section m help

[Mistyrose123]

hello all, I am new to MDS. have two situations that I need clarification with.

1. had a patient go to hospital with a unstagable pressure ulcer, acquired. res returned with a stage 3 pressure ulcer. is this still acquired or admitted.

2. If friction occurs in say the sacral area, is this a skin tear. is not a stage 2. is clearly from being dragged.

thanks for any help.

[Talino]

1. Not present on admission” since the unstageable injury was originally acquired in the facility.

"4. If the pressure ulcer was unstageable on admission/entry or reentry, but becomes numerically stageable later, it should be considered as present on admission” at the stage at which it first becomes numerically stageable. If it subsequently increases in numerical stage, that higher stage should not be considered present on admission.” RAI, M7

In your case, it would be the reverse.

2. Since it's in a bony-prominent area, it is a St 2

Stage 2 pressure ulcers are often related to friction and/or shearing force, and the care plan should incorporate efforts to limit these forces on the skin and tissues. RAI, M-9

A pressure ulcer is localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction. RAI, M-4

Key areas for pressure ulcer development include the sacrum, coccyx, trochanters, ischial tuberosities, and heels. Other areas, such as bony deformities, skin under braces, and skin subjected to excess pressure, shear or friction, are also at risk for pressure ulcers. RAI, M-4

[Mistyrose123]

thank you talino!! it seems I know this but when someone else says it, it makes better since. thank you very much