Introduction Flashcards
List all the D/C destinations
- ICU
- acute care
- inpatient rehab
- subacute/TCU
- SNF
- home health
- outpatient
- hospice
Describe PT in the ICU
PT may have a role but it depends on how hemodynamically stable the patient is
Describe PT in Acute Care
pt is still critical but is more stable
Describe PT in Inpatient Rehab
intense hospital-based therapy due to daily 3 hour duration
Describe PT in Subacute/TCU
less intense
hospital-based therapy
2hrs/day duration
Describe PT in a SNF
less intense
skilled nursing-based therapy
2hrs or less/day duration
Describe PT in Home health
home based therapy
usually 3x/week
patient must be home bound
Describe PT in Outpatient
best for mobile patients
Describe PT in Hospice
appropriate for pts with diagnoses or 6 months or less to live
prescribed by MD
State all the different infection control precautions
- Standard precautions
- Transmission based
- contact
- enteric
- droplet
- airborne
- neutropenic
What are standard precautions used for?
- to control nosocomial infections
- reduce the risk of blood borne pathogens and pathogens from most body substances
What do standard precautions apply to?
- blood
- body fluids
- secretions
- excretions (except sweat)
- non-intact skin
- mucous membranes
What is the most effective way to prevent the spread of disease?
Hand washing
What are transmission based precautions used for?
- patients documented or suspected to be infected or colonized with highly transmissible or epidemiologically important pathogens
- used in conjunction with standard precautions
What is included in transmission based precautions?
- Contact precautions
- Droplet precautions
- Airborne precautions
- Neutropenic precautions
What are contact precautions used for?
known or suspected infectious microorganisms that are transmitted by indirect or direct contact
Ex:
- MRSA
- VRE
- norovirus
- C-Diff
- Chicken pox
What do contact precautions include?
- Standard precautions
- private room
- gloves/gown prior to entering room; removed/placed in designated container before leaving room
- designated non-critical client care items (stethoscope, gait belt, cuff weights, goni, AD)
- disinfect all equipment/surfaces with approved disinfectant prior to use with other people
What are enteric precautions?
A subtype of contact precaution used for C-diff, norovirus, and rotavirus
What do enteric precautions include?
- handwashing with soap and water
- all equipment cleaned with chlorine based disinfectant
- contact precautions
What are droplet precautions?
involves pathogens >5microns that travel in droplets
- droplets travel < 3ft and infect host’s conjunctivae or mucous membranes
Ex:
- pneumonia
- influenza
- whooping cough
What do droplet precautions include?
- Standard precautions
- private room
- face mask (visitors, patient if they leave room)
- goggles/face shield in case of spray
What are airborne precautions?
- pathogens < 5 microns that can remain suspended in the air for several hours and are dispersed by air currents
- infects host via inhalation or direct transmission
Ex:
- chicken pox
- TB
- measles
What do airborne precautions include?
- Standard precautions
- Don/doff respirator outside of room
- isolation room with negative pressure
What are neutropenic precautions?
- used to protect an immunocompromised patient due to chemotherapy, radiation, or immunosuppression drugs
What do neutropenic precautions include?
- Careful attention to handwashing
- disinfect equipment before interaction with the patient
- HCP don mask when in pt’s room and pt wears mask if leaving their room
- diet restrictions:
- avoid uncooked fruit/veggies
- avoid tap water
- avoid ice from ice machine
- no fresh flowers
- restricted number of visitors and visitors who feel ill
What does the AM-PAC 6 Clicks measure?
FUNCTIONAL MOBILITY
- predicts D/C setting after acute care
- helps eliminate lag period before D/C
What are the cut-off scores the AM-PAC 6 Clicks?
< 17 is predictive of institutional discharge
What does the DEMMI measure?
FUNCTIONAL MOBILITY, BALANCE (sitting/standing)
- measures and monitors mobility in patients making transition from hospital to community
What do higher DEMMI scores indicate?
better mobility
What does the PFIT-s measure?
STRENGTH, MOBILITY
- measures mobility and strength in ICU patients
What is PFIT-s scoring like?
0-12
higher scores = increased level of independence
Who is PFIT-s used for?
low level, non-ambulatory pts
What does the FSS-ICU measure?
FUNCTIONAL MOBILITY
- contains ICU/acute care setting appropriate items from the FIM
- predictive of D/C location when measured at time of ICU D/C
What are the median scores for the FSS-ICU?
28 or lower = home
20 or lower = IP rehab
9 or lower = SNF
What does the CPAx measure?
FUNCTIONAL MOBILITY, STRENGTH, RESPIRATORY FUNCTION, BALANCE
- measures physical function in the ICU
What are higher scores on the CPAx associated with?
shorter hospital LOS
What does the Perme ICU Mobility Score measure?
COGNITION, MOBILITY, STRENGTH, ENDURANCE
- assesses mobility status of patients in the ICU
- identifies pts with potential mobility barriers and need for assistance
What is great about the Perme ICU Mobility Score measure?
it can be incorporated into tx
What does the ACIF measure?
FUNCTIONAL MOBILITY, COGNITION
- used to predict D/C setting
- developed to measure functional status at levels of function required in acute care
- should be done within 24hrs of acute care admission
What are the cut-off scores for ACIF?
< 0.4 predicts d/c to a setting other than home
