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Using Standardized Tools

By Sherry Neal, RN – BC, CDDN

 

Nurses are very familiar with evidence-based practice. It is using the most recent and best evidence in the decision-making process for patient care. Part of evidence-based practice is using the most current standardized tools for assessment or screenings in determining individualized risks.

There are many assessments and screenings that are completed on individuals with IDD. Some are completed by behavior analysts, some by QDDPs and yet others by nurses or other members of the interdisciplinary team. It is important that standardized assessments/screenings be used. Utilizing a standardized assessment or screening means it has been tested and the results have been validated. A validated tool means it really does what it is supposed to do. If a tool has been validated to screen for depression, the result truly determines if the person meets criteria for depression or not.

Interrater reliability is also a key factor to look for when utilizing any assessment/screen. If Person A screens Individual XYZ, and Person B also screens that same individual, the results should be the same. Interrater reliability means that two people given the same information should get the same results. This shows the tool is not open to wide interpretation.

There are many standardized tools that are used in the field of IDD. Many we know by the acronyms only and if we do not personally administer the tools, we may not know what those abbreviations stand for or what the tools are even used for.

“A validated tool means it really does what it is supposed to do. If a tool has been validated to screen for depression, the result truly determines if the person meets criteria for depression or not.”

Here are some of the common ones:• Abnormal Involuntary Movement Scale (AIMS) – A scale used to determine if signs or symptoms of tardive dyskinesia are present. http://www.cqaimh.org/pdf/tool_aims.pdf

• Braden Scale – An assessment to determine a person’s risk for developing pressure ulcers. It evaluates 6 areas that contribute to risk. http://www.healthcare.uiowa.edu/igec/tools/pressureulcers/bradenscale.pdf

• Bristol Stool Chart – A chart of standard descriptions for bowel movements. It describes seven different types of bowel movements and indicates what constipation, diarrhea and normal stool looks like. https://static1.1.sqspcdn.com/static/f/1451532/22180508/1363249562587/bristol_stool_chart.pdf

• Dyskinesia Identification System Condensed User Scale (DISCUS) – Another scale used to determine if signs or symptoms of tardive dyskinesia are present. http://hrstonline.com/wp-content/themes/healthrisk/article/DISCUS.pdf

• Health Risk Screening Tool (HRST) – A screening tool to determine individual health risk and identify early health destabilization. http://hrstonline.com/

• Inventory for Client and Agency Planning (ICAP) – Measures motor skills, personal living skills, community living skills, social and communication skills, and broad independence as well as eight categories of maladaptive behavior. http://icaptool.com/

• Monitoring of Side Effects Scale (MOSES) – Measures medication side effects, particularly psychiatric medications. https://www.dshs.wa.gov/sites/default/files/FSA/forms/pdf/10-334.pdf

• Supports Intensity Scale-A (SIS-A) – Measures the individual’s support needs in personal, work-related, and social activities, in order to identify and describe the types and intensity of the supports an individual requires. https://aaidd.org/publications/supports-intensity-scale#.WFraXPkrLic

This short list describes just some of the standardized tools that you may find useful (or are used) in your setting. Hopefully this helps untangle all those abbreviations!