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Description

Determination of which contributing factor(s) related to patient/resident management are known.

On-Screen Instructions

Select all that apply.

Field Type

Checkbox (multiselect)

Responses


Initial diagnosis

The initial diagnosis contributed to the event.

Includes

  • Misdiagnosis

  • Incomplete diagnosis

  • Patient self-diagnosis

  • Initially following incorrect diagnostic path, missed diagnosis

  • Diagnoses based on incorrect or inaccurate laboratory values, test results, or missing communication from outside sources

Excludes

  • Patient self-diagnosis

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Response to changing condition or delay in care

Provider or staff response to changing condition or a delay in care contributed to the event.

Includes

  • Delays in treatment related to failure to recognize significance of signs and symptoms, lack of test results, or incorrect or missing information

Excludes

No additional information provided.

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Accuracy of care plan

The accuracy of the care plan contributed to the event.

Includes

  • Inaccurate or out of date care plans

Excludes

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Implementation of care plan

The implementation of the care plan, or lack thereof, contributed to the event.

Includes

  • Care plan not followed

  • Partial implementation of care plan

Excludes

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Patient/resident assessment

The patient/resident assessment contributed to the event.

Includes

  • Inaccurate assessment

  • Incomplete assessment

  • Untimely assessment

  • Omitted assessment

Excludes

No additional information provided.

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Follow-up care

The follow-up care, or lack thereof, contributed to the event.

Includes

  • Care related to discharge information relayed to other care facility or home

  • Inadequate or inappropriate follow-up care or patient tracking

Excludes

No additional information provided.

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Other (please describe)

Any other factor related to patient management, not included in the list above, which contributed to the event.

Includes

  • Issues related to DNR and POLST

  • Patient consent process

Excludes

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Guide for Use

If “Other” is selected, a text box for a description will also appear.

History

Start Date

2006

End Date

n/a

Change History

Spring 2012: PSRP implementation

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