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Table 1.1. Sample CNA Documentation Data Elements Comparison Grid: Worksheet

On-Time Quality Improvement Manual for Long-Term Care Facilities

Row #On-Time Requirement
CNA Data Elements
Facility: Element AvailableFacility: Element Not Available
 WeightX 
 Eating  
 Unavailable for Meal X
        76-100%X 
        51-75%X 
        26-50%X 
        1-25%X 
 RefusedX 
 NPO X
 Tube feeding X
 Bowels  
        No bowel movement X
        Continent stoolsX 
        Incontinent stoolsX 
        Loose stoolsX 
 Bladder  
        Did not void X
        Indwelling catheterX 
        Continent urineX 
        Incontinent urineX 
 Skin Observations  
        Red areas X
        Open areas X
        None of the above observed X
 Behavior Symptoms  
        Frequent crying X
        Repeats verbalization X
        Repeats movement X
        Yelling/screaming X
        Kicking/hitting X
        Pinching/scratching/spitting X
        Biting X
        Wandering X
        Abusive language X
        Threatening behavior X
        Sexually inappropriate X
        Resistant to care X
        None of the above observed X

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Current as of January 2011
Internet Citation: Table 1.1. Sample CNA Documentation Data Elements Comparison Grid: Worksheet: On-Time Quality Improvement Manual for Long-Term Care Facilities. January 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/long-term-care/resources/ontime/ontimeqimanual/qimanltab1-1.html