ROUTINE ASSESSMENT OF PATIENT PROGRESS - A MULTIFORMAT, CHANGE-SENSITIVE NURSES INSTRUMENT FOR ASSESSING PSYCHOTIC INPATIENTS

A new instrument, the Routine Assessment of Patient Progress (RAPP), i s a standardized scale with a unique format that allows trained nurses to incorporate both interview and observational data into a comprehen sive assessment of psychiatric inpatients. The scale was developed to accurately document treatment effects, assist in treatment planning, a nd provide ancillary judgments of psychopathology that may affect diag nosis. The RAPP demonstrates satisfactory interrater reliability and i nternal consistency. The RAPP total score and its two subscales correl ated highly, where expected, with an observation-based nursing scale, global measures, and an interview-based psychopathology scale. RAPP sc ores demonstrated sensitivity to change over time in patient functioni ng. It reliably discriminated among patients discharged to settings wi th varying degrees of independent living. The use of the RAPP over sev eral years on a psychiatric in patient unit has shown it to be a pract ical clinical tool that eases nurses' charting demands, helps create c are plans, and facilitates interdisciplinary communication.