MDS Alert
Before You Call Your Risk Assessment A Wrap, Check Out The Pressure Ulcer RAP
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PRESSURE ULCERS CARE RAP KEY TRIGGERS (a) Note: Codes 2, 3 and 4 also trigger on the Nutritional Status RAP. GUIDELINES
Pressure ulcer present or risk for occurrence if one or more of following present:
Pressure Ulcer(s) (Present)(a)
[M2a = 1, 2, 3, 4]
Bed Mobility Problem (Risk)
[G1aA = 2, 3, 4, 8](b)
Bedfast (Risk)
[G6a = checked]
Bowel Incontinence (Risk)
[H1a = 1, 2, 3, 4]
Peripheral Vascular Disease (Risk)
[I1j = checked]
Previous Ulcer (Risk)
[M3 = 1]
Skin Desensitized to Pain or Pressure (Risk)
[M4e = checked]
Daily Trunk Restraint (Risk)(c)
[P4c = 2]
(b) Note: Codes 2, 3 and 4 also trigger on the ADL RAP.
(c) Note: This code also triggers on the Falls RAP and Physical Restraints RAP.
Other factors that address or may complicate treatment of pressure ulcers or risk of ulcers:
Diagnoses or Conditions: Diabetes [I1a], Alzheimer's Disease [I1q], Other Dementia [I1u], Hemiplegia/Hemiparesis [I1v], Multiple Sclerosis [I1w], Edema [J1g]
Interventions/Programs:
- Pressure Relieving Chair/Beds [M5a, M5b]
- Turning/Repositioning [M5c]
- Nutrition or Hydration Program to Manage Skin Care Problems [M5d]
- Ulcer Care [M5e]
- Surgical Wound Care/Treatment [M5f]
- Application of Dressings (With or Without Topical Medications) Other Than to Feet [M5g]
- Application of Ointment/Medications (Other Than to Feet) [M5h]
- Preventative or Protective Skin Care (Other Than to Feet) [M5i]
- Preventative or Protective Foot Care [M6e]
- Application of Dressings to Feet (With or Without Topical Medications) [M6f]
- Use of Restraints [P4c,d,e]
Medications:
- Antipsychotics [O4a]
- Antianxiety [O4b]
- Antidepressants [O4c]
- Hypnotics [O4d]
Source: RAI User's Manual, appendix C.
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