Rachel Blackwood – Fall Risk and Functional Impairments: Using Standardized Tests to Guide Treatment

Outline

BACKGROUND INFORMATIONBACKGROUND INFORMATION

• 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 appropriate Unsure 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 Test Four 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 Scale Fullerton 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

• 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