Using Nursing Assessments of Mobility and Activity to Prioritize Patients Most Likely to Need Rehabilitation Services.
Arch Phys Med Rehabil
; 104(9): 1402-1408, 2023 09.
Article
em En
| MEDLINE
| ID: mdl-37028697
ABSTRACT
OBJECTIVE:
To identify nursing assessments of mobility and activity associated with lower-value rehabilitation services.DESIGN:
Retrospective cohort analysis of admissions from December 2016 to September 2019SETTING:
Medicine, neurology, and surgery units (n=47) at a tertiary hospital.PARTICIPANTS:
We included patients with a length of stay ≥7 days on units that routinely assessed patient function (n=18,065 patients).INTERVENTIONS:
Not applicable. MAINOUTCOME:
We examined the utility of nursing assessments of function to identify patients who received lower-value rehabilitation consults, defined as those who received ≤1 therapy visit.MEASURES:
Patient function was assessed using 2 Activity Measure for Post-Acute Care (AM-PAC or "6 clicks") inpatient short forms (1) basic mobility (eg, bed mobility, walking) and (2) daily activity (eg, grooming, toileting).RESULTS:
Using an AM-PAC cutoff value of ≥23 correctly identified 92.5% and 98.7% of lower-value physical therapy and occupational therapy visits, respectively. In our cohort, using a cutoff value of ≥23 on the AM-PAC would have eliminated 3482 (36%) of lower-value physical therapy consults and 4076 (34%) of lower-value occupational therapy consults.CONCLUSIONS:
Nursing assessment, using AM-PAC scores, can be used to help identify lower-value rehabilitation consults, which can then be reallocated to patients with greater rehabilitation needs. Based on our results, an AM-PAC cutoff value of ≥23 can be used as a guide to help prioritize patients with greater rehabilitation needs.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Atividades Cotidianas
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Terapia Ocupacional
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article