F tag 309 for pain survey protocol related f tags
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F-tag 309 for Pain: Survey Protocol & Related F-tags PowerPoint PPT Presentation


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F-tag 309 for Pain: Survey Protocol & Related F-tags. Investigative Protocol. QOC related to recognition & management of pain Determine whether facility has provided & resident has received care & services to address & manage pain

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F-tag 309 for Pain: Survey Protocol & Related F-tags

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F-tag 309 for Pain: Survey Protocol & Related F-tags


Investigative Protocol

  • QOC related to recognition & management of pain

    • Determine whether facility has provided & resident has received care & services to address & manage pain

    • Applies to residents who state they have pain, who display indicators of pain, are assessed with pain, receives pain treatment, has elected hospice benefit for pain management


Survey Procedures

  • Observe residents

  • Interview residents or family

  • Interview nurse aides

  • Review records

    • Assessment

    • Care plan, including revisions

  • Interview health care practitioners & other health professionals


Determining Compliance

  • Facility is in compliance if EACH resident has their pain managed in alignment with their goals to attain the highest practicable physical, mental, & psychosocial well-being

  • Recognized & evaluated pain to determine cause

  • Developed & implemented comprehensive care plan

  • Provided measures to minimize, prevent, or treat pain

  • Monitored effects of interventions

  • Communicated with health care practitioner when appropriate to obtain new orders or revise current orders


Noncompliance Determination

  • Failure to show adequate proof that ALL of the previous steps are followed is non-compliance

  • Non-compliance can be at any step along the way

    • Recognize & evaluate

    • Intervene & treat

    • Prevent or minimize

    • Monitor

    • Communicate & coordinate


Relationship with other f-tags


Related or Associated F-tags

  • F155 – Right to refuse treatment

    • Facility must assess reason, clarify & educate resident of consequences, offered alternatives & documented these steps

  • F157 – Notification of changes

    • Health care practitioner notified if pain persisted or there were adverse consequences

    • Notified responsible party of changes

  • F242 – Self-determination & participation

    • Facility provided resident with relevant options to manage pain


Related or Associated F-tags

  • F246 – Accommodation of needs

    • Adopted resident’s physical environment to reasonably accommodate resident’s pain

  • F272 – Comprehensive assessments

    • Was a comprehensive assessment done

  • F278 – Accuracy of assessments

    • Does the assessment reflect the resident’s condition


Related or Associated F-tags

  • F279 – Comprehensive care plan

    • Did care plan include measureable objectives, time frames, & specific interventions/services

    • Was it consistent with resident’s risks, needs, goals, preferences, & current standards of practice

  • F280 – Comprehensive care plan revision

    • Ensure periodic review of plan & revision as needed by qualified TEAM with input from resident or responsible party


Related or Associated F-tags

  • F281 – Services meet professional standards of quality

  • F282 – Care provided by qualified person in accordance with plan of care

  • F329 – Unnecessary drugs

    • Are medications monitored for effectiveness & adverse consequences

    • Are symptoms resident has related to meds


Related or Associated F-tags

  • F385 – Physician supervision

    • Is pain management supervised by physician, including participation in comprehensive assessment process, development of treatment regimen, monitoring & response to notification of changes in resident status

  • F425 – Pharmacy services

    • Were medications available & administered as indicated, ordered at admission & throughout stay


Related or Associated F-tags

  • F501 – Medical Director

    • Did Medical Director help develop & implement appropriate policies consistent with standards of practice

    • Did Medical Director interact with resident’s physician supervising the care if requested by facility

  • F514 – Clinical records

    • Did clinical records accurately & completely document resident status, care/services provided, in accordance with standards & resident goals

    • Did records provide a basis for determining & managing resident progress & responses to care


Adapted and used with permission of D. Bakerjian, PhD, MSN, APRN, University of CA, San Francisco, 2009.


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