MDS Alert
Test Yourself ~ Nail Down What Triggers The Delirium Quality Measure/Indicator
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Question: How does the postacute delirium QM/QI work in terms of the MDS assessments and items that trigger it? Does the measure have any exclusions or a covariate?
Answer: "The QM/QI for delirium is a prevalence-based postacute care measure," says Sheila Capitosti, RN, BSN, a consultant with LTCQ Inc. in Lexington, MA. The measure "triggers for any short-stay resident with at least one symptom of delirium that represents a departure from his usual functioning on the PPS 14-day assessment" (at least one item at B5a through B5f = 2). The "2" "indicates that the behavior has been present over the last seven days and appears different from the resident's usual functioning (e.g., new onset or worsening)," adds Capitosti. The postacute delirium QM/QI has a covariate for residents who have no prior residential history documented on an admission assessment (AB5a through AB5e are not checked and AB5f is checked). Residents are excluded from the measure if they satisfy any of these following conditions:
1. Residents are comatose (B1 = 1) or the comatose status is unknown on the 14-day assessment.
2. Residents with end-stage disease (J5c is checked) or end-stage disease is unknown on the 14-day assessment.
3. Residents are receiving hospice care or the hospice (P1ao) status is unknown on the 14-day assessment.
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