On-Time Pressure Ulcer Healing: Facilitator Training

Introduction to Pressure Ulcer Healing Reports Slide Presentation: AHRQ’s Safety Program for Nursing Homes

Text version of slide presentation.

Slide 1: Introduction to Pressure Ulcer Healing Reports

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AHRQ’s Safety Program for Nursing Homes:
On-Time Pressure Ulcer Healing Facilitator Training

Slide 2: Pressure Ulcer Healing Electronic Reports

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  • Electronic Reports:
    • Existing Pressure Ulcers Report.
    • Pressure Ulcers at Risk for Delayed Healing.
    • Weekly Wound Rounds Report.
    • Weekly Pressure Ulcer Treatment Summary Report.
    • Pressure Ulcer Counts by Month Report.

Slide 3: Teaching the Pressure Ulcer Healing Electronic Reports

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  • The teaching sessions for each report should include the following content:
    • Purpose of the report.
    • Content of the report.
    • Calculation details.
    • Quizzes and exercises.

Slide 4: On-Time Pressure Ulcer Assessment

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On-Time Pressure Ulcer Assessment

Slide 5: Purpose of On-Time Pressure Ulcer Assessment

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  • Provides information used in healing reports.
  • Provides a set of structured, standardized data elements for comprehensive documentation of weekly pressure ulcer characteristics.
  • Incorporates elements from the Bates-Jensen Wound Assessment Tool (BWAT) with standardized treatment and intervention descriptors.
    • Treatment interventions are consistent with those cited in current International Pressure Ulcer Prevention and Treatment Guidelines.

Slide 6: Content of On-Time Pressure Ulcer Assessment

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  • Ulcer origin (present on admission [POA] or in-house acquired [IHA]).
  • Onset date.
  • Site.
  • Initial stage.
  • Size (length, width, depth).
  • Wound edges.
  • Undermining.
  • Tunneling.
  • Necrotic tissue type and amount.
  • Drainage/exudate type and amount.

Slide 7: Content of On-Time Pressure Ulcer Assessment

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  • Periwound area (skin color, heat/redness, edema, induration).
  • Granulation tissue.
  • Epithelialization.
  • Ulcer pain.
  • Current stage.
  • Followup status (improving, no change, worsening) per nurse observation.
  • Treatments.
  • Adjunctive therapies.
  • Interventions and consultations.

Slide 8: Sample On-Time Pressure Ulcer Assessment

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Image: The first page of a sample On-Time Pressure Ulcer Assessment form is shown.

Slide 9: Sample On-Time Pressure Ulcer Assessment

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Image: The second page of a sample On-Time Pressure Ulcer Assessment form is shown.

Slide 10: Sample On-Time Pressure Ulcer Assessment

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Image: The third page of a sample On-Time Pressure Ulcer Assessment form is shown.

Slide 11: Sample On-Time Pressure Ulcer Assessment

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Image: The fourth page of a sample On-Time Pressure Ulcer Assessment form is shown.

Slide 12: Sample On-Time Pressure Ulcer Assessment

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Image: The fifth page of a sample On-Time Pressure Ulcer Assessment form is shown.

Slide 13: Existing Pressure Ulcers Report

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Existing Pressure Ulcers Report

Slide 14: Existing Pressure Ulcers Report

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  • Provides the clinician with a comprehensive list of all residents currently in the facility who have at least one existing pressure ulcer during the report week.
  • Displays the following:
    • Resident name and room number.
    • Days from admission to ulcer onset and ulcer days.
    • Ulcer onset date, site, initial and most recent stage.
    • Ulcer status, number of treatments.
    • If an ulcer is considered "at risk for delayed healing."

Slide 15: Existing Pressure Ulcers Report

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  • Drawn from nurse documentation of weekly pressure ulcer assessments.
  • Displays each pressure ulcer separately (i.e., residents with >1 ulcer will appear multiple times).
  • Can be filtered to display residents at the unit and facility level.
  • Not intended to be used as a standalone report in care planning and clinical decisionmaking but can provide a summary of current pressure ulcers being monitored.

