Is it a Surgical Wound, Skin Lesion or Open Wound according to OASIS?
We all know that in the world of OASIS what we think is a surgical wound, skin lesion or open wound may not be considered to be and what we think is not a surgical wound, skin lesion or open wound may be. Here is an attempt to clarify some of the muddy waters.
A Surgical Wound is:
A Surgical wound that has not epithelized yet, a surgical wound epithelialized less than 30 days is still a surgical wound and would be scored 0-newly epithelialized on M1342, a surgical wound epithelialized more than 30 days that has dehisced, a surgical wound epithelialized more than 30 days that is infected, each orthopedic pin site, wounds with drains, a muscle flap to repair a pressure ulcer, a skin advancement flap to treat a pressure ulcer, a rotational flap to treat a pressure ulcer, a take down of a bowel ostomy, central line sites, a Medi-port and an implanted infusion device.
A Pressure Ulcer is:
A pressure ulcer any stage or unstageable, a pressure ulcer that has been surgically debrided, a pressure ulcer that has a skin graft (not one of the grafts noted above to treat a pressure ulcer).
A Stasis Ulcer is:
Only a venous stasis ulcer is a stasis ulcer for the purposes of the OASIS.
An Ostomy is: (Ostomies are not scored in the wound questions M1300 – M1350)
A bowel ostomy, a bowel ostomy being allowed to close on its own and an Ileostomy.
Skin Lesions or open wounds are: (for the purpose of M1350 you need to have orders to be treating or assessing them in your plan of care)
Surgical wounds that have been epithelialized more than 30 days without current complications (scars), Old scars, keloids, atrial stasis ulcers, diabetic ulcers, other ulcers, urostomy, tracheostomy, gastrostomy, cystostomy, nephrostomy, ureterostomy, urethrosotomy, PICC line site, peripheral IV site, sores, skin tears, burns, rashes, cellulitis, abscesses, trauma wounds, pustules, vesicles, wheals, crusts, abrasions, excoriation, fissure, petechiae, ecchymosis, cysts, nodules, edema, maceration, scale, lichenification.
So now you know a wound is not always a wound, an ostomy is not always an ostomy and edema is a skin lesion in the weird world of the Outcome Assessment and Information Set (OASIS). This list was compiled from the OASIS-C wound classification reference sheet at http://www.daymarck.com and Blueprint for OASIS Accuracy, 2010 Data Collection Workshop.