Acute Care Index of Function

Original Editor - Lucinda hampton

Top Contributors - Lucinda hampton and Safiya Naz  

Introduction

The Acute Care Index of Function (ACIF)

• Was developed for neurological patients.
• Is highly reliable for measuring physical function in ICU patients.
• Valid in ICU, being closely correlated with the ICU Mobility Scale.
• Strongly predicts the likelihood of discharge home from hospital.
• May be a useful in the core set of outcome measures for ICU survivors

Why Used

Early mobilisation of ICU patients results in shorter duration of ventilation, better functional outcomes and reduced delirium. Through effective collaboration of nursing, medical and physiotherapy staff, ICU patients are now achieving higher levels of physical function in the acute phase of their illness, including mobilisation whilst still ventilator-dependent.

Although early physical rehabilitation in ICU is of great importance, much of the rehabilitation continues beyond ICU discharge. As clinicians strive to minimise the physical, social and financial burdens of ICU survivorship, there is a need for measurement tools which can reliably and accurately describe physical function across the patient journey

The study found the ACIF to be both reliable and valid for ranking functional status in patients with acute neurologic deficits. Reliability analysis using Cohen's weighted Kappa showed values between 0.60 and 0.98, while validity analysis with Spearman's rank-order correlation yielded rs​=0.81,p<0.01.

Basics

A 20 item instrument with activities to measure cognition and functional mobility.

4 subscales

1. Mental Status
2. Bed mobility
3. Transfers
4. Mobility

Note: The ACIF has excellent inter-rater reliability in ICU patients and scores at ICU discharge predict the likelihood of discharge home.

The average amount of time required to administer the ACIF was 12 minutes.