"Pressure Ulcers: Case Study and Lessons Learned". (Letters to the Editor).Dear Editor: I have worked in long-term care long-term care (LTC), n the provision of medical, social, and personal care services on a recurring or continuing basis to persons with chronic physical or mental disorders. for many years in many capacities: as a staff nurse, as an MDS MDS, n See temporomandibular pain-dysfunction syndrome. MDS 1 Maternal deprivation syndrome, see there 2 Myelodysplastic syndrome, see there coordinator, as a reimbursement specialist, as an ADON, etc. I read Linda Williams' article ("Pressure Ulcers: Case Study and Lessons Learned," Nursing Homes/Long Term Care Management, January 2003, p. 64) with interest and would like to make the following comments: The current directives for coding the Minimum Data Set (MDS) 2.0 instruct coders that any ulcer appearing on a pressure point must be coded as a pressure ulcer, regardless of the type of ulcer. The directives include a body diagram specifying pressure points. This was done to put all facilities on a level playing field See net neutrality. regarding quality measures/quality indicators and to prevent facilities from doing what you suggested in your article, which is coding/referring to an ulcer as a "blister blister, puffy swelling of the outer skin (epidermis) caused by burn, friction, or irritants like poison ivy. A response of the body to protect deeper tissue, blisters generally contain serum, the liquid component of blood. ." If the suspected cause of the heel "blister" is the resident ambulating in the hallways, the most likely culprit would be the resident's shoe rubbing against her foot. That would still make the "blister" you described a pressure ulcer because pressure can be exerted from multiple sources: a shoe rubbing on the skin; shear when the resident constantly moves in bed; a splint splint, rigid or semiflexible device for the immobilization of displaced or fractured parts of the body. Most commonly employed for fractures of bones, a splint may be a first-aid measure that allows the patient to be moved without displacing the injured part, or it , cast, or immobilizer im·mo·bi·lize tr.v. im·mo·bi·lized, im·mo·bi·liz·ing, im·mo·bi·liz·es 1. To render immobile. 2. To fix the position of (a joint or fractured limb), as with a splint or cast. 3. ; etc. So if the MDS is coded correctly, regardless of what the nurses called the area, this facility would have been going to court with the primary assessment for state and federal reimbursement coded as a pressure ulcer. I think a clarification is needed. Betty Corey, RN CRNAC |
|
||||||||||||||
Printer friendly
Cite/link
Email
Feedback
Reader Opinion