The QIS staff interview questions can help with QI and survey preparation.
Staff can answer the interview questions by using resources such as the chart, MAR, flowsheets, etc.,says Diane Vaughn, RN, C, LNHA, regional director of Minnesota operations for Pathway Health Services in White Bear Lake, Minn. "For facilities that do have the QIS, it's great to go through the questions with [staff] so they won't be alarmed when they have to answer them during the survey,"Vaughn adds. The staff interviews tell you how well the nursing staff understands the residents' conditions or have the ability to find the information, adds Robin Bleier, RN, LHRM-FACDONA, principal of RB Health Partners Inc. in Tarpon Springs, Fla. For example, if the person has floated to a unit or is new to the building, does the person know how to access the data?
Check out the interview questions and related documentation:
Catheter Use
Is there use of an indwelling Foley catheter?
If yes, what is the reason for the catheter (the diagnosis of neurogenic bladder must be verified in the medical record). Mark all that apply.
Obstruction___
Neurogenic/atonic bladder ___
Stage III or IV perineal/sacral
pressure ulcer ___
Terminal illness ___
Mobility impairment ___
Coma ___
Resident request ___
Incontinence ___
Unknown ___
Other, describe ___
Nutrition
Is this resident receiving a nutritional supplement, defined as a prescribed high protein, high calorie,nutritional supplement between or with meals? (There must be documentation in the medical record.)
No ___
Yes ___
N/A, resident receives tube feedings/
NPO ___
Following discussion with staff about whether a resident receives a supplement, the interview guides the surveyor to request documentation of a recording and monitoring system to support a yes answer. This documentation may include a checkbox or checklist that the supplement was given, provide a percentage of supplement consumed or list the amount consumed. Any of these methods are acceptable. The following sources may provide supporting documentation:
Medication Administration Record
Treatment Record
Snack/Supplement List
Meal documentation with supplements listed separately
Other source(s) as indicated by facility staff
Skin Care/Pressure Ulcers
Does the resident currently have one or more pressure ulcers? If yes,indicate the stage of the most advanced pressure ulcer.
No ulcer
Stage I
Stage 2
Stage 3
Stage 4
Stage 4
STAGE I: a persistent area of skin redness (without a break in the skin) that does not disappear when pressure is relieved.
STAGE II: a partial thickness loss of skin layers that presents clinically as an abrasion, blister, or shallow crater.
STAGE III: a full thickness of skin is lost, exposing the subcutaneous tissues -- presents as a deep crater with or without undermining adjacent tissue.
STAGE IV: a full thickness of skin and subcutaneous tissue is lost, exposing muscle or bone.
Side rails
Are side rails (includes half or quarter rails) used for this resident?
If no, skip to contractures below.
If yes: Is the resident physically capable of getting out of bed on his or her own? If yes, when the rails are raised, do they prevent the resident from voluntarily getting out of bed?
Contractures
Does the resident have a contracture? (Defined as a condition of fixed high resistance to passive stretch of a muscle). If no, skip to falls.
If yes, does the resident receive range of motion services or have a splint device in place?
Falls and Fractures
Has the resident had a fall and/or sustained a fracture within the last 30 days?
Resource: Download the interview form at www.uchsc.edu/hcpr/qis_manual/Tab5/CMS20051%20Staff%20Interview.pdf.