PCM 2 Midterm Exam - sternal precautions, move in the tube, research articles, stairs, outcome measures

Sternal precautions are given to patients after

sternotomies to decrease risk of sternal wound complications (can vary but mostly based on expert opinion)

sternal precautions commonly involve restrictions for

weights/lifting 5-20lbs, shoulder movement lifting arms overhead, and pushing down through arms

sternal precautions are not based on any

specific evidence - why they can vary

sternal precautions can reinforce

fear of activity which will decrease overall functionality and mobility

alternative to sternal precautions

"mov in the tube"

move in the tube idea

keeping arms close to body (in the "tube") will decrease stress placed through sternum and perform more forceful movement without damaging sternal incision

move in the tube removes

sternal precaution limitations of force production and mobilization - just keeps its within the limits of the "tube" to protect the integrity of the surgery

when ascending the stairs, direct pt to go

up with the good (strong/unaffected limb first)

when descending stairs, direct pt to go

down with the bad (weak/affected limb first)

PT guarding with stair ascent

posterior on weaker side

PT guarding with stair descent

in front of patient

alternative stair methods

stairs with shower chair, butt scooting

Pt determination discharge disposition in acute care research study purpose

determine if PTs were accurate in determine home d/c disposition based on readmission and examine extent to which predictors of readmission are associated with PT d/c disposition

strongest predictors of readmission based on D/C study

PT recommendation for post-acute setting not being met

PT consultation in acute care contributes to

reduced readmission rates - study confirms accuracy of PT determination of d/c home

Early mobilization of ICU patients research study purpose

analysis of effect of early mobilization of critically ill patients

results of early mobilization study

early mobilization did not decrease duration of mechanical ventilation, did increase number of ventilator free days, increased discharge to home rate and did not increase rate of adverse events

Modified Dionne's Egress Test for Fall prediction study purpose

evaluate modified egress test as a predictor of falls compared to MFS

takeaways of fall prediction study

patient less likely to fall is they pass Egress and dont take benzodiazepines, using MFS as a fall predictor in inconclusive

outcome measure

result of a test used to objectively determine baseline function - same test is used to determine progress and treatment efficacy following treatment interventions

types of outcome measures

self report, performance based, observer reported, clinician reported

self report measures

questionnaire completed by patient, objectifies patient's perception of issue

performance based measure

pt completes set of movements or tasks and scored based on objective measurement or qualitative (quality of movement)

observer reported measures

measurements completed by someone who regularly observes the patient (# of times pt fell in a week, # of winces in pain for a movement, etc)

clinician reported measures

completed by healthcare professional, scores with clinical judgement to report patient behaviors (bed mobility, gait, etc)

psychometric properties of outcomes measures

validity, inter-rater reliability, intra-rater reliability, responsiveness, ceiling effects, floor effects, minimally important clinical difference