ADL General Collection Information: Difference between revisions

From CCMDB Wiki
Jump to navigation Jump to search
← Older edit
TOstryzniuk (talk | contribs)
CCMDB_legit, approved, Bureaucrats, Administrators
27,522 edits
mNo edit summary
 
(74 intermediate revisions by 10 users not shown)
Line 1: Line 1:
== General Considerations ==
The '''Activities of Daily Living''' (ADL) assesses a patient's capability to perform six 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 ==
* 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.
* Needs to include where this data is to be gathered from, and where '''not''', i.e. physio discharge notes 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. [[User:Ttenbergen|Ttenbergen]] 15:02, 21 August 2008 (CDT)
* 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]]


* Where and how should this information be collected? There are differences in how the hospital work, but we should have a common starting direction at least.
=== Timeframe ===
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


According to team meeting,  
=== Low functioning ADL due to condition that is expected to be temporary ===
* 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?
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.
}}


* 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. 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'''.
}}


* 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)


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?
== Data Entry Instructions ==
** Worst in some locations
For every Medicine profile, enter the status into the ADL dropdown boxes in the [[Patient Viewer Tab ADL]] in [[CCMDB.accdb]].
** most likely accurate in other location
** some use pre-admission ADL, some use only after WARD admission
** "how they are normally"
** some changed from "usual" pre-2007 to "worst" after
* "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.  


* NPO due to pt aphasic = major (I suspect disphagic was intended here, or do we also have patients NPO because they can't talk? )
=== Specific Activities collected ===
See the following for specific coding instructions for the different activities.
* [[ADL Bathing]]
* [[ADL Dressing]]
* [[ADL Toiletting]]
* [[ADL Transfering]]
* [[ADL Continence]]
* [[ADL Feeding]]


***I have a patient who came in with independent ADLs then went to the cath lab and had a coronary angio complicated by an embolic stroke.Now he is a complete in bathing and major in mobility .So I guess I can only change my adls if the stroke occurred within 24 hours .Is this correct?
== Data Use ==
* [[ADL Score]]
* [[ALERT Scale]]


== 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.


*[http://classes.kumc.edu/som/amed900/ExposureSkills/Katz_Index_ADL.htm http://classes.kumc.edu/som/amed900/ExposureSkills/Katz_Index_ADL.htm]
== Related articles ==
**This is a dead end link that doesn't provide any information, therefore should be taken out.
{{Related Articles}}
[[User:TOstryzniuk|TOstryzniuk]] 13:06, 19 November 2008 (CST)


* S Katz, TD Downs, HR Cash, RC Grotz, (1970). Index of Activities of Daily Living, ''The Gerontologist'', 1:20-301.
[[Category:ADL| *]]
 
[[Category:Data Collection Guide]]
 
[[Category:ALERT Scale Elements]]
 
 
{{stub}}
[[Category: ADL]]
[[Category: Questions_ADL]]

Latest revision as of 22:30, 29 June 2025

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

Collection Instructions

  • 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

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

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.

Example:   

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 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.

Example:   

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

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)

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

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:
Retrieved from "https://ccmdb.kuality.ca/index.php?title=ADL_General_Collection_Information&oldid=164537"