Competency:

Calculation of BODE Indexpre & post rehab to include with outcome data and to evaluate longer term patient prognosis

Name ______Date ______Dept. PULMONARY REHAB

Expectation: The pulmonary rehab staff member will assemble individual outcome measurements into a defined table & score those measurements to obtain a BODE Index score

Essential Elements of Performance: / Proficient / Needs Review/
Improvement / Inadequate
**
1 / Define BODE Index as a tool to help evaluate the seriousness of a patient’s pulmonary disease in terms of 5-year prognosis.
2 / Identify the 4 measurements that comprise the BODE Index below & discuss how the combination is a more potent predictor of long term status than each individual factor.
3 / B = Body Mass Index (Index), routinelycalculated from patient’s height & weight measured at rehab entry & exit
4 / O = Obstruction, as shown by FEV1 result required for rehab entry (unlikely to be repeated at end of rehab)
5 / D = Dyspnea, as self-reported prior to each 6’ walk test using the 0-4 scale of the Modified Medical Research Council
6 / E = Exercise, distance in meters performed on pre & post 6’ walk tests (divide feet by 3.3)
7 / Discuss which of the BODE factors might be impacted by PR participation
8 / Select a patient’s chart to use as a case example; find that patient’s values for each of the BODE components & enter those into a BODE scoring table
9 / Use the published BODE scoring guide to assign points to the patient’s values, then total the points to obtain overall BOPDE score
10 / Enter total BODE score into the appropriate column (pre or post) on the patient’s outcome data sheet
11 / Determine %prognosis from total points by using online calculating tool located at:
12 / Observe extent of change in total BODE score from pre to post rehab to note impact of PR on prognosis

Resources & References:

Reference:
Celli BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. New England Journal of Medicine 2004; 350 (10): 1005.12. / Resources:
  • BODE scoring guide & worksheet
  • MMRC dyspnea scale
  • Website for calculating prognosis:

Cross-reference:

AACVPR’s Clinical Competency Guidelines for Pulmonary Rehabilitation Professionals. JCRP 2010; pg 29, Patient Assessment & Management: Knowledge bullet 3:

Pulmonary assessments, diagnostic tests, & procedures including PFTs, staging of COPD, & BODE Index

Evaluation: Signature ______Date ______

** any/all ratings of Inadequate require a corrective action plan tailored to the staff member involved