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Boy,
this is confusing.... I think I'd code him either a 1 or a 2 . My reasoning
being he makes reasonable decisions when awake & alert, but obviously
when he is unresponsive someone else has to make decisions for
him.
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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