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NM PT > (1) Outcome Measures > Flashcards

(1) Outcome Measures Flashcards

1
Q

Types of measures

A

focus of outcome measure (disease specific or generic outcome measures–published normative values)
Mode of administration– Performance based and Self Report

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2
Q

How do objective measures enhance clinical practice?

A

identifying and quantifying limitations
forming evaluation, dx, and prognosis
informs plan of care
helps evaluate success of PT interventions

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3
Q

What are the aspects of objective measure decision making framework?

A

what to measure, purpose of measure, type of measure, pt and clinic factors, psychometric factors, feasibility

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4
Q

Purposes of outcome measures

A

quantify performance or health status
intended to track change in performance
can direct plan of care
determine progress/improvement
help with dx
predict future status

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5
Q

Purposes of outcome measures

A

discriminative (characteristics or predefined categories)
predictive (future status, identify risk, prognosis, discharge)
evaluative (effectiveness of intervention by evaluating change over time)

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6
Q

these factors closely match the pt goals and tx plan—-Motivation, dependent on stage of recovery, pt capability

A

patient factors

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7
Q

List examples of psychometric factors

A

reliability, validity, MDC, MCID

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8
Q

List examples of feasibility factor

A

time, space, equipment, training, cost, cultural and language limiters, proprietary issues

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9
Q

What is PPS?

A

Prospective payment system:
method used by centers of medicare/medicaid to determine projected pt length of stay and hospital reimbursement for pts

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10
Q

__________ is the medicare reporting instrument used by inpatient rehab facilities

A

IRF PAI: inpatient rehab facility – patient assessment instrument

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11
Q

IRF PAI reports standardized quality measures and pt assessment data in what 4 post acute settings?

A

inpatient rehab, skilled nursing, long-term acute care, home health

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12
Q

IRF PAI replaces FIM as means for determining level of function for what 2 things?

A

length of stay and reimbursement

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13
Q

IRF PAI must be scored within ______ days of admission and at discharge

A

3

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14
Q

Inpatient rehab facilities are reimbursed by taking these things into consideration (4)

A
  1. admitting dx
  2. tiered co-morbidities (unrelated to dx)
  3. admission functional and bowel/bladder scores
  4. some cases, pt age
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15
Q

What does section BB of IRF PAI assess?

A

hearing, speech, vision, ability to express ideas and wants as well as to understand verbal content

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16
Q

What does section C of IRF PAI assess?

A

cognitive patterns

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17
Q

What does section H of IRF PAI assess?

A

bowel and bladder continence

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18
Q

What does section GG of IRF PAI assess?

A

Functional abilities and goals
admission - pt’s baseline functional status conducted prior to the benefit of services

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19
Q

PLOF “every day activities”:

A

self-care, indoor mobility (ambulation), stairs, functional cognition

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20
Q

Prior level of assistance Scoring
3-
2-
1-
8-
9-

A

3- independent
2- needed some help
*1- dependent (helper does all the effort or assistance of 2 or more helpers is required for pt to complete activity even if it is stand by assist only and does not end up needed hands on assistance!)
8- unknown
9-N/A (pt did not perform immediately prior to current illness, exacerbation, or injury)

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21
Q

The list of devices and aids include: (6 items)

A

manual WC, motorized WC/scooter, mechanical lift, walker, orthotics/prosthetics, none of the above (no device or other device)

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22
Q

What items are on Mobility for ONLY PTs not OTs

A

car transfers, walking, steps, picking up object, wheelchair mobility

(OT and PT: roll L to R, sit to lying, lying to sitting on side of bed, sit to stand, chair/bed-to-chair transfer, toilet transfer)

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23
Q

Quality indicator grading
06
05
04
03
02
01

if activity not attempted
07
09
10
88

A
  1. independent
  2. set up/clean up
  3. supervision or touching assistance (cueing/CGA)
  4. Partial/Mod assist (helper does less than half the effort)
  5. substantial/maximal assist (helper does more than half the effort)
  6. dependent

if activity not attempted
07. pt refused
09. N/A (not attempted and pt did not perform before current illness…)
10. not attempted due to environmental issue (equipment, weather)
88. not attempted due to medical condition or safety concerns

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24
Q

Quality indicator grading:
not attempted due to medical condition or safety concerns

A

88

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25
Q

Quality indicator grade:
not attempted due to environmental issue (equipment, weather)

A

10

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26
Q

Quality indicator grade:
N/A (not attempted and pt did not perform before current illness…)

