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

Description

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Rachel Blackwood – PESI – 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.

Speaker
Rachel Blackwood, PT, DPT, is a licensed physical therapist with nearly 15 years of experience. She graduated from the University of Alabama at Birmingham with her M.S. in Physical Therapy, then went on to earn her Doctorate of Physical Therapy from the University of South Alabama. Although she has experience in a variety of settings, the majority of her career has been in acute care. She has been involved in program development, staff training, and clinical education. Ms. Blackwood has also served as adjunct faculty at the Jefferson State LPTA program. Her interests include acute and medically complex patients and she has been a team leader in critical care units. She is currently employed by Duke University Health Systems in Raleigh, NC as a weekend therapist. As a weekend PT, she encounters many patients who are “discharge issues”, where her use of standardized tests is a critical consideration for recommending the appropriate discharge placement.

Speaker Disclosures:
Financial: Rachel Ross Blackwood has an employment relationship with Duke Health Services. She receives a speaking honorarium from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Rachel Ross Blackwood has no relevant non-financial relationships.

Objectives

• 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

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 testsI
  CU 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

Target Audience

• Physical Therapists
• Physical Therapists Assistants
• Occupational Therapists
• Occupational Therapy Assistants
• Rehab Nurses
• Rehab Directors

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