MDS Alert

Pose these questions to perfect your CAA process.

The Resident Assessment Instrument (RAI) manual does not tell you how to further assess triggered areas in the Care Area Assessment (CAA) process, but that doesn’t mean you can let your MDS software do all the work. You still need to understand, interpret and double-check all the triggered areas in order to complete a solid care plan for each resident.

“Interpreting and addressing CAAs is the basis for the development of individualized care plans,” said Patsy Strouse, RN, the RAI Coordinator for Ohio, in a recent presentation. And each CAA will contain a list of items and responses from the MDS that serve as the triggers for review, called Care Area Triggers (CATs).

The RAI manual contains a list of 20 CAAs:

How Critical Thinking Comes into Play

“Critical thinking is the ability to think clearly and rationally,” Strouse stated. “It includes the ability to engage in reflective and independent thinking.” When you have critical thinking skills, you are able to:

• Understand the logical connections between ideas;
• Identify, construct and evaluate arguments;
• Detect inconsistencies and common mistakes in reasoning;
• Solve problems systematically;
• Identify the relevance and importance of ideas; and
• Reflect on the justification of one’s beliefs and values.

Employing the disciplined manner of thought that is critical thinking in the CAA review will help you to determine whether to go to the care planning stage. And to promote critical thinking, Strouse recommended utilizing the following questions:

• For clarification: Why do you say that? How does this relate?
• For assumptions: What could we assume?
• For reasons and evidence: What is an example?
• For viewpoints and perspectives: What is an alternative?
• What is another way to look at this?
• For implications and consequences: What are you implying? What generalizations can you make?
• Questions about the question: What was the point of this question? What does _______ mean? How does _______ apply in this situation?

Bottom line: Exercising critical thinking skills will help you to delve deeper into those CATs, better analyze the CAAs identified from the MDS, and ultimately develop a more complete and comprehensive care plan.