Slide 16: Existing Pressure Ulcers Report

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  • Complete information displays for each ulcer if the pressure ulcer assessment date is within 10 days of the prior report date.
  • If an ulcer has not healed and the last assessment date is >10 days prior, the following values will be blank:
    • Ulcer status.
    • Number of treatment changes.
    • At risk for delayed healing indicator.
    • Most recently assessed ulcer stage.
    • Ulcer days.

Slide 17: Sample Existing Pressure Ulcers Report

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On-Time Existing Pressure Ulcers Report
Unit: A
Date: 02/10/14

Resident Name (last, first) Room Number Days From Admit to Ulcer Onset Ulcer Onset Date Ulcer Site Ulcer Days Initial Ulcer Stage Most Recent Assessed Ulcer Stage Ulcer Origin Ulcer Status # Treatment Order Changes At Risk for Delayed Healing
Resident A 102 0 12/23/13 Cox 47 3 4 POA* IM 3 X
Resident B 111 482 12/23/13 Iliac L 50 3 3 IHA IM 2  
Resident D 113 49 12/30/13 Heel R 43 4 4 IHA WO 3 X
Resident D 113 0 11/12/13 Troch R 91 4 4 POA WO 1 X
Resident H 121 0 12/14/13 Anko R 59 1 3 POA* NC 1 X
Resident J 101 35 01/20/14 Ear L   1   IHA      

Note: POA* indicates that the pressure ulcer was present on admission but has gotten worse (increased in ulcer stage since admission).

Slide 18: Reviewing Existing Pressure Ulcers Report Calculation Details

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  • Days From Admit to Ulcer Onset.
  • Ulcer Onset Date.
  • Ulcer Location.
  • Ulcer Days.
  • Initial Ulcer Stage.
  • Most Recent Assessed Ulcer Stage.
  • Ulcer Origin.
  • Ulcer Status.
  • Number of Treatment Order Changes.
  • At Risk for Delayed Healing.

Slide 19: Check Your Understanding: Existing Pressure Ulcers Report Quiz

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  1. Residents with multiple pressure ulcers will appear multiple times on the Existing Pressure Ulcers Report.
    1. True
    2. False
  2. The Existing Pressure Ulcers Report may be used as a “standalone” report when making care planning decisions.
    1. True
    2. False

Slide 20: Check Your Understanding: Existing Pressure Ulcers Report Quiz

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  1. Complete information will not display for each ulcer if an assessment has been done:
    1. 1 day before the report date
    2. 5 days before the report date
    3. 7 days before the report date
    4. 11 days before the report date
    5. None of the above

Slide 21: Pressure Ulcers at Risk for Delayed Healing Report

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Pressure Ulcers at Risk for Delayed Healing Report

Slide 22: Pressure Ulcers at Risk for Delayed Healing Report

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  • Alerts staff to residents with pressure ulcers showing signs of potential delayed healing.
  • Promotes earlier identification so that interventions can be modified to hasten healing.
  • Displays the following:
    • Pressure ulcer details (onset date, location, initial stage, origin, current stage, number of treatment changes.
    • Surface area (initial and 3 most recent measures).
    • BWAT (initial and 2 most recent scores).
    • Delayed healing criteria.

Slide 23: Pressure Ulcers at Risk for Delayed Healing Report

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  • Delayed healing criteria developed with consideration of the current International Pressure Ulcer Prevention and Treatment Guideline and input from clinical experts in pressure ulcer and long-term care.

Slide 24: Pressure Ulcers at Risk for Delayed Healing Report

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  • Delayed healing criteria:
    • No reduction in surface area in past 2 weeks.
    • Increase in pressure ulcer stage.
    • Decline in tissue characteristics:
      • Decline in quality of granulation tissue.
      • Appearance of necrotic tissue when there was none on prior assessment.
      • Increase in necrotic tissue in wound bed.

Slide 25: Pressure Ulcers at Risk for Delayed Healing Report

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  • Delayed healing criteria:
    • Drainage characteristics:
      • Presence of foul odor.
      • Increase in amount of drainage.
      • Worsening in the nature of the drainage (e.g., new onset of bloody or purulent drainage).
    • Periwound characteristics:
      • Increased heat in the skin around the ulcer.
      • Increased induration in the skin around the ulcer.
    • Increase in pressure ulcer pain.

