MDS Alert
This resident developed a Stage 4 decub.
A resident with a reddened area developed a Stage 4 pressure ulcer (see the case study on p. 16). Assessment data included the following: • Braden Scale completed on admission. Score = 16 (mild risk) - No impaired sensory perception - Rarely moist - Chair-fast - Very limited mobility - Adequate nutrition - • Fall Risk = Borderline • Bowel & Bladder = Foley, continent bowel • Pain assessment = no pain • Side rails = indicated as enabler • Assessments done by RN • Chronic diagnoses include venous insufficiency, hypothyroidism, weight loss, GERD, HTN • Meds: Levoxyl, Aldactone, Prevacid, Lasix, Lovenox, Prilosec Hospital Information: • Admit Diagnoses S/P ORIF Lt Hip fx & Pinning Lt Humeral Fx - Hypothyroidism - Recent weight loss? Etiology - GERD - Bilateral venous insufficiency - Venous stasis changes - History of venous stasis ulcers - s/p Hepatitis - s/p Breast CA (in remission) - Foley catheter care RAPs: - ADL functional/rehabilitation - Urinary incontinence & indwelling catheter - Locomotion deficit/use of wheelchair, incongruent with previous lifestyle - At risk for falls - At risk poor nutrition, only eats 25 percent - Dehydration - diuretic/laxative use - Pressure ulcers, turning & repositioning, ulcer care, dressings, pressure relieving devices Source: Excerpted from a handout provided as part of an Advancing Excellence Webinar presentation by Debra Bakerjian, RN, MSN, PhD.
Problem with friction and shear
MDS Alert
- Medicare:
Leaving These Key RUG Drivers Behind Could Put Your SNF in a Fiscal or Survey Bind
Most SNFs home in on the IV fluids and IV meds in the hospital lookback. [...] - RUG Calculation:
Will the Resident Go Into SE1, SE2 or SE3?
Find out how the points add up If the resident is coded for receiving one [...] - Risk Management:
Shore Up Pressure Ulcer Care With 'Lessons Learned' From This Real-Life Scenario
Find out if your facility is wide open to a similar disaster A few common [...] - Quizzer (Answer page 23):
Cut Through the Confusion for Assessing, Coding Delirium
How would you code this resident's behavior at B5 (Indicators of Delirium -- Periodic Disordered Thinking/Awareness)? [...] - Quality Improvement:
Solid Case Management Can Move Your Rehab Program to the Head of the Class
These fail-proof strategies address what ails many rehab programs -- and will get your RUGs jumping. [...] - Resident Assessment:
This resident developed a Stage 4 decub.
A resident with a reddened area developed a Stage 4 pressure ulcer (see the case [...] - READER QUESTION:
Can SNFs Still Count Rehab Provided by Therapy Aides?
Question: Our facility has heard rumors that changes in therapist assistant requirements mean we can't [...] - ADL Assistance:
Turn Bath Time Into Quality-of-Life and Care Time
A combo of strategies can make a big difference in resident behavioral and satisfaction outcomes. [...] - Tool:
Check Out This Pressure Ulcer Risk Assessment
Determining a patient's pressure ulcer risk can start with a solid assessment form, although you [...] - Coding Tipster:
3 Strategies Help Error-Proof Pressure Ulcer Dx, Coding
Ease the pressure for getting it right. Accurately coding pressure ulcers in Section M is [...] - Coding Quizzer Answer :
Cut Through the Confusion for Assessing, Coding Delirium
Answer: a. Easily distracted: 2 (present, new) b. Periods of altered perception or awareness of [...] - MDS & Coding NEWS
Prepare for ICD-10 now to get a step ahead of the learning and software curve -- [...]
