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.  
* [[:Category:ADL | ADL]] - assess functional status during the '''first 24 hours''' after the patient has been "accepted" to medicine service by a medicine service attending physician. 
* If dependancy of an 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 ==
For every Medicine profile, enter the status into the ADL dropdown boxes in the [[Patient Viewer Tab ADL]] in [[CCMDB.accdb]].


== Discussion ==
=== Timeframe ===
=== where to get the data===
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.
This information can be obtained from a variety of sources '''in the first 24 hours''' depending on the timing and details documented.For example:
*OT/PT assessment
*Activity flow sheets if used
* Nursing data base
*nurses note
*risk assessment for falls form if used


=== which of several values to use ===
When possible, use an ADL assessment done within 24 hours after the [[Admit DtTm]].
*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?
** Worst in some locations
** 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


== Reference ==
=== Directed Restrictions ===
*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.  
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.


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


==Discussion==
=== Specific Activities collected ===
{{Discussion}}
See the following for specific coding instructions for the different activities.
*the charting of the assessment of ADL is different between hospitals. Bedside nurses do not use the same criteria (ADL guidelines) to assess minor vs major therefore, are other collectors having to make assumptions because it is not clear on the charting?
* [[ADL Bathing]]
*are other collectors able to clearly discern where the patient fits into each category for ADL or do they mostly have to make assumptions and use best guess?--Marie Laporte
* [[ADL Dressing]]
* [[ADL Toiletting]]
* [[ADL Transfering]]
* [[ADL Continence]]
* [[ADL Feeding]]


== Data Use ==
* [[ADL Score]]
* [[ALERT Scale Calculation]]


[[Category: ADL|*]]
== References/Background ==
[[Category: Questions_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, SD Downs, HR Cash, RC Grotz. Index of daily living. ''The Gerontologist'' 1:20-301.
 
== Related articles ==
{{Related Articles}}
 
[[Category:ADL| *]]
[[Category:Data Collection Guide]]
[[Category:ALERT Scale Elements]]

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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