Couple questions

[toicole]

Is there a place on the MDS to code for ileal conduit? If the person flags for delirium and you don't feel they are in delirium how can you justify this in your rugs, other than declining health or they have an illness?

[Talino]

Accdg. to the books, in an ileal conduit, the ureters are removed from the bladder and attached into a detached section of a part of the small intestine (the ileum) to drain urine. The end of the ileum is then brought out through an opening in the abdominal wall. Thus, meets the definition of Section Hi. Ostomy Present - "Any type of excretory ostomy of the gastrointestinal or genitourinary tract." M4g (for the surg'l site, not the stoma, if still new) M5f and P1af when applicable.

'am unclear w/ delirium "flag in rugs", unless you mean triggered in RAPs? If so, just write "See NN date 00/00/09" In the nurses notes or MD progress notes, the change in mental status is explained as attributed to a health condition. See an example in the RAI p4-12 to 4-13. An updated care plan to avert the adverse effects of the delirium will also be beneficial. Also, refer to the Delirum RAP p C5.

If you mean the QM/QI flag, the documentation above will suffice to support the reason.

[mdsnurse-k]

on Rap triggering for delirium. If u don't feel that it is true delirium. explain the situation and check the box for no need to care plan. If u check change in behavior or mood that will trigger delirium.

[nursekara78]

Delirium can also be triggered if you check 'decline in cognition' in B6 on a comprehensive assessment. Section B5 also triggers if any are coded as a 2.

For all RAPS it is a good idea to identify "why they triggered" and "what are you doing a/b it" (what are your interventions)"