Chapter 8 R-ACFI IRT Analysis A discussion of the benefits of IRT method are described in Chapter 2 Methods. IRT Analysis of ACFI ADL Data There were two modifications made to the ADL domain before application of the IRT analysis was applied. These were: (i) Nutrition item Based on the feedback from the consultations and data analysis the nutrition question was modified into a single checklist. As has been detailed in Chapter 4 the new R-ACFI Nutrition item now has four levels (Table A8.1). The IRT analysis used the recode Nutrition data in the analysis. Table A8.1: R-ACFI Nutrition Checklist Assistance level R-ACFI Nutrition Checklist Usual daily care needs for Eating and drinking activities (Tick one) Independent during the activity, staff standing by for Standard Care: 0 occasional or episodic assistance, provision of modified textured food and drinks and setting up activities e.g. taking lids off, cut up food, specialised plates and cutlery, special diets, placing food in front of resident etc. Monitoring: Needs general monitoring for an assessed nutritional need using 1 the mandated assessment. Includes residents with either ACFI checklist rating of ‘Physical Assistance’ for Readiness to Eat OR ‘Supervision’ for ‘Eating’. Moderate Assistance: 2 Always providing verbal or physical assistance, on a due to a basis, for part of the activity, whenever the activity is needed swallowing issue or other impairment. Includes residents with the ACFI checklist ratings of ‘Physical Assistance’ for ‘Readiness to Eat’ AND the ‘Supervision’ for ‘Eating’. Full assistance: 3 Always providing physical assistance, on a one-to-one basis, throughout the entire activity, whenever the activity is needed. Includes residents with the ACFI checklist rating of ‘Physical Assistance’ for ‘Eating’. (ii) The Personal Hygiene Checklist Item ‘Grooming’ The personal hygiene checklist item ‘grooming’ was removed from the analysis as it was not statistically discriminating and the effort is captured in other checklist items. This served to also simplify the provider claiming requirements. IRT Analysis Steps and Results While the R-ACFI ADL items are good measures of ADL performance, as with any other measures used to capture dependency or need, ability or performance can never be fully
Chapter 8 R-ACFI IRT Analysis A discussion of the benefits of IRT method are described in Chapter 2 Methods. IRT Analysis of ACFI ADL Data There were two modifications made to the ADL domain before application of the IRT analysis was applied. These were: (i) Nutrition item Based on the feedback from the consultations and data analysis the nutrition question was modified into a single checklist. As has been detailed in Chapter 4 the new R-ACFI Nutrition item now has four levels (Table A8.1). The IRT analysis used the recode Nutrition data in the analysis. Table A8.1: R-ACFI Nutrition Checklist R-ACFI Nutrition Checklist Usual daily care needs for Eating and drinking activities Assistance level (Tick one) Standard Care: Independent during the activity, staff standing by for occasional or episodic assistance, provision of modified textured food and drinks and setting up activities e.g. taking lids off, cut up food, specialised plates and cutlery, special diets, placing food in front of resident etc. 0 Monitoring: Needs general monitoring for an assessed nutritional need using the mandated assessment. Includes residents with either ACFI checklist rating of ‘Physical Assistance’ for Readiness to Eat OR ‘Supervision’ for ‘Eating’. 1 Moderate Assistance: Always providing verbal or physical assistance, on a basis, for part of the activity, whenever the activity is needed due to a swallowing issue or other impairment. Includes residents with the ACFI checklist ratings of ‘Physical Assistance’ for ‘Readiness to Eat’ AND the ‘Supervision’ for ‘Eating’. 2 Full assistance: Always providing physical assistance, on a one-to-one basis, throughout the entire activity, whenever the activity is needed. Includes residents with the ACFI checklist rating of ‘Physical Assistance’ for ‘Eating’. 3 (ii) The Personal Hygiene Checklist Item ‘Grooming’ The personal hygiene checklist item ‘grooming’ was removed from the analysis as it was not statistically discriminating and the effort is captured in other checklist items. This served to also simplify the provider claiming requirements. IRT Analysis Steps and Results While the R-ACFI ADL items are good measures of ADL performance, as with any other measures used to capture dependency or need, ability or performance can never be fully
acfi_review_report_part_3_appendices.docx