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Rachel Blackwood – Fall Risk And Functional Impairments: Using Standardized Tests To Guide Treatment

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Rachel Blackwood – Fall Risk And Functional Impairments: Using Standardized Tests To Guide Treatment
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.

Examine barriers with using standardized tests and how to avoid them
Demonstrate evidence based tests that are applicable in the acute care setting
Compose appropriate documentation with quantifiable, objective measures
Determine how standardized tests can be used in the ICU and with other medically complex patients
Discover how using standardized testing can guide discharge planning and reduce the risk of 30 day readmissions

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