CSM guidelines for Pressure Ulcers

[CapeCodMermaid]

Yikes...another "new" guideline....another item the state can tag us on. How are all y'all dealing with the new CSM guidelines on Pressure Ulcers? I am the wound committee and my corporation just rolled out a huge new policy on pressure ulcers. I am not really sure how in the world we will get the documentation done. I am everso thrilled that my facility has a VERY low incidence of acquired pressure sores, but the new regs seem unbelievably tedious and time consuming.

[southern_rn_brat]

It really isn't that you have to prevent the sore.. If a resident is at risk for a pressure ulcer, the facility must have a plan of care in place TO TRY and prevent the sore from occurring. This is where a great Care plan coor. would come in handy. If the facility has put interventions into place and the resident still develops the wound despite the facilities best efforts, then the sore must be tracked, the MD must be notified of healing/non healing, treatments that aren't working must be changed, etc. Hope this helps. I did read the big packet..haha If the facility fails to to do any of this, they could potentially be looking at a harm level citation.

oh sure sandra...show me up by reading that big packet

(can you pm me with the highlights? :chuckle )

[NRSKarenRN, BSN, RN]

Read the regs online!

Search for section:

483.25© Pressure Sores

http://www.cms.hhs.gov/manuals/107_som/som107ap_pp_guidelines_ltcf.pdf

[zuchRN]

Right now, we do weekly skin assessments on all residents. We rare;y deve;ope in-house pressure ulcers. I think we have had one in the last 6-months. obviously, our focus is prevention, because it is obviously too much work if one does develop!!! ha ha. I am blessed with wonderful nurses and aids who really understand and get it!!! I also do rounds on all shifts and rather than rant and rave if a heel isn't perfectly rfloated, I educate. I find that this works wonderfully and usually the same error in judgement does not occur again! However, we do admit people who have wounds. We complete pain assessments every shift, we complete documentation every shift: if the dressing is in place we document peri-wound and then if dressing is changed we document periwound, wound bed, wound edges, drainage and all the other wonderful wound stuff. We also complete the Braden scale on each residetn with a pressure ulcer weekly. The Braden scale is also done weekly upon admission. We now have to document the resons that they score low in a particular section of the braden scale and what interventions we are goingto put into place to help maximize the score in that category. I know that it sounds like a lot, but it takes minimal time. I do believe we probably spend a total of 1-2 hours a week on wound documentation. Hope this helps.

[CoffeeRTC, BSN, RN]

Didn't read the whole thing, but isn't this what we should be doing are are already doing? Looks like what we are doing now.