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

Outline

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
  • Rehab
  • SNF
  • Home health
• 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