Completed Self-Assessment Worksheet Facility Name: Sunny Tree NH Date Completed: 07/01/16 Completed By: Change Team Section 1: Pressure Ulcer Tracking and What tools, if any, does your facility use to monitor pressure ulcer healing? Check all that apply. Individual Patient/Resident Level Facility Level Advancing Excellence Pressure Ulcer Tracking Tool Facility-developed forms/database √ √ Corporate-directed forms/database Paper records/log √ √ PUSH Pressure Ulcer Scale for Healing – Tool BWAT Bates-Jenson Wound Assessment – Tool None of the above Other (specify) How often does your facility reassess pressure ulcers? Daily At every dressing change Weekly √ Other (specify):___we identify new pressure ulcer daily and at √ admission_____________ Does your facility collect the following information? Facility at Large Unit Level a. Total count of ulcers No Yes No √Yes b. Count of ulcers by stage No Yes No √Yes How often is the information updated? Total count of pressure ulcers is updated:
Completed Self-Assessment Worksheet Facility Name: Sunny Tree NH Date Completed: 07/01/16 Completed By: Change Team Section 1: Pressure Ulcer Tracking and What tools, if any, does your facility use to monitor pressure ulcer healing? Check all that apply. Individual Patient/Resident Level Facility Level Advancing Excellence Pressure Ulcer Tracking Tool Facility-developed forms/database √ √ Corporate-directed forms/database Paper records/log √ √ PUSH – Pressure Ulcer Scale for Healing Tool BWAT – Bates-Jenson Wound Assessment Tool None of the above Other (specify) How often does your facility reassess pressure ulcers? Daily At every dressing change √ Weekly √ Other (specify):___we identify new pressure ulcer daily and at admission_____________ Does your facility collect the following information? Facility at Large Unit Level a. Total count of ulcers √Yes No Yes No b. Count of ulcers by stage √Yes No Yes No How often is the information updated? Total count of pressure ulcers is updated:
puh-implementation-handouts.docx