User Interface Name

Field Identifier

Definition

Data Value Format (code or other value)

Value Sets

Date of Assessment

Assessment_Date

This is the date the actual assessment was carried out with the patient

8 digit numeric, CCYYMMDD
6 digit numeric: hh:mm:ss

Overall Mobility Classification

Mobility_Classification

This is to indicate the patients overall mobility classification

A

B

C

D

E

Fully Independent

Fully_Independent

This is to indicate whether the patient is fully independent

n1

1 Yes

2 No

Risk of Falls

Falls_Risk

This is to indicate whether the patient is at risk of falls

n1

1 Yes

2 No

Weighed

Weighed

This is to indicate that the patients weight was calculated from the patient being weighed on scales

Estimated

Estimated

This is to indicate that the patients weight is an estimated weight

Patient Reported

Patient_reported

This is to indicate that the patients weight was the weight reported by the patient

Sensory Factors

Sensory_Factors

This is to indicate whether the patient has a hearing or sight deficit and wears hearing aids or spectacles

n1

1 - Hearing deficit
2 - Hearing Aid
3 - Sight deficit
4 - Spectacles

Manual Handling Risk Factors / Constraints

Risk_Factors_Constraints

This is to identify any other factors that could affect the patients mobility, and/or impact on patient safety or safety of the carer.

n1

1 - Lack of comprehension / understanding
2 - Has confusion / agitation
3 - Lack of co-operation / compliance
4 - Skin lesions / wounds
5 - Disability
6 - Weakness
7 - Pain
8 - Infusion / catheter / drain etc.
9 - Cultural considerations
10 - Other e.g. traction, limb oedema (state)

Rolling / Turning

Rolling_Turning_In_Bed

This is to indicate whether the patient requires supervision or assistance with rolling / turning in bed or is able to move independently

n1

1 - Independent
2 - Supervision / verbal prompt
3 - Assisted
4 - N/A

Up / down bed

Up_Down_In_Bed

This is to indicate whether the patient requires supervision or assistance with moving up/down the bed or is able to move independently

n1

1 - Independent
2 - Supervision / verbal prompt
3 - Assisted
4 - N/A

Equipment (if required)

Moving_In_Bed_Equipment

This is to indicate whether the patient requires equipment to move in bed

n1

1 - Slide sheets
2 - Grab handle
3 - Other

Staff

Staff_moving_in_bed

This is to indicate how many staff are required to move the patient in bed.

n1

0
1
2
3
Other

Bed Rest

Bed_rest

This is to indicate whether the patient is on bed rest and requires equipment to move

n1

1 - Slide sheets
2 - Grab handle
3 - Other

Supine to sitting on edge of bed

Suppine_to_sittingonedgeofbed

This is to indicate whether the patient requires supervision or assistance from being in supine position to sitting on the edge of the bed or if they can move independently

n1

1 - Independent
2 - Supervision / verbal prompt
3 - Assisted
4 - N/A

Sitting on edge of bed to supine

Sittingonedgeofbed_to_suppine

This is to indicate whether the patient requires supervision or assistance in sitting on the edge of the bed to supine or if they can move independently

n1

1 - Independent
2 - Supervision / verbal prompt
3 - Assisted
4 - N/A

Staff

Staff_suppine

This is to indicate how many staff are required to move patient from supine to sitting on the edge of bed

n1

0
1
2
3
Other

Showering

Showering

This is to indicate whether the patient is able to shower independently or whether they require assistance or supervision

n1

1 - Independent
2 - Supervision / verbal prompt
3 - Assisted
4 - N/A

Equipment

Showering_Equipment

This is to indicate whether the patient requires equipment to shower

n1

1 - Hi-low hygiene chair
2 - Fixed height shower chair
3 - Shower Trolley

Staff

Showering_Staff

This is to indicate how many staff are required to assist with showering the patient

n1

0
1
2
3
Other

Bathing

Bathing

This is to indicate whether the patient is able to bathe independently or whether they require assistance or supervision

n1

1 - Independent
2 - Supervision / verbal prompt
3 - Assisted
4 - N/A

Equipment

Bathing_Equipment

This is to indicate whether the patient requires equipment to bathe

n1

1 - Bath / Hi-low bath
2 - Bath trolley / hoist
3 - Hoist & sling

Bath sling sizes

Bath_sling_sizes

This is to indicate what size bathing sling is being used

n1

1 - S
2 - M
3 - L
4 - LL
5 - XL

Staff

Bath_Staff

This is to indicate how many staff are required to assist with bathing the patient

n1

0
1
2
3
Other

Washing

Washing

This is to indicate whether the patient is able to wash independently or whether they require assistance or supervision

n1

1 - Independent
2 - Supervision / verbal prompt
3 - Assisted
4 - N/A

Equipment

Washing_equipment

This is to indicate whether the patient requires equipment to wash

n1

1 - Bed / assisted wash
2 - Chair

Staff

Washing_staff

This is to indicate how many staff are required to assist with washing the patient

n1

0
1
2
3
Other

Toileting

Toileting

This is to indicate whether the patient is able to go to the toilet independently or whether they require assistance or supervision

n1

1 - Independent
2 - Supervision / verbal prompt
3 - Assisted
4 - N/A

Equipment

Toileting_Equipment

This is to indicate whether the patient requires equipment for toileting

n1

1 - Toilet
2 - Commode
3 - Bedpan

Staff

Toileting_staff

This is to indicate how many staff are required to assist with toileting the patient

n1

0
1
2
3
Other

Walking

Walking

This is to indicate whether the patient is able to walk independently or whether they require assistance or supervision

n1

1 - Independent
2 - Supervision / verbal prompt
3 - Assisted
4 - N/A

Equipment

Walking_Equipment

This is to indicate whether the patient requires equipment for walking

n1

1 - Walking stick
2 - Walking Frame
3 - Walking Hoist

Staff

Walking_staff

This is to indicate how many staff are required to assist the patient with walking

n1

0
1
2
3
Other

All transfers (i.e. to/from bed, chair, commode, toilet etc)

Transfers

This is to indicate whether the patient requires assistance or supervision for all transfers or is able to do so independently

n1

1 - Independent
2 - Supervision / verbal prompt
3 - Assisted
4 - N/A

Equipment

All_transfers_equipment

This is to indicate whether the patient requires equipment for all transfers

n1

1 - Standing turntable
2 - Standing aid
3 - Bed assist, stand
4 - Transfer board

Hoist

Hoist

This is to indicate whether the patient uses a hoist

n1

1 - Active / standing hoist
2 - Passive hoist

Sling size

Sling_size_activestanding_hoist

This is to detail the size of the sling in use for the active / standing hoist

n1

1 - S
2 - M
3 - L
4 - XL

Sling size

Sling_size_passive_hoist

This is to detail the size of the sling in use for the passive hoist

n1

1 - S
2 - M
3 - L
4 - LL
5 - XL

Staff

Staff_alltransfers

This is to indicate how many staff are required to hoist the patient

n1

0
1
2
3
Other

Additional Resource Required:

Manager Name

Manager_name

This is the name of the manager who has authorised the additional resource

Free Text

Date Requested

Date_requested

This is the date the additional resource was requested

8 digit numeric, CCYYMMDD
6 digit numeric: hh:mm:ss

Date Provided

Date_provided

This is the date the additional resource was provided

8 digit numeric, CCYYMMDD
6 digit numeric: hh:mm:ss