ADL General Collection Information: Difference between revisions

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== General Considerations ==
The '''Activities of Daily Living''' (ADL) assesses a patient's capability to perform a certain daily self-care activities.  
* ADL - assess functional status during the '''first 24 hours''' after the patient has been "accepted" to medicine service by a medicine service attending physician. 
* Where a non-independent ADL is induced solely by medical intervention, estimate the ADL without intervention.
* ADL assesses a patient ''"capability"'' to perform a certain activity if allowed. Patients who are ordered not to do a certain activity should '''not''' be assessed as requiring assistance. If patient ''would be able'' to perform the activity if allowed then they are to be assessed as '''"unassisted"'''.


{{Discussion}}
== Collection Instructions ==
== Discussion ==
For every Medicine profile, enter the status into the ADL dropdown boxes in the [[Patient Viewer Tab ADL]] in [[CCMDB.accdb]].
=== where to get the data===
Different places use any of the following as sources for ADLs; are any of these inappropriate?


* physio discharge notes
=== Timeframe ===
** are inappropriate etc. Yes, the instruction that data should be during the first 24hrs may already say that, but maybe not for patients discharged after less than a day
The ADL assessment (done by allied health or nurses) we utilize is the patient's state of activity '''on admission''' (not at home prior to admission). It takes into consideration acute medical issues that resulted in admission to the hospital.


* Grace gets what they can off ER sheet, then use ward records; This may not be "within first 24 hrs of admission" - is it good enough?
When possible, use an ADL assessment done within 24 hours after the [[Admit DtTm]].


* Vic: go through ER, then as close as possible on Ward, OT/PT does good job usually within 24hr  ('''most''' patients are assessed). Lots of nursing home placements are why this is done - does OT/PT use the same criteria as us? If not, this likely is not appropriate.
=== Directed Restrictions ===
** The OT/PT notes include functional status prior to admission and a current functional status at the time of the assessment. These notes are very detailed. We have also been seeing more and more detailed home care reports on the patient's charts regarding functional status and services that are in place prior to admission.[[User:TAngell|TAngell]] 09:53, 20 November 2008 (CST)
Directed restrictions on a patient's activities should not be assessed as requiring assistance. For example, if a pt is on bed rest restrictions, it does not mean that they are unable physically to get out of bed. If the patient would be able to perform the activity if allowed then they are to be assessed accordingly.


* StB: ER assessment for falls assessment / risk sheet / prevention program; sometimes filled by ward nurses, then you have physio and OT and home care, latter usually for elderly patients only. - as above, are those who fill out other ADLs using the same criteria as us?
=== Where to get data ===
Data to evaluate ADL can be obtained from the following sources:
* OT/PT initial assessment
* Nursing activity flow sheets (if used)
* Nursing database or primary care patient record
* Integrated progress notes
* Risk assessment for falls form (if used)


=== which of several values to use ===
=== Specific Activities collected ===
We have addressed that status during first 24 hrs is what should be collected. Should it really be '''worst''' status during the first 24 hrs?
See the following for specific coding instructions for the different activities.
** Worst in some locations
* [[ADL Bathing]]
** most likely accurate in other location
* [[ADL Dressing]]
** some use pre-admission ADL, some use only after WARD admission
* [[ADL Toiletting]]
** "how they are normally"
* [[ADL Transfering]]
** some changed from "usual" pre-2007 to "worst" after
* [[ADL Continence]]
* "sedated patient is coded as if they were unassisted" - not true if the patient requires assistance when not sedated. Our definition above is clearer than this, so we should get rid of this.
* [[ADL Feeding]]


* NPO due to pt aphasic = major (I suspect disphagic was intended here, or do we also have patients NPO because they can't talk? )
== Data Use ==
* [[ADL Score]]
* [[ALERT Scale Calculation]]


== Reference ==
== References/Background ==
*Studies of Illness in the Aged: The Index of ADL; a standardized measure of ...ological and Psychological functioning. by Katz S, et al.. Copyright 1963 by the American Medical Association. Reprinted with permission of AMA via the Copyright Clearance Center.  
The evaluation tool used for all Medicine patients is the Katz ADL.
* S Katz et al. Studies of illness in the aged: the index of ADL. American Medical Association, 1963.
* S Katz, SD Downs, HR Cash, RC Grotz. Index of daily living. ''The Gerontologist'' 1:20-301.


* S Katz, TD Downs, HR Cash, RC Grotz, (1970). Index of Activities of Daily Living, ''The Gerontologist'', 1:20-301.
== Related articles ==
{{Related Articles}}


 
[[Category:ADL| *]]
 
[[Category:Data Collection Guide]]
 
[[Category:ALERT Scale Elements]]
{{stub}}
[[Category: ADL|*]]
[[Category: Questions_ADL]]

Latest revision as of 15:51, 21 April 2022

The Activities of Daily Living (ADL) assesses a patient's capability to perform a certain daily self-care activities.

Collection Instructions

For every Medicine profile, enter the status into the ADL dropdown boxes in the Patient Viewer Tab ADL in CCMDB.accdb.

Timeframe

The ADL assessment (done by allied health or nurses) we utilize is the patient's state of activity on admission (not at home prior to admission). It takes into consideration acute medical issues that resulted in admission to the hospital.

When possible, use an ADL assessment done within 24 hours after the Admit DtTm.

Directed Restrictions

Directed restrictions on a patient's activities should not be assessed as requiring assistance. For example, if a pt is on bed rest restrictions, it does not mean that they are unable physically to get out of bed. If the patient would be able to perform the activity if allowed then they are to be assessed accordingly.

Where to get data

Data to evaluate ADL can be obtained from the following sources:

  • OT/PT initial assessment
  • Nursing activity flow sheets (if used)
  • Nursing database or primary care patient record
  • Integrated progress notes
  • Risk assessment for falls form (if used)

Specific Activities collected

See the following for specific coding instructions for the different activities.

Data Use

References/Background

The evaluation tool used for all Medicine patients is the Katz ADL.

  • S Katz et al. Studies of illness in the aged: the index of ADL. American Medical Association, 1963.
  • S Katz, SD Downs, HR Cash, RC Grotz. Index of daily living. The Gerontologist 1:20-301.

Related articles

Related articles:
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