Smoking Audit Documentation

V 2.0

Introduction

Resident Selection

Residents Included

All Residents who on their most recent assessment (Admission or Smoking Assessment) have been identified as smoking cigarettes, using e-cigarettes, chewing smokeless tobacco, or using nicotine patches. This does not include residents who are in a smoke free facility.

Business Rules

Tasks:

  1. Next Smoking Assessment - Assign a due date for next Smoking Assessment (Q1409)

    1. Location in PCC:

      1. Assessments → Smoking Assessment

    2. Business Rule:

      1. IF a resident uses any nicotine, or e-cigarette products,
        THEN there must be a completed smoking assessment within 90 days of the last smoking assessment/nursing admission evaluation.

    3. Due Date:

      1. 90 Days after the last assessment

    4. Is classified as missed on the report:

      1. 30 days after the due date.

    5. Is no longer relevant to the report:

      1. If the resident is no longer a smoker.

  2. Assessment Completed Correctly - A Smoking Assessment has been completed correctly for the resident. (Q1401)

    1. Location in PCC:

      1. Assessments → Smoking Assessment

      2. Assessments → Admission Assessment → Section 2 

    2. Business Rule:

      1. IF a Resident smokes cigarettes,
        AND their most recent assessment is a Smoking Assessment,
        THEN the following sections of the assessment must be completed in full:

        1. Cognition

        2. Vision

        3. Dexterity

        4. Safety

      2. IF a Resident uses smokeless tobacco,
        AND their most recent assessment is a Smoking Assessment,
        THEN the following sections of the assessment must be completed in full:

        1. Cognition

        2. Dexterity

        3. Safety

      3. IF a Resident only uses e-cigarettes,
        AND their most recent assessment is a Smoking Assessment,
        THEN the following sections of the assessment must be completed in full:

        1. Cognition

        2. Dexterity

      4. IF a Resident uses nicotine patches,
        AND their most recent assessment is a Smoking Assessment,
        THEN the following section of the assessment must be completed in full:

        1. Cognition

      5. IF a Resident smokes cigarettes,
        OR the Resident uses smokeless tobacco,
        AND their most recent assessment is an Admission Assessment,
        THEN the following sections of the assessment must be completed in full:

        1. Cognition

        2. Dexterity

        3. Safety

      6. IF a Resident only uses e-cigarettes,
        AND their most recent assessment is an Admission Assessment,
        THEN the following sections of the assessment must be completed in full:

        1. Cognition

        2. Dexterity

      7. IF a Resident uses nicotine patches,
        AND their most recent assessment is an Admission Assessment,
        THEN the following section of the assessment must be completed in full:

        1. Cognition

    3. Due Date:

      1. Immediately

    4. Is classified as missed on the report:

      1. Immediately

    5. Is no longer relevant to the report:

      1. If the resident is no longer a smoker.

  3. Cognitive Decline Supervision - For cognitively impaired Residents, there is documentation in the assessment for supervision while smoking. (Q1408)

    1. Location in PCC:

      1. Assessments

    2. Business Rule:

      1. IF a Resident smokes,
        AND the most recent smoking assessment or admission assessment indicates the resident is cognitively impaired,
        THEN the most recent smoking assessment must indicate the resident requires supervision when smoking.

    3. Due Date:

      1. Immediately 

    4. Is classified as missed on the report:

      1. Immediately

    5. Is no longer relevant to the report:

      1. If the resident is no longer a smoker.

  4. Resident Capabilities - The Smoking assessment establishes the resident’s capabilities and deficits to determine if adaptive equipment or supervision is required. (Q1405)

    1. Location in PCC:

      1. Assessments

    2. Business Rule:

      1. IF a Resident smokes,
        AND the most recent smoking assessment or admission assessment indicates the resident has deficits in capability in any of the following:

        1. Visual Deficit

        2. Dexterity Problems

        3. Inability to Light Cigarettes

        4. Displaying Tremors

        5. Inability to Dispose of Cigarette

        6. Difficulty Swallowing

THEN the assessment must indicate the adaptive equipment necessary for the Resident to smoke safely.

  1. Due Date:

    1. Immediately 

  2. Is classified as missed on the report:

    1. Immediately

  3. Is no longer relevant to the report:

    1. If the resident is no longer a smoker.

  1. Care Plan Focus - A Care Plan Focus exists identifying the Resident as a smoker. (Q1403)

    1. Location in PCC: 

      1. Care Plan

        1. Focus

    2. Business Rule:

      1. IF a Resident smokes,
        THEN there must be a Care Plan Focus indicating that the Resident is a smoker.

    3. Due Date:

      1. Within 24 Hours of the smoking or admission assessment that identifies the resident as a smoker OR
        Within 3 weeks of admission for new admissions

    4. Is classified as missed on the report:

      1. N/A

    5. Is no longer relevant to the report:

      1. If the resident is no longer a smoker.

  2. Cognitive Decline Care Plan - For cognitively impaired Residents, there is documentation in the care plan for supervision while smoking. (Q1404)

    1. Location in PCC:

      1. Assessment

      2. Care Plan

        1. Interventions

    2. Business Rule:

      1. IF a Resident smokes,
        AND the most recent smoking assessment indicates the resident is cognitively impaired,
        THEN the requirement of supervision must be recorded in the care plan.

    3. Due Date:

      1. Within 24 Hours of the smoking or admission assessment that identifies the resident as a smoker OR
        Within 3 weeks of admission for new admissions

    4. Is classified as missed on the report:

      1. N/A

    5. Is no longer relevant to the report:

      1. If the resident is no longer a smoker.

  3. Adaptive Equipment Care Plan - For Residents who require adaptive equipment the smoking care plan mentions the appropriate interventions. (Q1406)

    1. Location in PCC:

      1. Assessments

      2. Care Plan

        1. Interventions

    2. Business Rule:

      1. IF a Resident smokes,
        AND the assessment indicates that the Resident requires adaptive equipment for the Resident to smoke safely,
        THEN the care plan must include an intervention that mentions the necessary adaptive equipment.

    3. Due Date:

      1. Within 24 Hours of the smoking or admission assessment that identifies the resident as a smoker OR
        Within 3 weeks of admission for new admissions

    4. Is classified as missed on the report:

      1. N/A

    5. Is no longer relevant to the report:

      1. If the resident is no longer a smoker.

  4. Independent Smokers Care Plan - For independent smokers, the care plan indicates that the resident is independent with smoking. (Q1407)

    1. Location in PCC:

      1. Assessments

      2. Care Plan

        1. Interventions

    2. Business Rule:

      1. IF a Resident smokes,
        AND the assessment indicates that the Resident can smoke safely independently,
        THEN the care plan must include an intervention that mentions that the Resident is an independent smoker.

    3. Due Date:

      1. Within 24 Hours of the smoking or admission assessment that identifies the resident as a smoker OR
        Within 3 weeks of admission for new admissions

    4. Is classified as missed on the report:

      1. N/A

    5. Is no longer relevant to the report:

      1. If the resident is no longer a smoker.