Guest Post by Elizabeth A. Ayello, PhD, RN, ACNS-BC, CWON, MAPWCA, FAAN.
Are you ready for the changes in MDS 3.0, Section M: Skin Condition? Having just developed the slide materials and provided the instruction on this for the CMS “Train the Trainer” programs in April 2010, I strongly believe that because section M is expanded to three pages, now is the time for clinicians, MDS coordinators, administrators and facilities to get ready for the CMS projected October 2010 implementation date of MDS 3.0.
Criteria used to evaluate pressure ulcer risk (section M0100) as well as the clinical decision as to whether a resident is at risk for a pressure ulcer (M0150) are now part of section M of MDS 3.0. Documentation must make it possible to determine which pressure ulcers were present on admission to the facility, the date of the oldest stage 2 pressure ulcer (M0300B3) as well as the dimensions (M0610) and most severe type of tissue present (M0700) in the largest pressure ulcer.
Reverse staging in long term care is finally gone!!! Accurate ability to stage according to CMS adapted definitions of pressure ulcer classification is required. If you need help with pressure ulcer staging, one educational resource is the Document Dermis™ Pocket Guide to Pressure Ulcers which is published and distributed by the New Jersey Hospital Association. For each pressure ulcer stage, the number of pressure ulcers present must be recorded (M0300 A-G). MDS 3.0 includes a place to record unstageable pressure ulcers due to either a non-removable dressing or device (M0300E), slough and/or necrotic tissue (M0300F) or intact skin from deep tissue injury ((M0300G). Just as in MDS 2.0, any pressure ulcer that presents as a blister regardless of what it is filled with, is documented on MDS 3.0 as a stage 2.
These are just some of the highlights of revised section M of MDS 3.0. You can read more about MDS 3.0 Section M Skin Conditions in my article which I co-authored with Dr. Jeffrey Levine, a practicing internist, geriatrician, and wound care specialist and Sharon Roberson RN, the Northeast Consortia Technical Lead, Survey and Certification from the Centers for Medicaid and Medicare Services entitled “Essentials of MDS 3.0 Section M: Skin Conditions” pubished in this month’s issue of Advances in Skin and Wound Care.
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Reference for this post was Levine, Roberson, Ayello. Essentials of MDS 3.0 Section M: Skin Conditions. Advances in Skin & Wound Care. June 2010, 23(6), pp 273-284.
See also Roberson, Ayello, Levine. Clarification of Pressure Ulcer Staging in Long-term Care under MDS 2.0, Advances in Skin & Wound Care. May 2010, 23(5), pp 206-210.
Order your Pocket Guide to Pressure Ulcers using this Order Form.
To view all blog posts on revised Minimum Data Set 3.0 click on the MDS 3.0 blog archive.
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