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- W2338765891 abstract "5is a practical, easy to use instrument that can identity patients at risk for functional decline during and after an acute hospital admission. The HARP instrument stratifies patients’ risk for new ADL disability into low, medium, or high-risk categories based on scores obtained including age, preadmission Instrumental Activities of Daily Living (IADL) score, and an abbreviated Folstein Mini-Mental Status Exam 6 (MMSE) score. The seven IADLs included in the HARP instrument include: managing finances, taking medications, use of the telephone, shopping, transportation, housekeeping, and food preparation. The abbreviated MMSE (range 0-21) omits the language items from the standard 30-item MMSE. TARGET POPULATION: The HARP screening tool was designed to stratify older medical inpatients for their risk of developing new disabilities in ADLs during acute medical illnesses and hospitalization, who might benefit from geriatric interventions to reduce or prevent functional decline. The instrument was not tested on patients hospitalized for surgical procedures, those living in nursing homes before admission and those who were in critical care units. VALIDITY AND RELIABILITY: The HARP was developed and validated in a multi-center prospective cohort study conducted in four university and two private non-federal acute care hospitals (development cohort n = 448 and validation cohort n = 379). Logistic regression analysis revealed three patient characteristics that were independently predictive of functional decline: older age, cognitive impairment and lower preadmission IADL scores. A scoring system was then developed for each of the predictor variables, and patients were assigned to low, medium and high-risk categories. The rates of ADL decline at discharge for the low, medium and high-risk groups were 17%, 28% and 56% in the development cohort, and 19%, 31%, and 55% in the validation cohort. In both cohorts, patients who scored as high risk were three times more likely to have a loss in ADL function at discharge than those in the low risk group, and patients in the low risk group were significantly more likely to recover ADL function and avoid transfer to a nursing home. 5" @default.
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- W2338765891 date "2012-01-01" @default.
- W2338765891 modified "2023-09-27" @default.
- W2338765891 title "Best Practices in Nursing Care to Older Adults general assessment series" @default.
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