Slide 26: Sample Pressure Ulcers at Risk for Delayed Healing Report

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On-Time Pressure Ulcers At Risk for Delayed Healing Report
All Units
Date: 02/10/14

Resident Name Room Ulcer Onset Date Ulcer Location Ulcer Days Initial Ulcer Stage Ulcer Origin Current Stage
Resident A 102 12/26/13 Cox 47 3 POA* 4
Resident D 113 12/30/13 Heel R 43 4 IHA 4
Resident D 113 11/12/13 Troch R 91 4 POA 4
Resident H 121 12/14/13 Anko R 59 1 POA* 3
Resident S 221 01/20/14 Sacr 22 3 POA* 4
Resident V 222 02/02/14 Heel R 9 4 POA 4
Resident W 233 12/13/13 Cox 60 3 IHA 3
Resident Y 311 01/20/14 Ischia R 22 3 IHA 4

(continued)

Resident Name # Tx Order Changes Surface Area BWAT
Initial and 3 Most Recent Initial and 2 Most Recent
Since Onset Initial 1/23/14 1/30/14 2/6/14 Initial 1/13/14 1/20/14
Resident A 3 2.6 1.6 1.3 1.1 38 24 23
Resident D 3 4.0 3.2 2.9 3.2 44 25 24
Resident D 1 2.3 1.3 1.2 1.3 43 27 25
Resident H 1 0.8 1.7 1.7 1.6 26 26 28
Resident S 3 5.2 6.7 6.2 5.5 45 29 29
Resident V 3 2.0 2.0 2.3 2.3 26 27 27
Resident W 2 1.8 1.2 1.2 1.2 23 20 20
Resident Y 2 2.0 1.7 1.5 1.5 29 25 23

(continued)

Resident Name At Risk for Delayed Healing Reasons
No Reduction in SA in 2 Weeks Increase in Stage Decline in Tissue Characteristics Drainage Periwound Increase in Pressure Ulcer Pain
Resident A         H  
Resident D X         X
Resident D X       H X
Resident H       O    
Resident S       W H  
Resident V X   N      
Resident W X   G      
Resident Y   X   A↑   X

 

Notes: Decline in Tissue Characteristics: G = decline in quality of granulation tissue; N= new appearance of necrotic tissue; N↑= increase in necrotic tissue.
Drainage: O= foul odor; A↑= increase in the amount of drainage; W = worsening in the character of the drainage.
Periwound: H= heat in periwound skin; I= induration in periwound skin.
POA* indicates that the pressure ulcer was present on admission but has higher ulcer stage since admission.

Slide 27: Reviewing Pressure Ulcers at Risk for Delayed Healing Report Calculation Details

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  • Information displayed is identical to that displayed on the Existing Pressure Ulcers Report for:
    • Ulcer Onset Date.
    • Ulcer Site.
    • Ulcer Days.
    • Initial Ulcer Stage.
    • Current Stage.
    • Ulcer Origin.
    • Total Treatment Changes.
  • Surface Area – Initial and 3 Most Recent.
  • BWAT – Initial and 2 Most Recent.
  • At Risk for Delayed Healing Reasons.

Slide 28: Check Your Understanding: Pressure Ulcers at Risk for Delayed Healing Quiz

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  1. Signs of delayed healing include possible infection.
    1. True
    2. False
  2. "Most Recent Stage," as displayed on the Existing Pressure Ulcers Report and the Pressure Ulcers at Risk for Delayed Healing Report, shows the highest stage ever recorded for a pressure ulcer.
    1. True
    2. False

Slide 29: Check Your Understanding: Pressure Ulcers at Risk for Delayed Healing Quiz

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  1. Pressure ulcers will be flagged on the Pressure Ulcers at Risk for Delayed Healing Report if the surface area has not improved in the past week.
    1. True
    2. False
  2. If a resident has two pressure ulcers and one is healing on schedule and the other is showing signs of delayed healing, both pressure ulcers will display on the Pressure Ulcers at Risk for Delayed Healing Report because they belong to the same resident.
    1. True
    2. False

Slide 30: Weekly Wound Rounds Report

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Weekly Wound Rounds Report

Slide 31: Weekly Wound Rounds Report

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  • Provides the wound team and other clinicians monitoring residents’ pressure ulcers with clinical details about factors that may affect healing.
  • Informs clinical decisionmaking and prompts earlier followup.

