AHRQ's Safety Program for Nursing Homes: On-Time Pressure Ulcer Prevention

Facilitator Training—Additional Exercises (continued)

Resident Clinical, Functional, and Intervention Profile Report

Exercise #1: Report Information

Choose the best answer to the questions.

  1. The Resident Clinical, Functional, and Intervention Profile Report can be run to show quarterly trends.
    1. True
    2. False
  2. If the resident is not receiving a tube feed:
    1. The word "No" appears in the cell
    2. The cell is blank
    3. A dash appears (-)
    4. None of the above
  3. If a lab test was not performed:
    1. The word "No" appears in the cell
    2. The cell is blank
    3. A dash (-) is displayed
    4. None of the above
  4. If a weight was not obtained during one of the report weeks, the cell displays a dash.
    1. True
    2. False
  5. ADL function is displayed as:
    1. Self-performance only
    2. Support only
    3. Self-performance and support
    4. None of the above
  6. The number of pressure ulcers and stage of each is displayed.
    1. True
    2. False
  7. If temperature cell is blank, it means that the resident did not have a fever that week.
    1. True
    2. False
  8. In the "Habits" category under Bladder, if there is no information in a cell, that means:
    1. There was no documentation on continence/incontinence recorded that week
    2. The resident was continent that week
    3. The resident was using a catheter that week
    4. None of the above
  9. The ADL category EA/2 means:
    1. Extensive assist by 2 people
    2. Easy transfer by 2 people
    3. Enter with 2 people
    4. Evaluate before 2 p.m.
  10. The nursing assistants at Facility A work 12-hour shifts. The maximum number of shifts that a resident can be recorded as incontinent of urine on the Resident Clinical, Functional, and Intervention Profile Report is:
    1. 12
    2. 14
    3. 16
    4. 21
  11. Bladder—Daily Incontinence is displayed as a "Yes" when a resident is incontinent two or more times per shift.
    1. True
    2. False
  12. The Resident Clinical, Functional, and Intervention Profile Report may help staff gain insight into the nutritional status of a resident during the 4 weeks leading up to pressure ulcer development.
    1. True
    2. False

Answers:

  1. b
  2. a
  3. b
  4. b
  5. c
  6. b
  7. b
  8. c
  9. a
  10. b
  11. b
  12. a

Return to Additional Exercises Contents

Exercise #2: Using the Resident Clinical, Functional, and Intervention Profile Report

  1. What trends do you see regarding vital signs? Meal intake? ADLs?
  2. What questions would you ask the nursing assistant? The nurse manager? The dietitian?
  Week Ending
4/6/14 4/13/14 4/20/14 4/27/14
Vital Signs Number of pressure ulcers 0 0 2 2
Temperature   98.2   100.4
Pulse 82 88 99 110
Respirations 20 20 20 24
Blood pressure 134/68 130/74 126/70 100/42
O2 saturation 99 99 98 90
Weight Weight in pounds 160     156
Weight date 3/26 /14     4/23 /14
Nutrition / Vitamins & Supplements Diet Reg Reg Reg Reg
Tube feeding No No No No
Supplements No No Yes Yes
Multivitamin No No No Yes
Vitamin C No Yes Yes Yes
Arginaid No No No No
Zinc No No No No
Protein No No Yes Yes
Weekly average meal intake—percent        
   Breakfast 100 75 75 80
   Lunch 75 70 25 25
   Dinner 50 50 25 20
Nutritional supplement—percent        
   Breakfast 0 0 25 25
   Lunch 0 0 25 25
   Dinner 0 25 0 0
Bowel Habits Continent Continent Incontinent Incontinent
Loose stool No No No Yes
Incontinence        
   # shifts / week 0 0 2 14
   Daily incontinence       X
3 days without BM        
Bladder Habits Continent Continent Incontinent  
Catheter No No No Foley
Ostomy No No No No
Incontinence        
   # shifts / week 3 5 10 14
   Daily incontinence No No Yes Yes
Did not void # shifts / week 0 0 0 1
Restorative Bowel No No No No
Bladder No No No No
Eating No No No No
Mobility No No No No
Self-Performance/Support Provided2 Bed mobility EA/1 EA/1 EA/1 EA/2
Transfer EA/1 EA/1 EA/1 EA/2
Locomotion EA/1 EA/1 EA/1 EA/2
Dressing LA / set up LA/1 LA/1 EA/1
Eating LA / set up LA / set up LA/1 EA/1
Personal hygiene LA / set up LA / set up LA/1 EA/1
Toileting EA/1 EA/1 EA/1 EA/2
Labs1 Pre Albumin (19.5-35.8 mg/dL) 31.0   19.6  
Albumin (3.4-5.4 g/dL) 3.4      
Sodium (135-145 mEq/L) 135      
Potassium (3.5-5.2 mEq/L) 4.0      
Creatinine (0.7-1.3 mg/dL) 0.8      
BUN (6.0-20.0 mg/dL) 16.0      
Transferrin (20-50%) 20      
Bed Surfaces Air fluidized surface        
Dynamic / alternating pressure        
Low air loss X X X X
Replacement mattress        
Chair Surfaces Fluid filled or gel cushions X X X X
Foam cushions        
Combination cushions        
Other Heel boots        

Answers:

  1. Vital signs: There is a slightly elevated temp with pulse and respiratory rate trending up over the past 2 weeks. O2 sat has dropped over the past week.

    Meal intake: Breakfast is this resident's best meal; lunch and dinner intake have declined significantly over the last 2 weeks. Supplement intake is minimal.

    ADLs: It appears the resident is trending toward increased dependence, especially in the last 2 weeks.

  2. Questions for the nursing assistant: This resident seems to be declining in certain ADLs for several weeks. Have you noticed this? Can you provide more details? Do you have any idea of what's going on? How has her appetite been? Can you explain the dramatic reduction in meal intake for lunch and dinner over the last 2 weeks? Have you noticed a decline in her intake? Have you noticed any changes in her food preferences? How has her energy level been? Same or different? How about her orientation or cognitive level? Any differences there?

    Questions for the nurse manager: This resident now has two pressure ulcers. Has this newest ulcer been evaluated by the wound nurse? Have you discussed the progress of these pressure ulcers with the physician? How frequently are the labs drawn? Should labs be more frequent now with the additional pressure ulcer? There have been no changes in the support surfaces on the bed or chair. Should rehab evaluate these surfaces to make sure they are still the most appropriate options?

    Questions for the dietitian: This resident's meal intake has been declining but only for lunch and dinner. Do you have an explanation? Have you spoken to the resident about food preferences? With a new pressure ulcer, have calorie and vitamin requirements been re-evaluated? Would you recommend any particular labs be drawn?

Return to Additional Exercises Contents 
Return to Pressure Ulcer Prevention

Page last reviewed April 2016
Page originally created March 2013
Internet Citation: AHRQ's Safety Program for Nursing Homes: On-Time Pressure Ulcer Prevention. Content last reviewed April 2016. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/long-term-care/resources/ontime/pruprev/addexercises7.html