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It's cumulative. Rena addressed this issue a
couple of months back quite eloquently. The gist of it was that the changes need
to be taken into account as they occur, and once you have reached 2 or more,
then sig change is warranted.
HS
Holly F. Sox, RN, RAC-C
Clinical Editor
----- Original Message -----
Sent: Wednesday, March 03, 2004 9:30
AM
Subject: Re: Reasons for Sig.
Changes
So, Holly, what you're saying is that you may have one change on one
assessment and then 3 months later have one change and then a sig change
should be done? I thought it had to be 2 changes on the SAME
assessment. Thanks. Terri "Holly Sox, RN, RAC-C"
<[EMAIL PROTECTED]>
wrote:
According to the manual, the sig change is not
required unless there is a pattern of significant decline or improvement in
2 or more areas. I would not do the SC for any of the changes you mentioned
in the absence of other changes. However, like you said, it's better
to try to explain why you did than why you didn't. Whenever I identify
any of the changes that you mentioned, I write a progress note explaining
the change, and addressing the fact that other areas are stable. I ensure
that the care plan is up to date. That way, if another change happens, then
I have my documentation in order and proceed with the sig change at that
time. If not, then I feel fairly safe that my care plan is appropriate and
nothing is being missed.
HS
----- Original Message -----
Sent: Tuesday, March 02, 2004 10:52
PM
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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