Slide 32: Weekly Wound Rounds Report

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  • Displays resident-specific ulcer information.
  • Includes details from the prior week’s assessments related to:
    • Pressure ulcer (e.g., site, stage, dimensions).
    • Date last seen by primary care provider/wound clinic.
    • Resident (e.g., decline in mobility, transfer, and toileting, nutrition risk, average weekly meal intake, vitamin and supplement information, temperature, increase in urinary and bowel incontinence).
    • Indicates risk for delayed healing.

Slide 33: Sample Weekly Wound Rounds Report

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On-Time Weekly Wound Rounds Report
Unit: A
Date: 02/10/14

Resident Name (last, first) Ulcer Info
Ulcer Onset Date Ulcer Site Ulcer Days Initial Ulcer Stage Current Stage Ulcer Origin Ulcer Length (cm) x Width (cm) Ulcer Depth (cm) SA Change Total Tx Changes / last  Days from Admit to Ulcer Onset
Resident A 12/26/13 Cox 47 3 4 POA* 1.8 x 0.6 0.3 - 18.7% 3
01/14/14
0
Resident B 12/23/13 Iliac L 50 3 3 IHA 1.2 x 1.2 0.6 - 9.5% 2
01/24/14
482
Resident D 12/30/13 Heel R 43 4 4 IHA 1.8 x 1.8 0.8 +10.3% 1
01/17/14
49
Resident D 11/12/13 Troch R 91 4 4 POA 1.1 x 1.2 0.1 +8.3% 3
12/19/13
0
Resident H 12/14/13 Anko R 59 1 3 POA* 1.3 x 1.2 0.3 0.0% 1
01/26/14
0

(continued)

Resident Name (last, first) Last Seen Date Nutrition Within 7 Days Prior to Report Date
Primary Care Provider Wound Clinic On-Time Nutrition Risk Nutrition Weekly Avg Meal Intake Temp Increase Documented Decline Documented At Risk for Delayed Healing
Urine Incont Bowel Incont Mobility Transfer Toilet
Resident A 01/14/14   High Prot
12/28/13
75% 99.9       X X X
Resident B 01/24/14   High MVI
01/14/14
85%   X   X      
Resident D 02/02/14 1/25/14   MVI, Prot
11/12/13
63%   X         X
Resident D 02/02/14 1/25/14   MVI, Prot
11/12/13
63%   X         X
Resident H 01/26/14   Medium   80% 100.8 X   X X X X

Slide 34: Reviewing Weekly Wound Rounds Report Calculation Details

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  • Information identical to that displayed on the Pressure Ulcers at Risk for Delayed Healing Report for:
    • Ulcer Onset Date.
    • Ulcer Site.
    • Ulcer Days.
    • Initial Ulcer Stage.
    • Current Stage.
    • Ulcer Origin.
    • Total Treatment Changes.
  • Ulcer Length, Width, Depth.
  • Surface Area Change.
  • Days From Admit to Ulcer Onset.
  • Last Seen Date by Primary Care Provider.
  • Last Seen Date in Wound Clinic.
  • On-Time Nutrition Risk.

Slide 35: Reviewing Weekly Wound Rounds Report Calculation Details

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  • Nutrition.
  • Weekly Average Meal Intake.
  • Temperature.
  • Increase in Urine Incontinence.
  • Increase in Bowel Incontinence.
  • Decline in Mobility.
  • Decline in Toileting.
  • At Risk for Delayed Healing.

