Scores in all domains are added to obtain a total fim instrument score. The tool is used to assess a patients level of disability as well as change in patient status in response to rehabilitation or medical intervention. Functional independence measure rehabmeasures database. The scoring considers the use of adaptive equipment andor the extent of personal assistance or supervision required to complete the task. Functional independence measure fim assessment overview assessment area icf domain. The fam functional assessment measure was developed as an adjunct to the fim to specifically address the major functional areas that are relatively less emphasized in the fim, including cognitive, behavioral, communication and community functioning measures. The functional independence measure fim instrument is a basic indicator of patient disability. According to a cms fact sheet on the proposed rule, data collected through the fim are being captured in other parts of the assessment instrument. An assessment of the severity of patient disability. Mar 2017 functional independence measurement fim user manual, version 1.
Patient assessment instrument irfpai data to conform with centers for medicare and medicaid services cms regulations. Care and needs scale cans for adults with a brain injury. If more than one assessment has been done, which one will be used. Reprinted with the permission of udsmr, university at buffalo, 232 parker hall, 3435 main street, buffalo, ny 14214 fim instrument motor subtotal score cognitive subtotal score total fim score modified independence. The most secure digital platform to get legally binding, electronically signed documents in just a few seconds. Paediatric care and needs scale pcans2 for young people aged five15 years with a brain injury. The developers of the push scale deserve credit for allowing their tool to.
Functional independence measure fim the fim was developed in 1983 by a task force created by the american congress of rehabilitation medicine and the american academy of physical medicine and rehabilitation headed by carl granger and byron hamilton. Sign, fax and printable from pc, ipad, tablet or mobile with pdffiller instantly. Its area of use can include skilled nursing facilities and hospitals aimed at acute, subacute and rehabilitation care. Set, measurement scale, impairment codes, and refinements thereto for the irfpai, and for the guide for the uniform data set for medical rehabilitation, as incorporated or referenced herein. The katz index of independence in activities of daily living, commonly referred to as the katz adl, is the most appropriate. Tasks are rated on a 7 point ordinal scale that ranges from total assistance or complete dependence to complete independence. Hence the functional assessment measure is abbreviated to. Irfpai training manual revised 011602 the process of taking a wellknown clinical tool and making it the basis of a national prospective payment system. Assessment of motor and process skills amps barthel index bi. Measurement scales used in elderly care 60 functional independence measure and functional assessment measure functional independence measure the functional independence measure fim scale assesses physical and cognitive disability. Comparing the functional independence measure and the. The higher the score is for a task, the more independent a person is at performing the task. Although many scoring cutoffs have been suggested, there.
The clinician performing the assessment scores each item on a scale of 1 to 7. The fim is an 18item ordinal scale, used with all diagnoses within a rehabilitation population. Fam items are rated on the same 7level scale as the fim items although the scaling. For a variety of economic, political, and humanitarian reasons, it is important to ensure the quality and effectiveness of our full range of healthcare services. It is very important to evaluate the degree of disability in subjects with rf who are. Rehabilitation medicine, university of gothenburg approved by fuglmeyer ar 2010 1 fuglmeyer assessment id. Toilet not mention transfer in transfer there are 3 items and mobility 2 item walkingwc and stairs. Katz index of independence in activities of daily living adl. The functional independence measure fim is an assessment tool that aims to evaluate the functional status of patients throughout the rehabilitation process following a stroke, traumatic brain injury, spinal cord injury or cancer. For a variety of economic, political, and humanitarian reasons, it is important to ensure the quality and. Functional independence measure fim spinal cord injury. Fim scores range from 1 to 7 1 total assist and 7 complete independence.
Pdf the dimensionality of functional independence measure fim. Functional independence measure tm and functional assessment measure brain injury scale. Functional independence measure an overview sciencedirect. Fim 7 modified independence fim 6 supervision or setup fim 5 standby assistance contact guarding minimal contact assistance fim 4 moderate assistance fim 3 maximal assistance fim 2 total assistance fim 1 evaluation criteria all of the task described as making up the activity are typically. Today i will be walking you through the functional independence measure assessment commonly known as the thin the thin is an 18. Fuglmeyer ar, jaasko l, leyman i, olsson s, steglind s. The functional independence measure fim 31 is a widely accepted functional assessment measure used during inpatient rehabilitation. Her global perspective, clarity of thought, and emphasis on the importance of the research findings has ensured that the system will be of the highest quality. The helper applies the universal cuff on to the patients hand before she eats. Today i will be walking you through the functional independence measure assessment commonly known as the thin the thin is an 18 item assessment that is based on a 7 level scale now out of these 18 items i will only be walking. From february to march 2009, we searched medline, ovid, cinahl, and ebsco for fulltext articles written in english. Using the fim scale to assess and treat for next level of. The functional independence measure fim scale is a basic indicator of patient disability.
It is the product of an effort to resolve the long standing problem of lack of uniform measurement and data on disability and rehabilitation outcomes. The higher the score is for a task, the more independent a. The functional independence measure fim is widely used and accepted as a functionallevel assessment tool that evaluates the functional status of patients throughout the rehabilitation process. The functional independence measure fim is an 18item measurement tool that explores an individuals physical, psychological and social function. Cms wants to drop functional measure, 2 quality reporting.
