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Advanced instruction to the MDS

Staff Development Weekly: Insight on Evidence-Based Practice in Education, January 30, 2004

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A resident with Alzheimer's disease and short-term memory loss has a documented history of poor decision-making and an inability to make safe self-care decisions at home. This resident appears to manage well in the structured setting of a nursing facility with minimal cues and supervision. Nursing staff, accustomed to providing support for more impaired residents, charts this resident's performance as relatively independent, as they only remind the resident to dress, bathe, or come to the dining room. As a result, the resident is coded on the MDS as showing modified independence in decision-making (B4=1), when in reality his or her performance may be moderately impaired (B4=2). Inconsistencies and misinterpretations of the MDS can be avoided when all staff members are trained in basic MDS definitions. Flow sheets, nursing documentation, certified nursing assistant (CNA) ADL forms, and other resident care-related documents should reflect MDS language.

Editor's note: The above is an excerpt from the new online course "Advanced instruction to the MDS." For more information on this course and other Long Term Care (LTC) courses go to www.hcprofessor.com and click on SNF/LTC Training.

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