Slide 36: Check Your Understanding: Weekly Wound Rounds Report Quiz

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  1. The Weekly Wound Rounds Report displays declines in ADLs that have occurred in the past:
    1. Month
    2. Quarter
    3. Week
    4. None of the above
  2. Complete information will display for each ulcer if the pressure ulcer assessment has been done:
    1. 1 day before the report date
    2. 2 days before the report date
    3. 5 days before the report date
    4. 7 days before the report date
    5. All of the above

Slide 37: Check Your Understanding: Weekly Wound Rounds Report Quiz

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  1. An increase in incontinence noted in the past month will display on the Weekly Wound Rounds Report.
    1. True
    2. False

Slide 38: Weekly Pressure Ulcer Treatment Summary Report

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Weekly Pressure Ulcer Treatment Summary Report

Slide 39: Weekly Pressure Ulcer Treatment Summary Report

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  • Displays a 6-week view of treatments administered for a single ulcer, as well as characteristics of the pressure ulcer during that time.
  • Provides clinicians with a comprehensive summary of treatment changes over time that can be referenced if/when a pressure ulcer worsens.
  • Helps generate discussion and collaboration about the underlying root cause of lack of pressure ulcer healing and supports decisionmaking and care planning.

Slide 40: Weekly Pressure Ulcer Treatment Summary Report

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  • Includes descriptive details about the ulcer as in the Wound Rounds Report and Pressure Ulcer at Risk for Delayed Healing Report, but also notes information about the following treatments and interventions:
    • Treatments (e.g., wound cleanser, debridement, topical and protective agents, dressings).
    • Surfaces (e.g., bed, seating, other off-loading strategies).
    • Nutritional interventions (e.g., vitamins, supplements).
    • Consults (e.g., dietitian, rehab).
    • Lab values.

Slide 41: Sample Weekly Pressure Ulcer Treatment Summary Report

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On-Time Weekly Pressure Ulcer Treatment Summary Report

Report Date: 02/10/14
Resident Name: Resident A
Ulcer Location: Coccyx

Assessment Assessment Date
01/02/14 01/09/14 01/16/14 01/23/14 01/30/14 02/06/14
Length: clock method cm 1.9 2.1 2.0 2.0 1.9 1.8
Width cm 0.8 1.0 0.8 0.8 0.7 0.6
Depth cm 0.2 0.5 0.4 0.4 0.3 0.3
Braden score 13 14 - - 16  
Healed            
Improving     X   X X
No change       X    
Worsening   X        
Signs of Delayed Healing X X        
Current Stage 3 4 4 4 4 4
Treatments
Wound Cleanser Saline Saline Saline Saline Saline Saline
Debridement Autolytic Autolytic
Conservative sharp
       
Topical and Protective Agents (including for periwound skin) Liquid skin protectant Liquid skin protectant Liquid skin protectant Liquid skin protectant Liquid skin protectant Liquid skin protectant
Dressings Hydrogel
Hydrocolloid
Hydrogel
Hydrocolloid
Alginate
Gauze
Alginate
Gauze
Alginate
Gauze
Alginate
Gauze
Additional Treatments Ultrasound Ultrasound        
Surfaces
Support Surfaces for Bed Low-air-loss Low-air-loss Low-air-loss Low-air-loss Low-air-loss Low-air-loss
Seating Support Surfaces Foam cushion Air cushion Air cushion Air cushion Air cushion Air cushion
Additional Off-Loading Strategies T&P schedule
Elevate heels
T&P schedule
Elevate heels
T&P schedule
Elevate heels
T&P schedule
Elevate heels
T&P schedule
Elevate heels
T&P schedule
Elevate heels
Nutritional Interventions
Vitamin or mineral supplement X X X X X X
Nutritional supplement provided with meals            
Nutritional supplement provided between meals or with medication pass   X X X X X
Monitor protein, calorie, and fluid intake X X X X X X
Other intervention(s) to maintain/ improve nutrition and hydration status            
Consults Dietitian Rehab     Dietitian
Rehab
 
Labs
* Indicates value outside normal range
Prealbumin (18-45 mg/dL) 22       24 30
Albumin (3.5-5.5 g/dL) 3.4       3.5 3.8
Sodium (136-145 mEq/L)         147* 136
Creatinine (0.7-1.3 mg/dL)         1.9* 1.8*
BUN (8-20 mg/dL) 22*     15.4 13.5 12.6
Transferrin (212-360 mg/dL)         282 312
Hgb (M: 14-17; F: 12-16 g/dL) 15.2         16
Hct (M: 41-51%; F: 36-47%) 38%         39%

 

Slide 42: Reviewing Weekly Pressure Ulcer Treatment Summary Report Calculation Details

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  • Ulcer Location.
  • Assessment Date.
  • Length, Width, and Depth.
  • Braden Score.
  • Healed, Improving, or Worsening.
  • Signs of Delayed Healing.
  • Current Stage.
  • Treatments.
  • Surfaces.
  • Nutritional Interventions.
  • Consults.
  • Labs.

