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Titre : | Using Nursing Assessments of Mobility and Activity to Prioritize Patients Most Likely to Need Rehabilitation Services (2023) |
Auteurs : | Carmen E. Capo-Lugo ; Kevin H. McLaughlin ; Bingqing Ye ; Kelly Daley ; Daniel Young ; Annette Lavezza ; Michael Friedman ; Erik H. Hoyer |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 104, n° 9, 2023) |
Article en page(s) : | p. 1402-1408 |
Note générale : | https://doi.org/10.1016/j.apmr.2023.03.018 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Amélioration de la qualité ; Medecine hospitaliere ; Réadaptation ; Recherche sur les services de santé ; Sécurité des patients |
Résumé : | Objective To identify nursing assessments of mobility and activity associated with lower-value rehabilitation services. Design Retrospective cohort analysis of admissions from December 2016 to September 2019 Setting Medicine, neurology, and surgery units (n=47) at a tertiary hospital. Participants We included patients with a length of stay ?7 days on units that routinely assessed patient function (n=18,065 patients). Interventions Not applicable. Main Outcome We examined the utility of nursing assessments of function to identify patients who received lower-value rehabilitation consults, defined as those who received ?1 therapy visit. Measures Patient function was assessed using 2 Activity Measure for Post-Acute Care (AM-PAC or ?6 clicks?) inpatient short forms: (1) basic mobility (eg, bed mobility, walking) and (2) daily activity (eg, grooming, toileting). Results Using an AM-PAC cutoff value of ?23 correctly identified 92.5% and 98.7% of lower-value physical therapy and occupational therapy visits, respectively. In our cohort, using a cutoff value of ?23 on the AM-PAC would have eliminated 3482 (36%) of lower-value physical therapy consults and 4076 (34%) of lower-value occupational therapy consults. Conclusions Nursing assessment, using AM-PAC scores, can be used to help identify lower-value rehabilitation consults, which can then be reallocated to patients with greater rehabilitation needs. Based on our results, an AM-PAC cutoff value of ?23 can be used as a guide to help prioritize patients with greater rehabilitation needs. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999323001867 |