A

9

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27
Q

Quality indicator grade:
pt refused

A

07

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28
Q

Quality indicator grade:
dependent

A

01

29
Q

Quality Indicator grade:
substantial/max assist

A

02

30
Q

Quality Indicator Grade:
Partial/mod assist

A

03

31
Q

Quality Indicator Grade:
supervision or touching assist

A

04

32
Q

Quality Indicator Grade:
set up or clean up

A

05

33
Q

Quality Indicator Grade:
independent

A

06

34
Q

Only select “activity not attempted” if…

A

activity not completed or cant be determined by pt/caregiver, collaboration with other faculty staff, assessment of similar activities

35
Q

How would you score this bed mobility:
pt was able to perform task, but required PT to put rails up and down

A

set up: 05

36
Q

List some examples for a score of 88

A

pain, doctor orders restrict mobility, inability to lower head of bed due to medical condition

37
Q

How would you score this for toilet transfer?

stand lift was used to help pt stand

A

1

38
Q

How would you score this toilet transfer?
hoyer lift used due to medical/safety issues

A

88

39
Q

How would you score this toilet trasnfer?
pt was unable to complete this task before current illness/injury

A

09

40
Q

T/F: Pt must complete walking task to receive a score

A

T

41
Q

T/F: pt may take a brief sitting rest break
(walking)

A

FALSE: they can take a standing break

42
Q

T/F getting to a standing position is not considered when scoring walking

A

True

43
Q

T/F: a pt can get a different score for each walking activity

A

true

44
Q

How would you score this pt for walking?
pt begins activity, but cannot complete and a helper does not complete activity for pt

A

88

45
Q

how would you score this for walking?
2 helpers with one helper providing trunk support or WC follow

A

1

46
Q

T/F: You can score walking with exoskeleton

A

false

47
Q

T/F: steps have a specific height in stairs scoring

A

false

48
Q

T/F: Stair scoring – if a pt cannot perform one of the activities, you move on to the next one

A

false, you cannot score subsequent activities if you cant do it

49
Q

T/F: rest breaks between activities are allow for stair scoring

A

true

50
Q

T/F stair scoring for curb cannot include parallel bars

A

true

51
Q

T/F: stair scoring for curb can include railings

A

true

52
Q

Considerations for picking up object from floor

A

must be standing to perform activity

53
Q

t/f: a reacher may not be used for assistance in retrieving item if they need assistance to use the device

A

true
they can use it if they can do so independently

54
Q

wheelchair scoring consists of

A

wheeling at least 50 feet and make 2 turns – 90 degrees same or different directions

55
Q

What is the only condition that you would code “0” no
(wheelchair scoring)

A

pt does not have wc or scooter at time

56
Q

(core outcome measures)
establish the minimum measures needed to quantify function in the constructs of: (4)

A

balance, walking speed, walking endurance/distance, transfer ability

57
Q

What are the 6 core outcome measures?

A

Berg balance, functional gait assessment, ABC activities specific balance confidence scale, 10m wt, 6MWT, 5TSTS

58
Q

Can you use AD in balance tests for Berg?

A

NO

59
Q

Berg: item 8 use ______ to reach forward

A

both arms

60
Q

Berg: If you have unilateral involvement, which side do you test for items 13/14?

A

involved limb

61
Q

FGA: Under what conditions can you use 4 steps?

A

BILAT railings and step height 7 3/4 - 9 inches

62
Q

FGA: Are AD permitted?

A

yes, where scoring indicates a score for completion with device, it is a 0 for other items

63
Q

FGA: where should you stand in comparison to pt?

A

at least a half step behind pt (not directly in front or beside)

64
Q

ABC scale: how do you score a test that is incomplete?

A

sum the ratings and divide by the number of items completed

65
Q

ABC Scale: how many items must be completed to get a score?

A

12/16

66
Q

How do you score assistance for 10m walk test?

A

7 point ordinal scale

1= total assist
2= max assist
3= mod
4= min
5= supervision
6= mod independent – AD, extra time, mild safety issues
7- independent

67
Q

A score of 0 is indicated for 10m test if…

A

pt requires total assistance, unable to ambulate, requires assistance for limb swing or forward propulsion

68
Q

Where should the PT stand for 10m walk test

A

at least half a step behind pt (avoid “pacing” by walking in front or next to)

69
Q

10mWT cut off scores
Household ambulator
Limited community ambulator
community ambulator

A

< 0.4 m/s
0.4 - 0.8 m/s
> 0.8 m/s

NM PT (16 decks)

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