Slide 43: Check Your Understanding: Weekly Pressure Ulcer Treatment Summary Report Quiz

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  1. The Weekly Pressure Ulcer Treatment Summary displays the following information for each pressure ulcer:
    1. Location
    2. Dimensions
    3. Stage
    4. Dressing
    5. Nutritional interventions
    6. All of the above
  2. Pressure ulcer stage is reported as the highest stage the ulcer is/was regardless of current healing status.
    1. True
    2. False

Slide 44: Check Your Understanding: Weekly Pressure Ulcer Treatment Summary Report Quiz

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  1. Pressure ulcer status (improving, worsening, no change) is derived from the values recorded for the Braden Score.
    1. True
    2. False
  2. Which of the following pieces of information would you not find on the Treatment Summary Report:
    1. Whether antimicrobials had been administered
    2. The pressure ulcer’s Braden Score
    3. Whether the resident had experienced a decline in ADL
    4. The site/location of the pressure ulcer on the resident

Slide 45: Pressure Ulcer Counts by Month

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Pressure Ulcer Counts by Month

Slide 46: Pressure Ulcer Counts by Month Report

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  • Assists clinicians with internal reporting and helps monitor pressure ulcer rates each month.
  • Intended to be run monthly at the end of each month.
  • Used in combination with other reports for root cause analysis.
  • Displays information for an entire facility with breakdown by unit.

Slide 47: Pressure Ulcer Counts by Month Report

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  • Captures pressure ulcer data in the weekly pressure ulcer assessment.
  • Provides an option to select one or more pressure ulcer measures or pressure ulcer counts.

Slide 48: Sample Pressure Ulcer Counts by Month Report

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Pressure Ulcer Count by Unit
Facility Level
Month: January 2014

  All Pressure Ulcers # Ulcers Present on Admission (POA) # Ulcers In-House Acquired (IHA)
Ulcer Stage 1 2 3 4 U Totals 1 2 3 4 U Totals # All 1 2 3 4 U Totals % All
Current Pressure Ulcers 12 21 13 5 0 51 10 7 7 5 0 29 57% 2 14 6 0 0 22 43%
New 6 4 0 0 0 10 4 1 0 0 0 5   2 3 0 0 0 5  
Worsening   2 5 3 0 10   2 1 3 0 6   0 4 0 0 4

 

Slide 49: Sample Pressure Ulcer Counts by Month Report

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Pressure Ulcer Count by Unit
Facility Level by Unit
Month: January 2014

  All Pressure Ulcers # Ulcers Present on Admission (POA) # Ulcers In-House Acquired (IHA)
Ulcer Stage 1 2 3 4 U Totals 1 2 3 4 U Totals # All 1 2 3 4 U Totals % All
Unit A Current Ulcers 5 9 5 2 0 21 5 5 2 2 0 14 67% 0 4 3 0 0 7 33%
New 2 3 0 0 0 5 1 0 0 0 0 1   1 3 0 0 0 4  
Worsening   1 2 1 0 4   1 1 1 0 3   0 1 0 0 1
Unit B Current Ulcers 3 7 4 1 0 15 3 2 3 1 0 9 60% 0 5 1 0 0 6 40%
New 2 0 0 0 0 2 2 0 0 0 0 2   0 0 0 0 0 0  
Worsening   1 1 0 0 2   1 0 0 0 1   0 1 0 0 1
Unit C Current Ulcers 4 5 4 2 0 15 2 0 2 2 0 6 40% 2 5 2 0 0 9 60%
New 2 1 0 0 0 3 1 1 0 0 0 2   1 0 0 0 0 1  
Worsening   0 2 2 0 4   0 0 2 0 2     0 2 0 0 2  
All Units Current Ulcers 12 21 13 5 0 51 10 7 7 5 0 29 57% 2 14 6 0 0 22 43%
New 6 4 0 0 0 10 4 1 0 0 0 5   2 3 0 0 0 5  
Worsening   2 5 3 0 10   2 1 3 0 6   0 4 0 0 4

