Rachel Blackwood – Fall Risk and Functional Impairments
BACKGROUND INFORMATION
Functional impairments relate to 30 day readmission risk
Barriers preventing standardized testing in acute care
Time constraints
Infection control issues
Multiple lines/ICU patients
Unsure which test is most appropriate
Benefit of adding standardized tests into electronic chart
PSYCHOMETRICS- A REVIEW OF TERMS
Floor and ceiling effects
Responsiveness
Interpreting results
Translating results into meaningful assessment
FUNCTIONAL IMPAIRMENT TESTS
6 clicks- Activity Measure for Post-Acute Care Inpatient Short Form
Acute Care Index of Function
GAIT: WHEN DOCUMENTING DISTANCE AND LEVEL OF ASSIST ISN’T ENOUGH
Importance of standardized gait tests
Gait velocity- a new vital sign?
Standardized gait tests
2, 3, and 6 minute walk tests
10 meter/50 foot walk test
Dynamic Gait Index
Four Step Square Test
Gait tests and productivity standards
Case study and lab ICON—BOTH SIDE BY SIDE
BALANCE TESTS
Quantifying fall risk
Standardized balance tests, including those taking LESS than 2 minutes to perform
BESTest/mini-BESTest
360 Turn Test
Function in Sitting Test
Fullerton Advance Balance Scale
Which test is best
Setting
Patient frailty
Time constraints
Using tests to justify discharge plan
Case study and lab ICON—BOTH SIDE BY SIDE
BENEFITS OF ICU STANDARDIZED TESTING
ICU Specific tests
ICU mobility scale
ICU PFIT
PERME ICU mobility
Complications
Frailty
Managing lines/tubes
Case study and lab ICON—BOTH SIDE BY SIDE
ADLS AND STANDARDIZED TESTS
Insight into ability to perform functional tasks
Incorporating tests into discharge planning
Case study and lab ICON—BOTH SIDE BY SIDE
CVA SPECIFIC TESTS
Justifying further therapy
Review of specific tests
Action Research Arm Test
Box and Blocks Test
Orpington Prognostic Scale
Postural Assessment Scale for Stroke Patients
Stroke Rehabilitation Assessment of Movement
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Description:
Therapists and other healthcare practitioners have an increasingly complex role in discharge planning from acute care as hospital stays become shorter and 30 day readmission rates are more closely scrutinized. It is imperative that acute care therapists not only identify but also be able to quantify functional impairments and fall risk. Standardized testing in hospitals is complicated by the frailty of the patient population, management of multiple lines and medical issues, as well as time constraints.
This course is designed to help healthcare practitioners by familiarizing them with the variety of tests to choose from, and to assist them in making sense of test outcomes. You will learn and practice tests that can be used on patients with high levels of mobility, as well as those tests that are appropriate for the ICU. During this lab-intensive course, you will be introduced to an array of objective measures that can be used to enhance assessments and documentation, to guide treatment, and to aid in discharge planning.
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