4. Abnormal findings — the necessity chain
Finding → severity → comparison → risk → intervention → notification (provider + representative) → orders → response → reassessment.
Model abnormal 1 |
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Worsening perineal breakdown / moisture-associated skin damage: new or worsening denudement and erythema of the perineal/genital skin in an incontinent resident (or a perineal wound with increasing size, drainage, or periwound erythema) — a breakdown/infection concern. The skin/wound assessed and measured, the moisture-barrier and containment plan intensified, pressure offloading reinforced, the provider notified, treatment adjusted per order, and the resident monitored for infection; the care plan revised. Will reassess and trend the skin/wound; supports the Section M update. Skilled recognition and management required. (Staging and treatment detail route to the Skin reference.) |
Model abnormal 2 |
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Fournier gangrene — surgical emergency: rapidly spreading perineal/genital/scrotal erythema with dusky or black skin, crepitus, pain out of proportion, foul odor, and systemic signs (fever, tachycardia, confusion) — concerning for a necrotizing perineal infection. The provider notified urgently, the sepsis pathway initiated, emergency transfer activated, and the resident monitored; the responsible party notified. Skilled recognition required, as Fournier gangrene is a life-threatening surgical emergency. (Sepsis surveillance routes to the Sepsis overlay.) |