AHRQ's Safety Program for Nursing Homes: On-Time Pressure Ulcer Prevention
Functional Specifications
3. Specifications for Each Pressure Ulcer Prevention Report (continued)
3.5. Trigger Summary Report: Unit Level
3.5.1. Report Description
The unit-level view displays the number of residents (and percentage of the total nursing unit census) who have met each pressure ulcer risk criteria for 4 consecutive weeks. The report displays an indicator or color-coding to show improvement (green) or decline (red) in values from the prior report week. The type of indicator to use for improvement/decline depends on the EMR vendor. The vendor may offer table results in a graphic display as well.
3.5.2. Dependencies and Clinical Assumptions
See above for Resident Level.
3.5.3. Report Example
Pressure Ulcer Triggers | Week 4 5/10/14 |
Week 3 5/17/14 |
Week 2 5/24/14 |
Week 1 5/31/14 |
---|---|---|---|---|
Wt Loss ≥ 5% in Prior 30 Days (ANY) | 1 (3%)(c) | 2 (6%)(a) | 1 (3%)(b) | 1 (3%)(c) |
Wt Loss ≥7.5% in Prior 90 Days (Point-to-Point) | 1 (3%)(c) | 1 (3%)(c) | 1 (3%)(c) | 1 (3%)(c) |
Wt Loss ≥10% in Prior 180 Days (Point-to-Point) | 1 (3%)(c) | 2 (6%)(a) | 1 (3%)(b) | 2 (3%)(a) |
2 Meals ≤50% in 1 Day | 5 (14%)(c) | 4 (11%)(b) | 4 (11%)(c) | 7 (20%)(a) |
Weekly Meal Intake Average <50% | 3 (9%)(c) | 3 (9%)(c) | 2 (6%)(b) | 3 (9%)(a) |
Daily Urine Incontinence | 2 (6%)(c) | 3 (9%)(a) | 3 (9%)(c) | 5 (14%)(a) |
>3 Days Bowel Incontinence | 5 (14%)(c) | 4 (11%)(b) | 3 (9%)(b) | 7 (20%)(a) |
Foley Catheter | 8 (23%)(c) | 7 (20%)(b) | 5 (14%)(b) | 8 (23%)(a) |
Current Pressure Ulcer | 0 (0%)(c) | 0 (0%)(c) | 0 (0%)(c) | 0 (0%)(c) |
Note: The report has been color coded with red (a) representing an increase, green (b), a decrease, and white (c), no change in weekly pressure ulcer trigger prevalence.
3.5.4. Valid Input, Calculations, and Displays
3.5.4.1. Completeness of main categories for each resident must be >75% in order to calculate the triggers.
3.5.4.2. The report uses static week calculations for all 4 weeks, unlike the Nutrition Risk Report, which uses a dynamic week for the first or current report week.
3.5.4.3. The current week is the most recent full week (e.g., if the report is generated on a Tuesday, then use the week ending date for the prior Saturday or Sunday, depending on which days the facility uses for its static week parameters).
Report Rows | Data Source | Valid Input & Display |
---|---|---|
Wt Loss ≥5% in Prior 30 Days (Any) | Vital Signs or Weight documentation | For each static week:
|
Wt Loss ≥7.5% in Prior 90 Days (Point-to-Point) | Vital Signs or Weight documentation | For each static week:
|
Wt Loss ≥10% in Prior 180 Days (Point-to-Point) | Vital Signs or Weight documentation | For each static week:
|
2 Meals ≤50% in 1 Day | CNA documentation of meal intake | For each static week:
|
Weekly Meal Intake Average <50% | CNA documentation of meal intake | For each static week:
|
Daily Urine Incontinence | CNA documentation of resident bladder habits | For each static week:
|
>3 Days Bowel Incontinence | CNA documentation of resident bowel habits | For each static week:
|
Foley Catheter | Physician Orders or nurse documentation | For each static week:
|
Current Pressure Ulcer | Nurse Wound Assessment | For each static week:
|
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