The Effect on Inter-Rater Consistency Using a Standardized Assessment Tool/Framework in Musculoskeletal Examinations

2.50
Hdl Handle:
http://hdl.handle.net/10755/621823
Category:
Full-text
Format:
Text-based Document
Type:
Presentation
Level of Evidence:
N/A
Research Approach:
N/A
Title:
The Effect on Inter-Rater Consistency Using a Standardized Assessment Tool/Framework in Musculoskeletal Examinations
Other Titles:
Clinical Care Practices
Author(s):
Brewer, Debra Lynn
Lead Author STTI Affiliation:
Mu Xi
Author Details:
Debra Lynn Brewer, DNP, RN, FNP-BC, Professional Experience: As a CRNP- Family Practice, since 1998, I perform a variety of clinical practice activities, including physical examinations, on a routine basis. I also provide education for patients, colleagues, and/or students daily. As an Advanced Practice Nurse with years of experience, I have a vast knowledge base that enables me to identify problems and seek solutions in clinical practice. Author Summary: Debra Brewer is a Family Nurse Practitioner with years of experience in a variety of healthcare settings in the Western Pennsylvania region of the United States. She has worked in rural medical practices and also urban medical centers. Ms. Brewer enjoys expanding her knowledge base and seeks opportunities to participate in challenging endeavors. Debra graduated in May, 2017, from Carlow University with a Doctor of Nursing Practice degree.
Abstract:

This quality improvement (QI) project was conducted to determine if a standardized assessment framework/tool for clinician use when conducting musculoskeletal examinations for disability claims would increase inter-rater consistency. The problem of inconsistent musculoskeletal examination outcomes was identified when clinicians performing disability examinations at a large healthcare organization reported a lack of criteria on which to base the determination of “functional loss.” The finding of “functional loss” was being made independently by each clinician without any specific criteria and the examination outcomes lacked inter-rater consistency. A survey of the clinicians revealed that several examiners concluded that an examinee experienced "functional loss" in a large percentage of the examinations they completed, while other clinicians rarely indicated a "functional loss" existed, despite similar findings in examination metrics, such as range of motion and/or pain. This resulted in unfair compensation for the disability claimants. Standardized assessment tools have been used widely in a variety of settings in various disciplines and have proved to be beneficial in identifying and quantifying body function and structure limitations; this improves inter-rater consistency and clinical practice. A thorough evaluation of available tools and frameworks for use in musculoskeletal examinations was conducted and an appropriate framework was selected for use in this QI project by the clinicians performing the disability examinations. Rhetorical education, lunch-time discussions, slide presentations, and case studies were carried out to convey all educational information necessary regarding the purpose, function, and use of the selected framework. Clinicians were required to achieve an 80% pass rate on a post-education examination to assure appropriate use of the selected framework. A three-month period of post-education shoulder examination data was collected for comparison with the previously collected data. A Pearson’s Chi-Square test performed to analyze the data and revealed a statistically significant association (a=0.05 level) between post vs. pre-intervention for “functional loss” findings by clinicians, along with a seven-fold increase in overall positive findings for “functional loss” by clinicians using the standardized framework to perform the musculoskeletal examinations.

Keywords:
Inter-rater Consistency; Musculoskeletal Examinations; Standardized Framework/Tool
Repository Posting Date:
13-Jul-2017
Date of Publication:
13-Jul-2017
Other Identifiers:
INRC17D13
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePresentationen
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titleThe Effect on Inter-Rater Consistency Using a Standardized Assessment Tool/Framework in Musculoskeletal Examinationsen_US
dc.title.alternativeClinical Care Practicesen
dc.contributor.authorBrewer, Debra Lynnen
dc.contributor.departmentMu Xien
dc.author.detailsDebra Lynn Brewer, DNP, RN, FNP-BC, Professional Experience: As a CRNP- Family Practice, since 1998, I perform a variety of clinical practice activities, including physical examinations, on a routine basis. I also provide education for patients, colleagues, and/or students daily. As an Advanced Practice Nurse with years of experience, I have a vast knowledge base that enables me to identify problems and seek solutions in clinical practice. Author Summary: Debra Brewer is a Family Nurse Practitioner with years of experience in a variety of healthcare settings in the Western Pennsylvania region of the United States. She has worked in rural medical practices and also urban medical centers. Ms. Brewer enjoys expanding her knowledge base and seeks opportunities to participate in challenging endeavors. Debra graduated in May, 2017, from Carlow University with a Doctor of Nursing Practice degree.en
dc.identifier.urihttp://hdl.handle.net/10755/621823-
dc.description.abstract<p><span>This quality improvement (QI) project was conducted to determine if a standardized assessment framework/tool for clinician use when conducting musculoskeletal examinations for disability claims would increase inter-rater consistency. The problem of inconsistent musculoskeletal examination outcomes was identified when clinicians performing disability examinations at a large healthcare organization reported a lack of criteria on which to base the determination of “functional loss.” The finding of “functional loss” was being made independently by each clinician without any specific criteria and the examination outcomes lacked inter-rater consistency. A survey of the clinicians revealed that several examiners concluded that an examinee experienced "functional loss" in a large percentage of the examinations they completed, while other clinicians rarely indicated a "functional loss" existed, despite similar findings in examination metrics, such as range of motion and/or pain. This resulted in unfair compensation for the disability claimants. Standardized assessment tools have been used widely in a variety of settings in various disciplines and have proved to be beneficial in identifying and quantifying body function and structure limitations; this improves inter-rater consistency and clinical practice. A thorough evaluation of available tools and frameworks for use in musculoskeletal examinations was conducted and an appropriate framework was selected for use in this QI project by the clinicians performing the disability examinations. Rhetorical education, lunch-time discussions, slide presentations, and case studies were carried out to convey all educational information necessary regarding the purpose, function, and use of the selected framework. Clinicians were required to achieve an 80% pass rate on a post-education examination to assure appropriate use of the selected framework. A three-month period of post-education shoulder examination data was collected for comparison with the previously collected data. A Pearson’s Chi-Square test performed to analyze the data and revealed a statistically significant association (a=0.05 level) between post vs. pre-intervention for “functional loss” findings by clinicians, along with a seven-fold increase in overall positive findings for “functional loss” by clinicians using the standardized framework to perform the musculoskeletal examinations.</span></p>en
dc.subjectInter-rater Consistencyen
dc.subjectMusculoskeletal Examinationsen
dc.subjectStandardized Framework/Toolen
dc.date.available2017-07-13T16:13:16Z-
dc.date.issued2017-07-13-
dc.date.accessioned2017-07-13T16:13:16Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
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