MDS Alert

Are you including these issues in your risk-management meetings?

Perspective can be everything when it comes to identifying resident's risks for negative outcomes.And sometimes you may have to think outside the usual risk parameters -- or focus more intensely on the usual ones -- to keep problems from falling through the cracks.

Key: Look at how you define high-risk when reviewing residents at routine risk-management meetings. For example, do you include residents who can't communicate their needs? asks Joy Jordan, RN, MSN , RAC-CT, a consultant with Boyer & Associates Inc. in Brookfield, Wis. Surveyors will want to make sure that staff members are anticipating those residents' needs, she cautions.

In addition, review anyone on thickened liquids, and monitor whether the resident has thickened liquid at the bedside and how long it sits there, Jordan adds. "Does everyone involved in the resident's care know how to mix the thickened liquids?"

Target this before surveyors do: Look for residents who have an episode of choking documented in the medical record who haven't received a speech therapy evaluation, advises Cheryl Boldt, RN, a consultant in Omaha, Neb.

Also use the risk management meeting to review patients on psychotropics who have behavioral symptoms, even though you're also taking a look at those folks during behavioral and/or pharmacy reviews, advises Jordan. "What else is the facility doing or should it be doing if the person on the medication still has behaviors?"

"The same is true of weight loss and pressure ulcers," advises Jordan. Those "issues are often reviewed in separate meetings, but they are also high-risk issues."

Also identify residents with a stage 1 pressure ulcer as high risk because the wound will progress if the team doesn't do anything about it, advises Jordan.