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ADL General Collection Information: Difference between revisions

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


== Collection Instructions ==
== Collection Instructions ==
The ADL assesses a patient's capability to perform a certain activity. Enter the status into the ADL dropdown boxes in the ADL tab in [[CCMDB.mdb]].
* The ADL assessment should reflect the amount of assistance a patient requires to perform the six activities. It takes into consideration acute medical issues that resulted in admission to the hospital.
* Using your best judgment based on age, diagnosis, pre hospital admission ADL, and [[#Where to get data]] below, select the option that best reflects their ADL status
* For ostomy care see [[ADL Toiletting]] and [[ADL Continence]]
* For use of mechanical aids see [[ADL Transfering]]


=== Timeframe ===
=== Timeframe ===
An ADL assessment is usually done within 24 hours of admission (done by allied health or nurses).
The ADL assessment (done by allied health or nurses) we utilize is the patient's state of activity on first [[Service tmp entry]]. When possible, use an ADL assessment done within 24 hours after the admission to the ward
The ADL assessment 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.
 
=== Low functioning ADL due to condition that is expected to be temporary ===
If a patient is admitted with a diagnosis that is expected to improve to the point of higher functioning ADLs (and they possibly have improved already by the time collection happens), code the ADLs that are expected to be the long-term state.
{{Ex|
A patient is admitted with [[Diabetic ketoacidosis (DKA)]] and is expected to improve with treatment to the point where they can manage their activities of daily living (ADLs) independently. Code the ADLs based on their anticipated long-term state of independent functioning, even if they are still experiencing limitations at the time of data collection.
}}


=== Directed Restrictions ===
=== Directed Restrictions ===
Directed restrictions on a patient's activities should not be assessed as requiring assistance. For example, if a pt is on bedrest 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.
Directed restrictions on a patient's activities should not be assessed as requiring assistance. Code these based on what the patient would actually be capable of doing if they were permitted.
{{Ex|
A patient comes in with a stroke. They can mobilize independently and go to the washroom. The patient is then ordered to be on bedrest after a procedure. If the patient would be able to perform the activity if allowed then they are to be assessed accordingly. So in this case they would would be coded as '''unassisted'''.
}}


=== Where to get data ===
=== Where to get data ===
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* Integrated progress notes
* Integrated progress notes
* Risk assessment for falls form (if used)
* Risk assessment for falls form (if used)
== Data Entry Instructions ==
For every Medicine profile, enter the status into the ADL dropdown boxes in the [[Patient Viewer Tab ADL]] in [[CCMDB.accdb]].


=== Specific Activities collected ===
=== Specific Activities collected ===
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* [[ADL Bathing]]
* [[ADL Bathing]]
* [[ADL Dressing]]
* [[ADL Dressing]]
* [[ADL Toileting]]
* [[ADL Toiletting]]
* [[ADL Transfering]]
* [[ADL Transfering]]
* [[ADL Continence]]
* [[ADL Continence]]
* [[ADL Feeding]]
* [[ADL Feeding]]


== Scoring ==
== Data Use ==
The field is driven by [[S_ADLOptions table]].
* [[ADL Score]]
 
* [[ALERT Scale]]
score used by {{discussion}} by what, [[created_variables_common_maker query]], [[created_variables_CC_maker query]]?? Ttenbergen 16:14, 2017 February 6 (CST)
 
Performance of each of the activities is evaluated as unassisted (0 points), minor assistance (3 points), or major assistance (6 points).
 
'''Total ADL Score''' is the sum of points of all the six activities.
 
ADL is also part of the [[MOST]] score.
 
=== in CCMDB.mdb ===
In CCMDB the ADLs are stored as their full words rather than scores, e.g. "ADL_Bathing" might have a value of "unassisted". The values are entered via dropdown list, which is driven by table [[s_ADLOptions]]. In that table there is a column "sorter" with numbers used to change the order the values appear in the dropdown list. The column is '''not''' a score and not used for anything beyond sorting.
 
=== In TMSX ===
As per email from Julie 2013-12-17:
::Ed’s database assigns the points 1, 3, 6 to unassisted, minor and major respectively.
::
::But in calculating the MOST Score, the point for unassisted  has zero point instead of one.
::
::So maybe you have to change the S_ADL options from 2,4,6  not to 1,3,6  but 0,3,6.
 
Presumably Ed assigns the score upon importing the True/false columns and processing them.
 
If we were to change the numbers to 0, 3, 6, then do we use ADL score anywhere other than MOST, where this would mess with data?
 
For now I will add "ADL_Score" and "MOST_Score" columns to s_ADLOptions with the values as described.


== References/Background ==
== References/Background ==
The evaluation tool used for all Medicine patients is the Katz ADL.
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 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, SD Downs, HR Cash, RC Grotz. Index of daily living. ''The Gerontologist'' 1:20-301.


[[Category:ADL|*]]
== Related articles ==
[[Category:Medicine Elements]]
{{Related Articles}}
[[Category:MOST Score Elements]]
 
[[Category:ADL| *]]
[[Category:Data Collection Guide]]
[[Category:ALERT Scale Elements]]
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