THE DISABILITY STATUS OF INJURED PATIENTS MEASURED BY THE FUNCTIONAL INDEPENDENCE MEASURE (FIM) AND THEIR USE OF REHABILITATION SERVICES

The type and severity of disability following major trauma was evaluat ed wing the Functional Independence Measurement (FIM) in 93 patients b rought to the Royal London Hospital (RLH) by helicopter. The range of values for FIM is from 18 (dependent) to 126 (fully independent) in th e sir sections of self-care, sphincter control, mobility, locomotion, communication and social cognition. The sections are divided into 18 s eparate items and graded 1-7. Forty-eight patients were discharged dir ectly to home with a median FIM scare of 124; 11 were transferred to a nother acute hospital with a median FIM of 63 and seven went to rehabi litation unit with a median FIM of 58. At six months, 79 per cent of t he patients reported no disability and 89 per cent of the original 93 patients were at home with a median FIM of 126. The mean amount of reh abilitation provided at the RLH for all patients was 11 h 20 min with a mean in-patient length of stay of 14 days. The actual and optimal am ount of therapy for rehabilitation worked out at less than 1 h per day in the acute hospital. FIM is a useful, practical and simple methodol ogy for recording disability in the acute hospital. It provides a meas ure far assessing the original disability, its progress and residual l imitations. Nurses, doctors and therapists can use it for establishing care plans and goals as well as deciding the transfer of the patient to the mast appropriate place for future care.