Functional Quadriplegia

SUSAN.SHULIK

Our CDI Department would like input on the proper use of the diagnosis of Functional Quadriplegia, we have not used this diagnosis much and would like feedback on it if possible. This is a scenario that arose recently, we had a patient with severe End Stage MS, described as contractures of extremities with muscle wasting, suprapubic catheter, feeding tube, wound vac, H and P describes unable to move her legs, and has a hard time moving her left arm, (no description of the right arm given).  Neuro states paraparesis and limb ataxia of the left arm, nursing documents right arm 4/5, right leg 1/5, left arm 4/5 , left leg 1/5. With the function of the right arm would this negate the use of this diagnosis- as it states QUADRIPLEGIA. What has triggered the use of this diagnosis in your Facilities? 
 Thank You ahead of time.      Sue
susan.shulik @Butlerhealthsytem.org

kwilliams@halifaxrmc.org

Did patient require TOTAL nursing care? Turning, feeding, bathing, dressing, grooming, toileting? If total care... Yes, Functional Quadriplegia. There is great definition in 2016 CDI Pocket Guide.

rwillcutt

Patients who are functionally quadriplegic are dependent with ADL's such as communication, ambulation, transferring, dressing, eating, swallowing, toileting and bathing.  If you patient is 1/5 only in her LE she would be more functionally paraplegic, wouldn't you say?   This is a perfect example of when you go and speak directly with the nurse who is taking care of the patient.  If she can participate in feeding or turning herself, I would not query.