WOUND BLOG

Strategies for dealing with new CMS pressure ulcer guidelines involve accountability on many levels. This includes unit level acountability. In this case staff will complete a Cause Analysis on every Stage 2, 3, or 4 pressure ulcer determined to be caused after admission. When needed a plan of action should be created and initated with units that need improvement. These units will be responsible for reporting back to the present on admission committee (The group responsible for CMS POA oversite) six months after implementing the action plan. An example of a plan of action (for a unit that has routinely inappropriately assessed a stage 2 ulcer or denuded skin as a Stage 3 or 4 pressure ulcer) would be performing nursing peer review on every Stage 3 or 4 pressure ulcer documented. Trends my form showing specific nurses or physicians who inappropriately label skin or wound conditions. Unit managers or wound care specialists can then  identify and mentor individuals in  basic wound identification. One way to reduce guilt or embarrassment related to selective education would be to include that individual in group rounds of wound care patients with a wound care specialist, dietary, and PT giving their take on the patient’s wound care assessment and plan of action.