FIM Flashcards
what does IRF PAI stand for
inpatient rehabilitation facility patient assessment instrument
FIM is what
a system to meet documentation and outcomes and determine length of stay and payment!
What is the purpose of the functional modifiers section
Assist in scoring relating FIM instrument items
Provide explicit info for how a particular FIM item was determined
Should be completed prior to FIM instrument
What are the main components to consider when determining burden of care for an activity
Assistance of another person and resources required
Resources include time and devices
FIM includes how many motor and how many cognitive items
13 motor
5 cognitive
FIM - use of level 0
YES on admission
NO on discharge! If they do not do something, they get a 1
FIM - what will you NEVER rate a 0
Bladder/Bowel management
Cognition
Self care includes what
Eating Grooming Bathing Dressing Toileting
Self care - Grooming includes what
Oral care (brushing only) Hair grooming (not shampooing) Washing, rinsing, drying hands Washing, rinsing, drying face Shaving or applying make up
Self care - Bathing includes what
Washing, rinsing, and drying body from neck down (not including neck and back) L UE, R UE Chest, abdomen Front perineal, back perineal L upper leg, L lower leg and foot R upper leg, R lower leg and foot
Self care - bathing - changing the temperature counts as
set up - so 5
Self care - bathing - what if using a bench?
is not a device for bathing (will be counted in transfer)
Self care - Dressing includes what
Upper body (above waist)
Lower body (below waist)
Obtaining the clothes
PUBLIC CLOTHING! not pjs
Self care - dressing - prosthesis
includes applying and removing prosthesis on their own
Self care - toileting - includes what
maintaining perineal hygiene and adjusting clothes before and after - so 3 steps
Adjusting clothes prior
Perineal hygiene
Adjusting clothes after
Sphincter control includes what
bowel and bladder management
Bowel and bladder management includes what
complete and intentional control of urinary sphincter and bowel movements, including use of equipment or agents for control
Bowel and bladder management - functional modifiers
2 of them (use the lower of the 2 for IRF-PAI)
Level of assist (3 days)
Frequency of accidents (7 days)
Bowel and bladder management - devices incldue
bedpan, ostomy, catheter, absorbent pad, depends
automatically a 6 with these
Transfers includes what
Bed, chair, wc
Toilet
Tub, shower
Transfers - assistance with limb
4 for one limb
3 for two
Transfers - lifting assistance for transfer
3 = lifting trunk 2 = lifting and lowering trunk 1 = mechanical assist or 2 people
Transfers - bed, chair, wc includes what
all aspects of the transfer, safety concern, and amoutn fo assist
Transfers - bed, chair, wc - devices include
sliding board, grab bars, arm rests, trapeze, mechanical lifts, braces
Transfers - toilet - includes
approach to toilet once in bathroom and getting on and off toilet
Transfers - toilet - devices include
commode, elevated toilet seat, grab bars, sliding board, prostheses and orthoses if used for transfer
Transfers - tub, shower - functional modifer
tub or shower
rate just one, leave other blank
Transfers - tub, shower - has to be a __ transfer
wet!
Transfers - tub, shower - devices include
tub seats/bench, shower chair, grab bars, mechanical lifts…
Transfers - tub, shower - includes what
approach to the shower or tub once in the bathroom
Locomotion includes what
Walk, wheelchair
Stairs
Locomotion - walk or wheelchair - function modifier
Record the admission and discharge rating based on most frequent mode used by the patient - what they will most frequently be using at discharge
Locomotion considers what factors
Distance
Assistance
Locomotion - walking starts
once in standing position
Locomotion - wheelchair starts
once in chair
Locomotion - walk or wheelchair - functional modifiers on the IRF PAI -
Distance walked
Distance traveled in wheelchair
Walk assist
Wheelchair assist
Locomotion - walk or wheelchair - what are defining distances
150 feet can score 3-7
under 150 feet can score 1, 2, 5
Locomotion - walk or wheelchair - 5 household
less than 150 feet but can do it independently
Locomotion - stairs - scored by
number of steps and assistance
Locomotion - stairs - no assistance, 12 to 14 steps
6 or 7
Locomotion - stairs - assistance, 12 to 14 steps
3, 4, 5
Locomotion - stairs - under 12 steps
1, 2, or 5 household
Locomotion - stairs - 5 household
4 to 6 steps independently (can use device)
Cognitive items - Communication includes
Comprehension
Expression
Cognitive items - social cognition includes
Social interaction
Problem solving
Memory
Cognitive items - communication - comprehension is
ability to understand complex and basic information (auditory or visual)
Cognitive items - communication - expression is
communicate about complex and basic information - vocal and non vocal
Cognitive items - communication - based on what time period
24 hours
Cognitive items - communication - rating scale change
level 5 = 90%
Cognitive items - social cognition - social interaction includes
getting along with and participating with others, appropriate interactions in therapeutic and social situations
Cognitive items - social cognition - problem solving is
skill related to solving problems of daily living, reasonable, safe and timely decisions
Cognitive items - social cognition - problem solving steps
Recognize problem exists Make appropriate decision Initiate steps and adjust to changing circumstances Carry out a sequence of steps Evaluate the solution
Cognitive items - social cognition - memory includes
skills related to recognizing and remembering while performing daily activities
ability to store and retrieve information
Cognitive items - social cognition - memory - functional evidence for memory
Recognizing people frequently encountered
Remembering daily routines
Executing requests without repetition
Benefits of FIM
Interdisciplinary Standardized terminology Monitors functional gains Outcomes data, detect trends Help set goals Basic indicator of severity of disability Generates data for accreditation