Subscores of the fim instrument, including a item motor scale, a 5item cognitive scale, an 11item without sphincter control items. Below is a summary of an article in which the weefim was used as the primary objective assessment of progress following an acquired brain injury abi. Performance of the child on each of the items is assigned to one of seven levels of an ordinal scale that represents the range of function from complete and modified independence levels 7 and 6 without a helping person to modified and complete dependence levels 5. The original fam items were developed by santa clara valley medical center scvmc, san jose, california. Fim is used to track the changes in the functional ability of a patient during an episode of hospital rehabilitation care.
The assessment slated for possible elimination is the functional independence measure fim, part of the irf patient assessment instrument. The fim measures progress in activities of daily living, mobility, and communication. Aug 26, 2011 the fim measures progress in activities of daily living, mobility, and communication. Fim, medical research council dyspnoea scale mrc, st george respiratory. Functional independence measurement fim user manual. Selfscoring templates for motor and cognitive subscales of the. The scoring on the fim was recoded to a 3point scale to indicate. The way to complete the online fim scale on the internet. Oct 30, 2018 the clinician performing the assessment scores each item on a scale of 1 to 7. Nov 29, 2009 functional independence measure fim the fim was developed in 1983 by a task force created by the american congress of rehabilitation medicine and the american academy of physical medicine and rehabilitation headed by carl granger and byron hamilton. Tenet irfs shall utilize the functional independence measure fim instrument to assist in classifying a patient into a case mix group cmg. Granger, deutsch, and linn 1998 have applied a rasch rating scale in order to transform the fims ordinal ratings to an equalinterval rating scale so that it can be used for linear regression models. The functional independence measure fim was developed to address the issues of sensitivity and comprehensiveness that were criticized as being problematic with the barthel index another measure of functional independence.
A manual for using the functional assessment rating scale fars florida version 199899, with text revisions 2004 introduction. The current form structure represents the version of fim developed between 1984 and 1987 by a national task force sponsored by the american academy of physical. The fim was also developed to offer a uniform system of measurement for disability based on the international classification. Jul 03, 2019 the modified rankin scale mrs is a commonly used scale for measuring the degree of see alsoedit. The fim instrument includes a sevenlevel scale that designates major gradations in behavior from dependence to independence.
Prudent consumers generally seek this type of information to select. Performing a factor analysis with our fim assessment. Tenet irfs shall utilize the functional independence measure fim instrument to assist in classifying a patient into a. The fim and the fam use a 7 level ordinal rating scale. Fim scale fill out and sign printable pdf template signnow. The scores for each of the 30 components are added together to form a composite score. A lack of comprehensiveness may result in problems with ceilingfloor effects duncan et al.
The fim was also developed to offer a uniform system of measurement for disability based on the international. Pediatric functional independence measure weefim full name of assessment. Using efa and fim rating scales could provide a more complete assessment of patients with acquired brain injury. Physical selfmaintenance scale activities of daily living, or adls in each category, circle the item that most closely describes the persons highest level of functioning and record the score assigned to that level either 1 or 0 in the blank at the beginning of the category. Hartford institute for geriatric nursing recommended for you. Pdf on oct 2, 2018, ladislav valach and others published the dimensionality of functional independence measure fim find.
Fim and weefim for people with a brain injury or burns. The fim motor scale had highexcellent reliability testretest and interrater reliability and highexcellent validity 0. Ability of functional independence measure to accurately. Each item is scored on a 7 point ordinal scale ranging from 1 total dependence to a score of 7 total independence. Functional assessment measure rehabmeasures database. The advanced tools of the editor will lead you through the editable pdf template. The functional independence measure fim is an 18item measurement tool that. It has been suggested as a more optimal tool to assess functional outcomes in. Functional independence measure and functional assessment measure functional independence measure the functional independence measure fim scale assesses physical and cognitive disability. Performance of the child on each of the items is assigned to one of seven levels of an ordinal scale that represents the range of function from complete and modified independence levels 7 and 6 without a helping person to modified and complete dependence levels 5 to 1 with a helping person. If theres more than one fim or weefim assessment, the one completed closest to the. Fim score percentage calculations for adls occupational. The main assessment tools we use in icare lifetime care and the icare workers care program are. The current form structure represents the version of fim developed between 1984 and 1987 by a national task force sponsored by the american academy of physical medicine and.
The modified rankin scale mrs is a commonly used scale for measuring the degree of see alsoedit. Apr 16, 20 the weefim ii system allows credentialed clinicians across the united states and around the world to measure and document functional performance in infants 03 years old, children, and adolescents with either acquired or congenital disease in a consistent manner. Previously validated in a mixed neurorehabilitation cohort, this. Functional independence fim technical manual and security guide, v. Functional independence measure for children weefim. Fim scale pdf fill online, printable, fillable, blank. Functional change is a key outcome measure of rehabilitation episodes. Barring unusual circumstances, a rehab patient is expected to gain one or two points per day. Functional independence measure fim the fim is an 18item, seven level ordinal scale. Aug 01, 2018 the functional ability of a patient changes during rehabilitation and the fim instrument is used to track those changes. Enter your official contact and identification details. These items do not stand alone, but are intended to be added to the 18 items of the fim. The katz index of independence in activities of daily living adl duration. The fim instrument comprises 18 items, each of which is assessed against a seven point ordinal scale, where the higher the score for an item, the.333 170 782 782 1483 1323 1483 416 763 1387 1304 1121 181 829 775 172 1571 262 481 146 1108 1087 752 1379 5 464 1598 873 213 822 336 850 131 761 739 1549 685 1137 1010 1215 1450 1436 1495 1268 252 641 810 1098 1210