Pressure Ulcer Staging: Should I Get My Raincoat?
For more than 20 years the National Pressure Ulcer Advisory Panel (NPUAP) has provided leadership in major topics surrounding pressure ulcers, including standardization of the staging system and introducing useful additional classifications of Unstageable and Deep Tissue Injury. However, recent changes on their website show new nomenclature that, in my opinion, risks introducing confusion for caregivers and policy makers. It looks like NPUAP is adding …Read More
Pressure Ulcer Nomenclature and Documentation
Flawed and inconsistent wound documentation has serious risk-management implications. This blog post will examine some fine points regarding pressure ulcer nomenclature and documentation. Many definitions and classification schemes for pressure ulcers were developed over the years and continue to be a source of confusion. As patients move across the healthcare continuum from hospital to rehabilitation facility to nursing home, descriptive data can vary greatly even if …Read More
New Rules for Pressure Ulcer Risk Assessment in Nursing Homes
MDS version 3.0, the mandatory assessment tool for residents of skilled nursing facilities, was finally implemented October 2010 after years of planning. Section M: Skin Condition has been completely revised and expanded. This blog post will address MDS 3.0 sub-section M0100: Determination of Pressure Ulcer Risk, which approaches “at-risk” status in a much more sophisticated and clinically acceptable manner than past versions, enabling better targeting of preventive …Read More
Government Study Cites Flawed Medical Device Approval Process
FACT: Many wound-care products are considered “medical devices” with limited data on efficacy. A new study released by the Institute of Medicine points out that the FDA’s approval process for medical devices is flawed. Medical devices include high profile items such as hip replacements, but this class of products also contains many items on the market to treat chronic wounds. The New York Times noted that even …Read More
Pressure Ulcer Prevention for Patients in Wheelchairs
In most cases pressure ulcer prevention can be accomplished by risk assessment followed by common sense choices for pressure reduction. In these days of evidence based medicine, health care providers need to listen to the evidence and implement best practices to reduce the incidence and prevalence of adverse outcomes such as pressure ulcers. An important research article on pressure ulcer prevention recently came out in …Read More
Free Online Training for MDS 3.0 Section M: Skin Condition
This is the video of the pressure ulcer assessment and coding training session for MDS 3.0 Section M: Skin Condition that I delivered in Las Vegas on August 10, 2010. It was posted online by the Centers for Medicare and Medicaid Services (CMS) on January 20, 2011. This lecture was part of the CMS sponsored introduction to MDS 3.0 that was free to any facility or provider who …Read More
Pressure Ulcer Guide Exhibited in Las Vegas at NPUAP
I just got back from the National Pressure Ulcer Advisory Panel Biennial Meeting in Las Vegas, where my Pocket Guide to Pressure Ulcers was exhibited and given its debut in digital format. The guide was authored by myself and Elizabeth Ayello PhD, RN, and has sold over 30,000 copies internationally. The book is published by New Jersey Hospital Association (NJHA) Healthcare Business Solutions, and their …Read More
Common Questions on Coding for MDS 3.0 Section M: Skin Conditions
I recently gave another training session for nursing home professionals for MDS 3.0 Section M: Skin Conditions. In the audience were nurses, directors of nursing, administrators, MDS coordinators and a smattering of physical therapists, doctors, and social workers. After the didactic I fielded questions and decided to share the most common ones with my blog readers. Question 1: How do I code Section M0700 when …Read More
Straight Talk on Reverse Staging of Pressure Ulcers
The issue of “reverse staging” or “backstaging” of pressure ulcers as they heal is often a cause for confusion, even for some experts. With this blog post I hope to clarify things and explain why reverse staging is now discouraged when assessing wounds, and place the issue in context with the revised Minimum Data Set (MDS) 3.0 Section M: Skin Conditions, which went into effect October …Read More
Does MDS 3.0 Section M Avoid the Unavoidable?
The revised Resident Assessment Instrument (RAI) with the new MDS 3.0 Section M: Skin Conditions radically expands the assessment process for pressure ulcers in Medicare certified skilled nursing facilities. In contrast to the prior version, there are data fields for improving or deteriorating pressure ulcers, ulcer measurements, and tissue type at the base of the wound. Important issues such as “present on admission” and updated …Read More
