Questionnaire CEC_08_PI_Prevalence_Community_Outpatient_2018_(4517) Patient Oriented Yes Questionnaire Instruction A guide for delivering the survey is available on the CEC website Creator Group New South Wales ( Pressure Injury ) Question Question Question Responses Instructions ID # type 10375 Single Q1. What sex is Female Record the patient’s sex from the medical record. Choice the person? Male Other should be selected when it is Other documented in the medical record that the patient identifies as intersex. 21167 Number Q2. What is the __Years If the person is less than 1 year old please with one age of the provide their age using a decimal value. i.e. 6 decimal person? months is 0.5 Years point 22976 Compliance Q3. Is there Yes Select Yes when there is documentation that a documentation of validated pressure injury risk assessment tool/ No a fully completed process appropriate for the patient population If Yes, jump to question no: 5; comprehensive in accordance with best practice guidelines, risk assessment AND a skin assessment that is based on visual (using a validated inspection has occurred. tool and Check the eMR, progress notes, clinical notes comprehensive or other nursing discharge summary’s for this skin assessment) information. at first presentation to The time of admission should be available from the community or the eMR, admission summary sheet or similar. outpatient service?
Questionnaire CEC_08_PI_Prevalence_Community_Outpatient_2018_(4517) Patient Oriented Yes Questionnaire Instruction A guide for delivering the survey is available on the CEC website Creator Group New South Wales ( Pressure Injury ) Question ID # Question type Question Responses Instructions 10375 Single Choice Q1. What sex is the person? Female Male Other Record the patient’s sex from the medical record. Other should be selected when it is documented in the medical record that the patient identifies as intersex. 21167 Number with one decimal point Q2. What is the age of the person? __Years If the person is less than 1 year old please provide their age using a decimal value. i.e. 6 months is 0.5 Years 22976 Compliance Q3. Is there documentation of a fully completed comprehensive risk assessment (using a validated tool and comprehensive skin assessment) at first presentation to the community or outpatient service? Yes No If Yes, jump to question no: 5; Select Yes when there is documentation that a validated pressure injury risk assessment tool/ process appropriate for the patient population in accordance with best practice guidelines, AND a skin assessment that is based on visual inspection has occurred. Check the eMR, progress notes, clinical notes or other nursing discharge summary’s for this information. The time of admission should be available from the eMR, admission summary sheet or similar.
Pressure-Injury-Point-Prevalence-Survey-Guide-2018.docx