Physician expert gives advice to nursing homes on state surveys.
Nursing homes continue to face significant challenges with their yearly state surveys. With a focus on wound and skin issues, it becomes critical that nursing facilities have a comprehensive skin program. How can your facility avoid a deficiency in skin and wound care on your next survey?
1. Make sure your staff and treatment nurses are properly educated on how to perform an assessment on a patient. It is important to know how to perform a risk assessment and a visual skin assessment.
2. For patients who have wounds on admission, a proper assessment includes, accurate diagnosis of etiology including staging if it is a pressure injury/ulcer.
3. One of the challenges we have found is that admissions may occur during off hours such as the weekend, and staff may not perform a comprehensive assessment.
4. When performing assessments it is very important to be truthful and accurate in the pressure ulcer staging.
5. When a treatment plan is formulated it should be revised if there is no improvement in the wounds after two weeks.
6. All wounds should be monitored and tracked for improvement and decline on a weekly basis, and a multi-disciplinary approach should be taken to wound care, which includes nutritional care, and other specialties.
At Skilled Wound Care our professional staff of physicians, physician assistants and nurses partner with nursing facility staff to heal wounds and achieve optimal outcomes. We provide in-services if needed for your staff so that assessments may be improved and a proper care plan can be formulated. Our providers round on a weekly basis with your nurses to formulate care plans, debride wounds if necessary, and perform assessments. Remember the nursing facility survey was devised so that the federal and state governments could assess the level of care being provided by individual nursing facilities. A nursing facility survey is not meant to assess the care provided by physician staff; physicians are monitored by the Medical Board of each respective state. Facilities should be focused on nursing care and not on the physician rounds at the facility during survey. Facilities should make certain that all patients with questionable skin issues are assessed in conjunction with physician staff to corroborate findings and double check care plans. We believe that if the guidelines above are followed facilities will have a smooth survey when it comes to skin and wound issues.
Dr. Bardia Anvar, MD
Please contact us for any assistance you may need at (866) WOUND-80