Week 4: Environmental Assessment Patient Safety & ADA

what are some examples of fall risk assessments?

- morse tool

- timed up & go (tug)

- berg balance scale

- functional reach test

- falls efficacy scale

what is the morse tool used for?

used to assess patients to determine their fall risk

what are the patient benefits of the morse tool?

best predictor of anticipated physiological falls (most common and preventable)

what are the risk factors of the morse tool for patients?

include injury, prolonged hospital stay, decreased mobility and activity restriction

what are the risk factors of the morse tool for practitioners?

include guilt, anxiety, legal liability, decreased compensation and loss of accreditation

what is the timed up & go (tug) test used for?

used to assess fall risk, balance and mobility in older adults

what are the materials needed for the timed up & go (tug) test?

- ruler/yardstick

- timer

what are the normative data and cut-off scores for the TUG test?

> 13.5 seconds = fall risk

what does the berg balance scale consist of?

14 objective items assessing balance and fall risk in older adults

what are the materials needed for the berg balance scale?

- 2 standard height chairs

- ruler

- step stool

- slipper/shoe

what are the normative data and cut-off scores available for the berg scale?

< 45 = fall risk

what does the functional reach test assess?

assess a patient's stability while reaching forward and outside of base support in stance (can be modified)

what are the materials needed for the functional reach test?

- ruler/yardstick

- tape

what is the falls efficacy scale consist of?

16 item self-report assessing fear of falling in older adults

what is the scale of the falls efficacy scale?

- 1: not at all concerned

- 2: somewhat concerned

- 3: fairly concerned

- 4: very concerned

what are the v.e.t.o. falls mean?

- visual management = visually identify that the patient is a high fall risk

- environment & equipment = protect the patient

- treat the risk = what interventions should be put in place?

- ongoing monitoring = ongoing communication and assessment of intervention

what did the ADA Title II do?

prohibits discrimination against individuals with disabilities in places of public accommodations (PPAs)

under title III, PPAs must...

- remove barriers to access

- provide alternative and reasonable accommodations if barriers cannot be removed

what are examples of violating title III?

- failure to admit an individual with a disability

- failure to provide goods/services

- failure to make reasonable accommodations

- failure to provide reasonable auxiliary aides

what are the exceptions to title III violations?

- do not have to provide auxiliary aides that alter the nature of goods/services or cause undue burden

- do not have to provide personal services or devices

what are the 4 main priorities to comply with barrier removal requirements?

- access to the PPA

- access to the areas where goods/services are available

- access to restrooms

- access to goods/services

what are the primary considerations when making recommendations according to creating SPACE?

- S = safe

- P = personal

- A = accessible

- CE = cost effective

what is universal design?

a process that seeks to design a product/service that can be used with a wide variety of people

what are strategies to optimize accessibility?

- changes made to current physical environment

- fall prevention

what are the important measurements to remember for minimal wheelchair accessibility?

- doorways = 32 in wide

- hallways = 36 in wide

what are the important measurements to remember for bathrooms?

- standard toilet height = 13-14.5 in

- ADA height = 17-19 in

what are the important measurements to remember for counter tops?

maximum height = 36 in

what are the important measurements to remember for ramps?

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