MDS Alert

Prevent recurring elopement with the Investigative Protocol.

When you have a resident who manages to escape or attempts elopement, you’ll have some serious damage control to do (after you find the resident, of course).

Remember: When wandering or elopement incidents occur, you would report them under F323, Accidents and Supervision (see MDS Alert, Vol. 10, No. 9, pages 105 – 108 for MDS coding instructions).

According to Betty MacLaughlin Frandsen, RN, NHA, MHA, C-NEin a recent article for the American Association of Nurse Assessment Coordination (AANAC), the Investigative Protocol for F323 includes the following steps to take regarding elopement concerns:

1) Review the RAI, progress notes, physician orders, and nurses’ and consultants’ notes regarding the assessment of the resident’s overall condition and risk factors, to determine:

o Whether the resident’s risk has been identified, evaluated, and analyzed; and

o Whether interventions are being implemented, monitored, and modified as necessary.

2) Determine whether the assessment is consistent with documentation in the record and reflects the resident’s elopement status.

3) Review the plan of care to determine whether elopement-prevention interventions were developed based on the resident’s individual risks, and whether the plan is modified as needed based on the resident’s response, outcomes and needs.

4) If elopement attempts occurred, determine whether the causes were investigated and interventions were revised to prevent additional avoidable occurrences.

5) Determine whether staff monitored the resident and reviewed the effectiveness of the plan of care interventions and either made revisions or documented justification for continuing the existing plan based on the following:

o The outcome and/or effects of goals and interventions;

o Resident failure to comply with the plan of care and interventions;

o Input by the resident and/or responsible party; and

o Changes in condition, such as decision-making ability, cognition, and functional impairment, or changes in the medication regimen.

Bottom line: "Impress on staff in every department that elopement prevention is everyone’s responsibility," Frandsen stressed in the article. "Only when employees from all departments are fully educated and protocols are followed on all shifts every day can we provide safety for our residents."