pressure ulcer tool

Advancing Excellence in America’s Nursing Homes

A Review of 2 Clinical Tools:Pressure Ulcer and

Restraints

www.nhqualitycampaign.org

Pressure Ulcer Tool

•Clinical tools are for internal performance improvement work only

•There is no website data entry required with the clinical goals

•Use this to track these clinical goals in the absence of the Quality Measures


Pressure Ulcer Campaign Resources

•Implementation Guide•Pressure Ulcer Fact Sheets

–1 for consumers–1 for nursing home staff

•Tracking Tool & Instructional Webex•Video’s, Guidance and much more

4

Resources


Website: Pressure Ulcer Resources


Pressure Ulcers– Goal Definition

Goal 4 Pressure Ulcers:

Nursing home residents receive appropriate care to prevent and appropriately treat pressure ulcers when they develop.


National Pressure Ulcer Data

Some Key Campaign Objectives: By December 31, 2011

• The national average for high risk pressure ulcers will be below 9%

• 30% of nursing homes will report rates of high risk pressure ulcers at or below 6%

• 22,500 fewer residents will have pressure ulcers compared to 6/06


Using The Pressure Ulcer Tool

• Go to the Goal and download the tool into your computer.• You will need Excel.• Size the tool to fit your computer.• The data is entered just one time per month – pick a date

and stay with it consistently.• Gathered information before filling out the tool.• Information can be found through several sources in your

nursing home including MDS 3.0 submissions and reports, Pressure Ulcer reduction committee notes, individual resident medical records and charting, and from admission information - to name a few sources.

• Data is entered in the blue columns.


Special Tool Features

• Allows nursing home to monitor in-house acquired and admission acquired by source and stage

• Identifies settings where pressure ulcers come from

• Provides multiple graphs for ongoing monitoring• There are currently no questions and answers

tied to this tool• The tool has been revised and updated for July

2011


Pressure UlcerTool

Demonstration/ Screen Shots


Pressure Ulcer Welcome Page


Pressure Ulcer Instruction Page


Pressure Ulcer Data Entry Page


Pressure Ulcer Tool - Graphs and Trends


Monthly Notes

www.nhqualitycampaign.orgwww.nhqualitycampaign.org

Physical Restraint Goal

Goal 3 – Physical Restraints: Nursing home residents are independent to the best of their ability and rarely experience daily physical restraints.


Restraint Campaign Resources

•Implementation Guide•Restraint Fact Sheets

–1 for consumers–1 for nursing home staff

•Tracking Tool•Video’s, Guidance and much more


Website: Restraint Goal Resources


Use the Restraint Tracking Tool

•Go to the Goal and download the Excel based tool

•Compile data monthly and update the tool (from MDS 3.0 and records)

•Enter data weekly – tool uses 12 weeks of data then start over

•Print off graphs for trending


Use the Restraint Tracking Tool

•Clinical tools are for internal quality improvement work only

•There is no website data entry required with the clinical goals

•Use this to track your restraints in the absence of the Quality Measures


Restraint Tool Welcome Page


Restraint Instruction PageRestraint Tool Instruction Page


Restraint Instruction PageRestraint Tool Q & A Page


Restraint Instruction PageRestraint Data Entry Page Week 1


Restraint Instruction PageRestraint Data Entry Page Week 2


Restraint Instruction PageRestraint Graph / Trends Page


Goal 6: Advance Care PlanningRestraint Goal Data Input Portal


Restraint Tracking Tool Questions

Q: What is a restraint? A: CMS defines “physical restraints” in the

State Operations Manual (SOM), Appendix PP as, “any manual method or physical or mechanical device, material, or equipment attached or adjacent to the resident’s body that the individual cannot remove easily which restricts freedom of movement or normal access to one’s body.



Q. Can restraints be used for the purpose of "safety" to reduce the potential for falls?

A: Although the requirements describe the narrow instances when physical restraints may be used, growing evidence supports that physical restraints have a limited role in medical care. Restraints limit mobility and increase the risk for a number of adverse outcomes. Physical restraints certainly do not eliminate falls. In fact in some instances reducing the use of physical restraints may actually decrease the risk of falling.



Q: How is the Physical Restraint rate calculated on the publicly reported long stay quality measure?

A: MDS 3.0 codes three categories for restraint use; "0" for no restraint, "1" for used less than daily, and "2" for daily use. Nurse must determine restraints used when resident is in bed separately from restraints used in chair or out of bed. Bed rails or chair preventing resident from rising, trunk restraints, and limb restraints are counted separately in each category. This is different than MDS 2.0. For the purposes of this tool, restraint use, following the guidelines of MDS 3.0, will be totaled for all residents who have a restraint while in bed and separately totaled for all residents who have a restraint while in chair or out of bed.



Q. May I go back and change incorrect information?

A: Yes. Simply highlight the information to change, right click, select "Clear Contents," and then enter the corrected data.

Q. Where do I find the data that I will enter on this internal tracking tool?

A: This data can be found in the most recent MDS Section P0100 of each resident MDS 3.0 and should be entered when coded as a 1 or 2 in section P. Your software provider may offer a submission summary form that will enable you to easily locate and tally this information. This tool is designed to assist NHs to collect their own internal data and to monitor their improvement.


No Campaign Data Entry

There is no Campaign Website Data entry required for any of the clinical goals.

This tools is provided for your internal tracking, monitoring and Performance Improvement purposes

Website data entry is only required for the “organizational” goals (goal #’s1,2,6,7 & 8)


Thank You!

Tammy Rolfe(207)242-5386

[email protected]

pressure ulcer tool

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