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:

  • Count the number of residents on the nursing unit with the specified trigger.
  • Divide the number of residents on the nursing unit with specified trigger by the total census on the unit during that week and display the value as a percentage in parentheses.
  • Display both the count and percentage in the same column.
Wt Loss ≥7.5% in  Prior 90 Days (Point-to-Point) Vital Signs or Weight documentation For each static week:

  • Count the number of residents on the nursing unit with the specified trigger.
  • Divide the number of residents on the nursing unit with specified trigger by the total census on the unit during that week and display the value as a percentage in parentheses.
  • Display both the count and percentage in the same column.
Wt Loss ≥10% in Prior 180 Days (Point-to-Point) Vital Signs or Weight documentation For each static week:

  • Count the number of residents on the nursing unit with the specified trigger.
  • Divide the number of residents on the nursing unit with specified trigger by the total census on the unit during that week and display the value as a percentage in parentheses.
  • Display both the count and percentage in the same column.
2 Meals ≤50% in 1 Day  CNA documentation of meal intake For each static week:

  • Count the number of residents on the nursing unit with the specified trigger.
  • Divide the number of residents on the nursing unit with specified trigger by the total census on the unit during that week and display the value as a percentage in parentheses.
  • Display both the count and percentage in the same column.
Weekly Meal Intake Average <50%  CNA documentation of meal intake For each static week:

  • Count the number of residents on the nursing unit with the specified trigger.
  • Divide the number of residents on the nursing unit with specified trigger by the total census on the unit during that week and display the value as a percentage in parentheses.
  • Display both the count and percentage in the same column.
Daily Urine Incontinence CNA documentation of resident bladder habits For each static week:

  • Count the number of residents on the nursing unit with the specified trigger.
  • Divide the number of residents on the nursing unit with specified trigger by the total census on the unit during that week and display the value as a percentage in parentheses.
  • Display both the count and percentage in the same column.
>3 Days Bowel Incontinence CNA documentation of resident bowel habits For each static week:

  • Count the number of residents on the nursing unit with the specified trigger.
  • Divide the number of residents on the nursing unit with specified trigger by the total census on the unit during that week and display the value as a percentage in parentheses.
  • Display both the count and percentage in the same column.
Foley Catheter  Physician Orders or nurse documentation For each static week:

  • Count the number of residents on the nursing unit with the specified trigger.
  • Divide the number of residents on the nursing unit with specified trigger by the total census on the unit during that week and display the value as a percentage in parentheses.
  • Display both the count and percentage in the same column.
Current Pressure Ulcer  Nurse Wound Assessment For each static week:

  • Count the number of residents on the nursing unit with the specified trigger.
  • Divide the number of residents on the nursing unit with specified trigger by the total census on the unit during that week and display the value as a percentage in parentheses.
  • Display both the count and percentage in the same column.

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Page last reviewed April 2016
Page originally created September 2014
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/pruprev-functspecs3-5.html