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Discussion

stasis vs.pressure

Have a resident admitted in March --staff documented pressure area on ankle which she had on admission stage two area---I can't remember looking at the area but feel I did---counted pressure area on 5 day,14 day,30 day and 60 day---for her 60 day the PA saw her and documented chronic stasis area for her stage two area on inner ankle that I counted as pressure--she did see her and documented that on her ARD for 60 day but her progress note was not available till few days later---the resident is now open for a quarterly 6-14-16--she was seen 6-10-16 and PA still document chronic stasis area---feel like I should change this to a stasis area??? if I put in stasis area ,question comes up for "was there a pressure area on last assessment"--should I keep coding pressure??? should I correct the 60 day???she does have dx PVD--she is to see a vascular doctor on 7-5-16---doesn't help me with this assessment---this is confusing I know and thank you ahead of time

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Was there a physician statement that the area was a pressure ulcer when captured in the prior MDSs? If it was solely based on a "nursing assessment", the PA's current diagnosis supersedes the previous finding. You will need to correct (modify) all MDSs that were miscoded as pressure ulcer.

That is certainly tricky. It may be both a stasis ulcer and a pressure ulcer. As Talino mentioned if there is no documentation for the previous MDS from the MD, and you have just based it on nursing judgement, it would be stasis.

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