Present-on-Admission Pressure Ulcers, Article Critique Example

Rogers, C. (2013). Improving processes to capture present-on-admission pressure ulcers. Advances in Skin & Wound Care: The Journal for Prevention and Healing, 26(12), 566-572.

This article addresses the significance of the identification of ulcers that are present at the time of admission to the hospital and to identify processes that will aid in this process. The article provides a summary of the primary points, including an abstract, and the introduction addresses policies and statistics regarding the prevalence of pressure ulcers in the United States (Rogers, 2013). The concept of present on admission (POA) is also identified and is not considered to be a reimbursable expense because it is often considered to be a hospital-acquired condition because of the high cost of the treatment that is required (Rogers, 2013). In addition, the article identifies some of the criteria that are associated with POA status and how this impacts patients in the context of proper coding to receive reimbursement (Rogers, 2013).

The article includes a literature review that is designed to encourage clinicians to promote greater accuracy when identifying this conditions so that reimbursements are appropriate and will meet the established criteria for the condition (Rogers, 2013). The study results indicate that over a period of time, there were fewer instances of missed POA determinations, thereby increasing reimbursement rates (Rogers, 2013). This coincided with the improvement of communication among healthcare providers, along with improved physician written communication (Rogers, 2013). The discussion section identifies some discrepancies in the data, yet it also demonstrates some improvements in how organizations make decisions regarding the data and information that is recorded at the nursing level to document POA ulcers (Rogers, 2013). The study ends with recommendations for improvement that might be effective in improving the standardization of terms and improved education for clinicians (Rogers, 2013).

Journal Critique

This article offers useful information regarding the role of physicians, nurses, and other healthcare providers in properly documenting patient information to increase reimbursement rates. The concept of present on admission is not typically part of routine language; therefore, it requires further investigation and evaluation. The article provides information regarding how to determine if reimbursements will be provided for pressure ulcers, depending on how they are documented and the level of clarity of the documentation that is provided. This information is useful because it provides a basis for examining the different constructs of reimbursement procedures and how careful wording and descriptions are required to ensure that reimbursements are maximized.

This article supports a number of recommendations to improve the practice environment, including but not limited to improvements in oral and written communication among staff members, along with an increased familiarity in terms that are directly related to this condition. It is important for clinicians to use this type of information in order to make definitive diagnoses at the appropriate time and to be clear and concise in their documentation efforts. This article provides support to field of gerontology because it encourages a greater understanding of the different elements of POAs that must be better understood in order to accomplish improved diagnostic, treatment, and reimbursement alternatives for this condition, which occurs frequently in older adults. This information provides a basis for examining new ideas and opportunities to improve health for older adults and to recognize how to diagnose, treat, and prevent pressure ulcers as best as possible. These techniques support the development of new ideas to encourage nurses and physicians to be proactive in treating patients who arrive at the hospital with existing pressure ulcers.

References

Rogers, C. (2013). Improving processes to capture present-on-admission pressure ulcers. Advances in Skin & Wound Care: The Journal for Prevention and Healing, 26(12), 566-572.