Personally, I think it is difficult to give a blanket statment as to do or not to do a
Significant Change on these residents. I think you need to look at the resident
(instead of the piece of paper) and the fact that, for example, they now need a
restraint- something has changed and how does this change impact on all the other
problems the resident has and what new problems will be created by the change. To me a
new stage 4 pressure ulcer, a new restraint, a new G-tube (just a few examples)
require a very serious look at the resident because of the clinical significance and
most likely the need for a significant change and revision of the care plan - which is
obviously not working or in need of major adjustment, for these are negative outcomes.
And although the surveyors are not my clients (the resident is), as someone has said
in the past, I would not want to defend to a surveyor why I did not do it.
Holly McGran
> -----Original Message-----
> From: [EMAIL PROTECTED] [SMTP:[EMAIL PROTECTED]
> Sent: Tuesday, March 02, 2004 10:52 PM
> To: [EMAIL PROTECTED]
> Subject: Reasons for Sig. Changes
>
> Hello All,
> I have a question to pose to the group. It may sound silly, but I have always
> been under the impression that if you have a resident with a significant weight
> loss, you do a Sig. Change. Also, for new stage 3 or 4 pressure area or a new
> restraint. I thought all of these should stand alone for a Sig. Change. Here at
> work recently, some people have really been questioning and trying to get out of
> doing the changes. I would rather have the Sig. Changes than try to explain why I
> didn't do one to the surveyors. On our recent annual survey we had done a Sig.
> Change on a lady, then three months later she got a lap buddy restraint. Surveyors
> cited us for not doing another change. Sorta slipped through the cracks. All info
> and opinions would be greatly appreciated. You all are a great resource.
>
> Susan Gibbs, RN
> MDS Coordinator
> Presbyterian Homes of TN
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