 

Slide 50: Sample Pressure Ulcer Counts by Month Report

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Pressure Ulcer Count by Unit
Unit A
Month: January 2014

  All Pressure Ulcers # Ulcers Present on Admission (POA) # Ulcers In-House Acquired (IHA)
Ulcer Stage 1 2 3 4 U Totals 1 2 3 4 U Totals # All 1 2 3 4 U Totals % All
Current Pressure Ulcers 5 9 5 2 0 21 5 5 2 2 0 14 67% 0 4 3 0 0 7 33%
New 2 3 0 0 0 5 1 0 0 0 0 1   1 3 0 0 0 4  
Worsening   1 2 1 0 4   1 1 1 0 3   0 1 0 0 1

 

Slide 51: Reviewing Pressure Ulcer Count by Month Calculation Details

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  • Current Pressure Ulcers by Stage.
  • New Pressure Ulcers.
  • Worsening Pressure Ulcers

Slide 52: Reviewing Pressure Ulcer Count by Month Calculation Details

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Pressure Ulcer Measures

  • Pressure Ulcer Prevalence:
    • Numerator: Number of current residents with at least one pressure ulcer.
    • Denominator: Number of all current residents.
  • % of Residents With New Pressure Ulcers:
    • Numerator: Number of current residents with a pressure ulcer that developed during the month.
    • Denominator: Number of all current residents.

Slide 53: Reviewing Pressure Ulcer Count by Month Calculation Details

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Pressure Ulcer Measures

  • % of Pressure Ulcers That Have Declined in Stage:
    • Numerator: Number of current pressure ulcers that declined in stage during the month.
    • Denominator: Number of all current pressure ulcers.
  • % of IHA Pressure Ulcers That Have Declined in Stage:
    • Numerator: Number of current IHA pressure ulcers that declined in stage during the month.
    • Denominator: Number of all current IHA pressure ulcers.
  • % of POA Pressure Ulcers That Have Declined in Stage:
    • Numerator: Number of current POA pressure ulcers that declined in stage during the month.
    • Denominator: Number of all current POA pressure ulcers.

Slide 54: Reviewing Pressure Ulcer Count by Month Calculation Details

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Pressure Ulcer Counts

  • Number of Residents With More Than One Pressure Ulcer;
    • May be any stage (or unstageable).
    • May be POA or IHA.
    • Count is taken on the last day of the month.
  • Number of Residents With More Than One IHA Pressure Ulcer.
  • Number of Residents With More Than One POA Pressure Ulcer.

Slide 55: Check Your Understanding: Pressure Ulcer Count by Month Quiz

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  1. The Pressure Ulcer Counts by Month Report may be used by the quality improvement team to identify a unit where there is a trend for pressure ulcers to worsen.
    1. True
    2. False

Slide 56: Check Your Understanding: Pressure Ulcer Count by Month Quiz

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  1. If a unit is identified with a trend for worsening pressure ulcers, what questions would the quality improvement committee ask?
    1. Were these residents identified as at risk for delayed healing of their pressure ulcers?
    2. What interventions were written into their care plans to promote healing?
    3. Were the interventions in the care plan developed by a multidisciplinary team? If so, which disciplines were involved?
    4. Were the interventions written in the care plan carried out? Why or why not?
    5. All of the above

Slide 57: Check Your Understanding: Pressure Ulcer Count by Month Quiz

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  1. A pressure ulcer that develops and heals during the report month is not counted in the number of current pressure ulcers.
    1. True
    2. False
Page last reviewed December 2016
Page originally created November 2016
Internet Citation: On-Time Pressure Ulcer Healing: Facilitator Training. Content last reviewed December 2016. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/long-term-care/resources/ontime/pruhealing/puh-erepguide-slides.html