Rachel Blackwood – Fall Risk and Functional Impairments

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Rachel Blackwood – Fall Risk and Functional Impairments

• Functional impairments relate to 30 day readmission riskFunctional impairments relate to 30 day readmission risk
• Barriers preventing standardized testing in acute care Barriers preventing standardized testing in acute care
  • Time constraintsTime constraints
  • Infection control issuesInfection control issues
  • Multiple lines/ICU patientsMultiple lines/ICU patients
  • Unsure which test is most appropriateUnsure which test is most appropriate
• Benefit of adding standardized tests into electronic chartBenefit of adding standardized tests into electronic chart

PSYCHOMETRICS- A REVIEW OF TERMSPSYCHOMETRICS- A REVIEW OF TERMS

• Floor and ceiling effectsFloor and ceiling effects
• ResponsivenessResponsiveness
• Interpreting resultsInterpreting results
• Translating results into meaningful assessmentTranslating results into meaningful assessment

FUNCTIONAL IMPAIRMENT TESTSFUNCTIONAL IMPAIRMENT TESTS

• 6 clicks- Activity Measure for Post-Acute Care Inpatient Short Form6 clicks- Activity Measure for Post-Acute Care Inpatient Short Form
• Acute Care Index of FunctionAcute Care Index of Function

GAIT: WHEN DOCUMENTING DISTANCE AND LEVEL OF ASSIST ISN’T ENOUGHGAIT: WHEN DOCUMENTING DISTANCE AND LEVEL OF ASSIST ISN’T ENOUGH

• Importance of standardized gait testsImportance of standardized gait tests
• Gait velocity- a new vital sign?Gait velocity- a new vital sign?
• Standardized gait tests Standardized gait tests
  • 2, 3, and 6 minute walk tests2, 3, and 6 minute walk tests
  • 10 meter/50 foot walk test10 meter/50 foot walk test
  • Dynamic Gait IndexDynamic Gait Index
  • Four Step Square TestFour Step Square Test
• Gait tests and productivity standardsGait tests and productivity standards
• Case study and lab ICON—BOTH SIDE BY SIDECase study and lab ICON—BOTH SIDE BY SIDE

BALANCE TESTSBALANCE TESTS

• Quantifying fall riskQuantifying fall risk
• Standardized balance tests, including those taking LESS than 2 minutes to perform Standardized balance tests, including those taking LESS than 2 minutes to perform
  • BESTest/mini-BESTestBESTest/mini-BESTest
  • 360 Turn Test360 Turn Test
  • Function in Sitting TestFunction in Sitting Test
  • Fullerton Advance Balance ScaleFullerton Advance Balance Scale
• Which test is best Which test is best
  • SettingSetting
  • Patient frailtyPatient frailty
  • Time constraintsTime constraints
• Using tests to justify discharge plan Using tests to justify discharge plan
  • RehabRehab
  • SNFSNF
  • Home healthHome health
• Case study and lab ICON—BOTH SIDE BY SIDECase study and lab ICON—BOTH SIDE BY SIDE

BENEFITS OF ICU STANDARDIZED TESTINGBENEFITS OF ICU STANDARDIZED TESTING

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• ICU Specific tests ICU Specific tests
  • ICU mobility scaleICU mobility scale
  • ICU PFITICU PFIT
  • PERME ICU mobilityPERME ICU mobility
• Complications Complications
  • FrailtyFrailty
  • Managing lines/tubesManaging lines/tubes
• Case study and lab ICON—BOTH SIDE BY SIDECase study and lab ICON—BOTH SIDE BY SIDE

ADLS AND STANDARDIZED TESTSADLS AND STANDARDIZED TESTS

• Insight into ability to perform functional tasksInsight into ability to perform functional tasks
• Incorporating tests into discharge planningIncorporating tests into discharge planning
• Case study and lab ICON—BOTH SIDE BY SIDECase study and lab ICON—BOTH SIDE BY SIDE

CVA SPECIFIC TESTSCVA SPECIFIC TESTS

• Justifying further therapyJustifying further therapy
• Review of specific tests Review of specific tests
  • Action Research Arm TestAction Research Arm Test
  • Box and Blocks TestBox and Blocks Test
  • Orpington Prognostic ScaleOrpington Prognostic Scale
  • Postural Assessment Scale for Stroke PatientsPostural Assessment Scale for Stroke Patients
  • Stroke Rehabilitation Assessment of MovementStroke Rehabilitation Assessment of Movement

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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.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.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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