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I know that is what the manual says.
That is why I am asking for help with scoring. The window period is 7 days
or 168 hours. For 8 + 12 + 8 + 7 + 23 + 2 + 7 + 5 = 82 hours, he was
unresponsive and flaccid. For the other 86 hours, he was alert, oriented, making
valid and reasonable decisions, communicating without problems. Would I code a
"2" for decision making, even though when he is awake his decisions are
reasonable and consistent?
----- Original Message -----
Sent: Thursday, December 18, 2003 10:43
AM
Subject: Re: how do I score this??
The instruction in the RAI User's Manual are to
code these items based on information collected across all shifts and all
disciplines for the entire observation period. It would not be
appropriate to selectively omit certain periods of time from the observation
period.
Since these items are important for care planning
purposes, it is important that the MDS coding be an accurate reflection of the
resident's overall status during the observation period.
Rena
Subj: how do I score this??
Date: 12/18/03 8:26:09 AM
Pacific Standard Time
From: [EMAIL PROTECTED]
Reply-to:
[EMAIL PROTECTED]
To: Undisclosed-Recipient:;
Sent
from the Internet
I have a resident on Medicare
A that is a hospital return following surgery for an above the knee
amputation due to irreversible critical ischemia. In the 7 day window,
since his return, he has had 4 periods of complete unresponsiveness with
flaccidity. These periods have lasted from 2 hours to 16 hours.
When he comes out of these episodes, he is totally alert and oriented,
communicates clearly, makes his own decisions, feeds himself, jokes with
staff, etc.
My question is on scoring section B - cognition and
memory. Do I score the way he is when he is unresponsive or do I score
for the alert and oriented, awake person? The episodes of each is
about 50% of the window period so neither one is a true picture of the
resident throughout the window as they are so completely polar of
status.
Sara Hayden RN,C
St. Mark's
Lutheran Home
Austin, MN
Rena R. Shephard, MHA,
RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment
Coordinators
[EMAIL PROTECTED]
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