Re: staging of a pressue area

[RRS2000]

To code an ulcer as anything except a Stage 1, it has to be open.  According to the definitions on page 3-159 of the RAI User's Manual, a Stage 2 has a partial thickness loss of skin layers, ad Stage 3 has a full thickness skin loss with subq tissues exposed, and a Stage 4 is a full thickness skin and subq tissue loss with muscle or bone exposed.   A Stage 4 may be open but covered by slough or eschar.

Since the wound you've described is not open and is still covered with skin, the only definition that applies is the Stage 1.

Rena

Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
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Subj: staging of a pressue area
Date: 12/29/03 9:41:08 AM Pacific Standard Time
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I have a question for the group. We had an admit over the weekend with a 4x4 area on her coccyx. It is closed, but discolored, with a 3x3 purple area in the center. Staff called it a Stage I . I am not comfortable with that. The nurse on the floor who does the wound care does not understand why I want to stage it differently. I am leaning toward a stage 4, only because we are not sure what is beneath that purple.
There is obviously underlined damage. What would you stage it?  Thanks Karen.