Clinical instruments for bedside functional assessment: Convergent validity among the AM‐PAC ‘6‐Clicks’ and BMAT

Abstract

Aims and Objectives:To determine the level of convergent validity of the '6-Clicks' Basic Mobility and Daily Activity with the Bedside Mobility Assessment Tool (BMAT) in patients admitted to a tertiary care academic hospital. Background:Accurately measuring a patient's ability to mobilise during hospitalisation is necessary but can be challenging. Two instruments, the Activity Measure for Post-Acute Care short-form '6-Clicks' and the BMAT, are commonly used to determine patients' mobility levels; however, these instruments have not been psychometrically evaluated together. Understanding the characteristics between these tools can support the process of shared decision making amongst healthcare providers. Design: Retrospective Cohort adhering to the STROBE statement. Methods: Using 13,498 individual patient admissions from an electronic health record, the BMAT score measured closest in time to the '6-Clicks' Basic Mobility and Daily Activity evaluation was collected. Spearman rank correlations with 95% confidence intervals (CIs) were calculated to determine the level of convergent validity between the '6-Clicks' Basic Mobility and Daily Activity with the BMAT. Pairwise correlations were also calculated and stratified by admitting medical service. Results: All correlations for the '6-Clicks' Basic Mobility or Daily Activity summative scores and the BMAT mobility levels were statistically significant and moderately correlated. The weakest correlations were seen within the Orthopaedic admitting service group. Most correlations stratified by admitting service [CVD/Pulmonary, Medicine/ Hospitalist, Other Surgery and Solid Organ Transplant] were moderate. The strongest correlations were seen within the Neuro/Stroke admitting service. Conclusion:Moderate levels of convergent validity exist between the '6-Clicks' and the BMAT in this sample. These findings demonstrate that the construct of patient mobility is not being assessed similarly between the two instruments. | 2049LININGER Et aL.

Staff Low Back Injury Risk During Assisted Falls Virtual Reality Simulations

“…There are many mobility clinical tools such as the Bedside Mobility Assessment Tool (BMAT) and Veterans Administration Mobility Screening and Solutions Tool (MSST) (Health Services Research & Development Forum, 2020; Hoyer et al, 2018; Lininger et al, 2021; Melillo et al, 2022). Most mobility screening tools evaluate patient functional status such as ability to sit on the edge of bed, upper and lower body strength, ability to stand, and ability to step or walk (Health Services Research & Development Forum, 2020; Hoyer et al, 2018; Lininger et al, 2021; Melillo et al, 2022). SPHM technology such as lateral transfer devices or powered sit to stand lifts may be used for toilet to wheelchair transfers depending on the mobility screening results (Andersen et al, 2014; Bergman & De Jesus, 2021; Kucera et al, 2019).…”

“…We recommend the use of mobility screening tools that assess the patient’s mobility level and therefore guide SPHM technology selection and use to help prevent patient falls and reduce the injury risk to both patients and staff. There are many mobility clinical tools such as the Bedside Mobility Assessment Tool (BMAT) and Veterans Administration Mobility Screening and Solutions Tool (MSST) (Health Services Research & Development Forum, 2020; Hoyer et al, 2018; Lininger et al, 2021; Melillo et al, 2022). Most mobility screening tools evaluate patient functional status such as ability to sit on the edge of bed, upper and lower body strength, ability to stand, and ability to step or walk (Health Services Research & Development Forum, 2020; Hoyer et al, 2018; Lininger et al, 2021; Melillo et al, 2022).…”

Reliability and validity of the Veterans Administration Mobility Screening and Solutions Tool

“…Two commonly used tools to determine patients’ mobility levels, including the Activity Measure for Post-Acute Care short-form ‘6-Clicks’ and BMAT, showed only moderate levels of convergent validity between them, indicating that they do not assess patient mobility similarly [ 12 ]. The BMAT, which showed a good interrater reliability (kappa = 0.91) between three nurses assessing 20 patients [ 10 , 11 ], is used in facilities across the VA.…”

Study on the Cutoff Value of Backward Walking Speed to Distinguish the Mobility Deficits of Stroke Patients

“…2,3 Mobility has been assessed by clinicians and researchers in terms of both functional mobility and living space mobility, and current research on mobility in stroke patients has focused on the former. 4 Mobility is exceptionally important for reducing patients' physical disability and maintaining independent living, 5 and it is also an important predictor of physical function, independence, and mortality, 6 so an accurate assessment of mobility can help nurses identify potential functional deficits and risks, and provide a basis for care planning and resource allocation. 7,8 Because of the dynamic and multidimensional nature of the concept of "mobility," 9 the assessment of mobility lacks a criterion standard and mostly uses self-reporting and performance measurement, where forward walking speed is a common parameter and indicator in performance measurement.…”