F 314 and F 315 Tags

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I am looking to see what other LTC organizations are doing...is one person dedicated to skin and incontinence or are the RN's on the individual units doing their own "thing."

I ask this because I track all the pressure ulcers and other skin issues in the building--the ones that I am enlightened enough to know about! However, when the EQUIP data comes out there are people listed that I was never informed of...makes tracking rather hard. People are missing things on initial assessments making some areas look like they are facility acquired when in actuality they were prior to admission. It becomes very frustrating! Each quarter I have to explain why these happened.

Also, as stated in the F-315 tag every resident is to be assessed and diagnosed for their type of incontinence (if they are). Are the RN's on individual floors doing all the assessments or is it better to have one dedicated person in the building? I figure if skin is being missed, reversible incontinence probably is also...

I just can't do all of this and run a unit also...I want to know is what are other places doing?????

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Specializes in Gerontology, Med surg, Home Health.

I've worked in many different facilitie and each one has their own way of doing things. Usually, the nurse manager is responsible for tracking any skin issues on the floor and doing the weekly measuring and documentation. Then there is one person in the building who is in charge of the 'wound program' and keeps track of ALL the wounds. It is crucial that skin be checked within 2 hours of admission. Some of the other admission paper work can wait, but skin is crucial. We got tagged once because we we're documenting someone's superficial.tiny stage 2. It was discovered on one unit and then she was shortly transfered to another. It had a treatment and healing in less than a week, but we got cited for delay of treatment. We had to institute a new form for the floor nurses to fill out to give to the wound queen (me) so the aforementioned queen could keep everything straight. Needless to say the form didn't get filled out too many times.

As for the bladder...we tried having a bladder committee but ended up discussing incontinence at care plan meeting. Corporate was really gungho about a bladder program when the tag first came out but then backed pff a bit because we didn't hear of anyone getting cited for the 'wrong' kind of incontinence. Corporate at on building cited us on mock survey because a resident became incontinent with no follow up, but the 'real' surveryors looked in her chart, too and didn't cite. It's never easy.

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Specializes in Nursing Home ,Dementia Care,Neurology..

We have what are called link nurses for : Infection,continence,wound care,health and safety,manual handling and fire safety.All nurses are responsible for checking their patients skin on the day they come in and documenting any wounds ,bruises or anything else affecting the skin.

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Capecod and nightmare...these dedicated nurses...the "link nurses" and you, CapeCod the "wound queen" is this the primary role that you play in your facility? What are your other duties. I am having a really hard time doing what I do and running a 40 bed unit in under 55-60 hours a week on a salary that didn't increase at all when the extra duties were thrown my way. I love everything that I do at the facility but feel that I need to do NM or Skin but not both.

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Specializes in Nursing Home ,Dementia Care,Neurology..

"Primary role" I wish! no we have to do these link duties on top of everything else we normally do.We do not get paid extra .As well as all the normal caring aspects of the job I also oversee the drug ordering,do the off duty and teach carers towards their SVQ's.There is never enough time in an eleven hour shift to get everything done that you what/need to do!

Different countries------same da*n problems!

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What F Tag has to do with discharge regulations? We are not dual certificated, we have 48 LTC beds and 22 Skilled beds, when a skilled patient is no longer skiled but requires LTC our facility says you can not make them leave so we now have our skilled unit filled up with LTC patients except for 4 skilled patients and 2 empty beds. How do I get administration to uderstand that we can force the issue of making a patient leave when they are no longer skilled. HELP.

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Specializes in ER CCU MICU SICU LTC/SNF.
What F Tag has to do with discharge regulations? We are not dual certificated, we have 48 LTC beds and 22 Skilled beds, when a skilled patient is no longer skiled but requires LTC our facility says you can not make them leave so we now have our skilled unit filled up with LTC patients except for 4 skilled patients and 2 empty beds. How do I get administration to uderstand that we can force the issue of making a patient leave when they are no longer skilled. HELP.

http://www.cms.hhs.gov/manuals/Downloads/som107ap_pp_guidelines_ltcf.pdf

see pp 40-48

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