When I have received "suggestions" like that from administrators or DONs, I have learned to do the following:
Say something along the lines of, "That raises a very interesting point. I think I know the answer, but with something that important, let me research and get the answer in writing." Then, I come to CMDG and say "HELP!!" There are some very, very educated and smart members on this list, and you will almost always get several answers, sometimes with links or directions to where you can get support in writing for your position. Print it all out, make an appt with the DON and administrator together, and say, "Ms/Mr DON asked me to find out about [how to code shearing areas in section M1 and M2. S/he was concerned about our QI in this area being so high. I have printed out several references, including one from the NPUAP website, which clearly indicate that shearing areas over pressure points meet the definition for ulcers as well as pressure areas. I wish our QI number was lower in this area, but would rather have that than a citation for inaccurate assessments. Perhaps we can work towards reducing shear and friction areas by staff education."] This is an actual example of a situation that I went through at my facility. However, there are also times that I am certain I am correct, and put the question out here, only to find out that I am wrong. In those cases, I print out the answers for my own reference, and have gone back to the other party and said, "You were absolutely right about [whatever]" It really helps to make for good relations when you are willing to admit when you are wrong. (Although, I admit there are some situations that nothing will improve ;-) Hope this is helpful. Holly Holly F. Sox, RN, RAC-C Clinical Editor, Careplans.com www.careplans.com [EMAIL PROTECTED] ----- Original Message ----- From: <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Tuesday, March 16, 2004 12:16 AM Subject: "Suggestions" to make QI report different > Have any of you had the experience of having your D.O.N. "suggest" that your coding is incorrect because we don't want that on the QI report? How did you handle it? I always think of the correct answer and hour after the conversation is over. > > > /---------------------------------------------------------- > The Case Mix Discussion Group is a free service of the > American Association of Nurse Assessment Coordinators > "Committed to the Assessment Professional" > Be sure to visit the AANAC website. Accurate answers to your > questions posted to NAC News and FAQs. > For more info visit us at http://www.aanac.org > -----------------------------------------------------------/ > /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/
