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]].
* 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)


* 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 admission''' (not at home prior to admission). It takes into consideration acute medical issues that resulted in admission to the hospital.


According to team meeting,  
When possible, use an ADL assessment done within 24 hours after the [[Admit DtTm]].
* 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?


* 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)


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?
=== Specific Activities collected ===
** Worst in some locations
See the following for specific coding instructions for the different activities.
** most likely accurate in other location
* [[ADL Bathing]]
** some use pre-admission ADL, some use only after WARD admission
* [[ADL Dressing]]
** "how they are normally"
* [[ADL Toiletting]]
** some changed from "usual" pre-2007 to "worst" after
* [[ADL Transfering]]
* "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 Continence]]
* [[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]]


***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?
== 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.


== Reference ==
== Related articles ==
*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.
{{Related Articles}}


* 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 15:51, 2022 April 21

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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