics
5Consult with other healthcare professionals and caregivers about patient's condition, as needed
6Refer patient, if appropriate, to other healthcare professionals (e.g., therapist, physician) for intervention beyond mastectomy fitter's scope of practice
 2. Formulation of Treatment Plan 15%
1Use the assessment results to formulate treatment plan, including goals and expected outcomes to increase patient comfort, enhance function, accommodate deformity (e.g., shoulder drop, scoliosis) and improve balance, symmetry and appearance
2Consult with licensed healthcare prescriber to obtain supporting documentation and/or modify the original prescription, if necessary
3Document the patient's need described in the treatment plan
4Identify post-mastectomy items to support the treatment plan
5Communicate to patient and/or caregiver about the recommended treatment plan and timeline for completion
6Inform patient or responsible parties of their financial responsibilities as they pertain to the recommended treatment plan and/or any coverage limitations
 3. Implementation of Treatment Plan 32%
1Measure patient and select appropriate post-mastectomy items to implement treatment plan
2Assess fit and comfort of post-mastectomy items and make any necessary adjustments
3Ensure that post-mastectomy items are provided as prescribed
4Educate patient and/or caregiver about the use and care of post-mastectomy items (e.g., wearing schedules, cleaning), including benefits, possible risks and warranty information
5Advise the patient and/or caregiver about their rights and responsbilities
6Document treatment using established record-keeping techniques to verify implementation of treatment plan
7Develop and communicate follow-up plan
 4. Follow-up 8%
1Obtain feedback from patient and/or caregiver about the outcome of the treatment plan (e.g., tolerance, comfort, ability to don and doff, proper usage and function)
2Re-evaluate the patient through a follow-up clinical examination that may include review of changes to patient status, shape and physical characteristics
3Identify need for changes relative to initial treatment goals and expectations by assessing fit of post-mastectomy items
4Modify or adjust post-mastectomy items based on assessment and/or patient/caregiver feedback
5Educate patient and/or caregiver on proper use of post-mastectomy items relative to modifications/adjustments
6Document follow-up care, including any changes in treatment plan
 5. Practice Management 16%
1Comply with federal and state regulations for the delivery of items within the Certified Mastectomy Fitter Scope of Practice (e.g., CMS, Medicaid, OSHA, HIPAA)
2Comply with policies and procedures regarding universal precautions and infection control
3Comply with documentation requirements (e.g., document retention, verification that post-mastectomy items were delivered and billed as prescribed)


Knowledge and Skills
 Knowledge of:
1Musculoskeletal anatomy, including upper limb and spinal
2Anatomical landmarks
3Tissue characteristics/management
4Post-surgical edema
5Range of motion
6Medical terminology
7Breast treatment options
8Lymphatic system
9Prescription/referral documents
10Documentation and document retention requirements
11Policies and procedures regarding Protected Health Information (PHI)
12Roles and responsibilities associated with other healthcare professions
13Reimbursement coverage criteria (e.g., CMS/third party payers)
14Material safety procedures and standards (e.g., OSHA, SDS)
15Universal precautions and infection control
16Ethical standards regarding proper patient management
17Scope of practice related to mastectomy fitter credential
18When to refer the patient to other healthcare providers/caregivers
19Post-mastectomy items
20Post-mastectomy item fitting criteria
21Examination techniques
22Measurement tools and techniques
23Care and maintenance of post-mastectomy items
24Item warranties
25Inventory control and management
26Federal and state rules, regulations, and guidelines (e.g., CMS, ADA, state licensure)
 Skill in:
27Performing clinical examinations and interviewing patients
28Interpretation of physical findings
29Developing or modifying a treatment plan
30Adapting treatment plan relative to the patient's functional needs (e.g., patients with stroke cognitive impairment)
31Measuring and fitting post-mastectomy items
32Evaluating fit and function of post-mastectomy items
 Mastectomy Item List
1Breast prosthesis, mastectomy bra
2Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral
3Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral
4External breast prosthesis garment, with mastectomy form, post-surgical
5Breast prosthesis, non-silicone
6Breast prosthesis, silicone
7Nipple prosthesis
8Custom-fabricated breast prosthesis
9Breast prosthesis, silicone, with integral adhesive
10Adhesive skin support attachment for use with external breast prosthesis
11Compression garments