f tag 309 for pain survey protocol related f tags n.
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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

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Presentation Transcript
investigative protocol
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
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
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
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
related or associated 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 tags1
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 tags2
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 tags3
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 tags4
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 tags5
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.