Understanding and Coding MDS Item E1000B: Wandering - Intrude on Privacy of Others

Understanding and Coding MDS Item E1000B: Wandering - Intrude on Privacy of Others

Introduction

Purpose:
MDS Item E1000B, "Wandering: Intrude on Privacy of Others," is used to assess and document whether a resident’s wandering behavior includes intrusions into the privacy or personal space of others in the facility. This item helps identify behaviors that may pose risks to the resident’s well-being or affect the safety and comfort of other residents. Accurately coding this item enables staff to develop care plans that address wandering behaviors, ensuring both the wandering resident and others in the facility receive appropriate care and protection.

What is MDS Item E1000B?

Explanation:
MDS Item E1000B is part of Section E, which addresses Behavioral Symptoms in the MDS 3.0 assessment. This item focuses on whether the resident exhibits wandering behaviors that lead them to intrude on the privacy or personal space of others in the facility. Wandering is often associated with cognitive impairments, such as dementia, and can result in the resident entering rooms or areas where they are not supposed to be, potentially causing distress to other residents.

Intruding on privacy refers to entering another resident’s room or private areas uninvited, or being inappropriately present in communal or restricted areas. This behavior can disrupt the privacy, comfort, and safety of others and may also indicate that the wandering resident is confused, disoriented, or looking for something (such as their own room).

• Relevance: Documenting wandering behaviors that involve privacy intrusions helps staff to assess the resident’s cognitive status and behavioral patterns. It also allows for the development of care plans to manage and mitigate wandering behaviors while protecting the privacy and safety of all residents.
• Importance: Proper coding of E1000B ensures that wandering behaviors are recognized and addressed in the resident’s care plan, reducing the risk of harm to the resident or others in the facility.

Guidelines for Coding MDS Item E1000B

Coding Instructions:

1. Observe and Document Behavior:
   The assessment period typically covers the look-back period (the past 7 days). During this time, staff should observe whether the resident has exhibited wandering behaviors that involve intruding into the privacy or personal space of others.

2. Answering E1000B:

   • Code 0 (No) if the resident does not intrude on the privacy or personal space of others during wandering in the observation period.
   • Code 1 (Yes) if the resident’s wandering includes entering other residents' rooms or private areas without permission, or otherwise intruding on others' personal space during the observation period.

3. Documentation Requirements:
   Document incidents where the resident wandered into another resident’s room or private area. This should include the date, time, and description of the behavior, as well as any interventions that were used to redirect the resident.

4. Verification:
   Ensure that wandering behaviors are well-documented in the resident’s medical records. Cross-reference with staff observations or behavior logs to confirm the frequency and nature of these behaviors.

Example Scenario:
During the observation period, Mr. Jones, a resident with dementia, was found multiple times wandering into other residents’ rooms, causing distress to the other residents. In this case, code 1 (Yes) for E1000B, as the resident’s wandering behavior involved intruding on the privacy of others.

Best Practices for Accurate Coding

Behavior Tracking:
Establish a behavior tracking system to record wandering incidents. Regular monitoring of these behaviors helps ensure accurate documentation and timely interventions.

Communication Among Staff:
Encourage open communication among staff to report wandering behaviors promptly. This ensures that all incidents are documented and addressed in the care plan, and that staff members can consistently monitor the resident.

Training:
Train staff on how to recognize wandering behaviors and respond to situations where residents intrude on others’ privacy. Staff should be aware of interventions to prevent such behaviors, such as environmental modifications or redirection techniques.

Conclusion

MDS Item E1000B is essential for identifying whether a resident’s wandering behaviors include intruding on the privacy or personal space of others. Accurate coding of this item ensures that wandering behaviors are appropriately documented and addressed in the resident’s care plan, protecting both the wandering resident and other residents in the facility. Proper documentation, consistent communication, and effective interventions are key to managing wandering behaviors and promoting a safe environment for all residents.

Click here to see a detailed step-by-step on how to complete this item set

Reference

For more detailed guidelines on coding MDS Item E1000B, refer to the CMS’s Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024, Chapter 3, Section E, Page 3-25.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item E1000B: "Wandering - Intrude on Privacy of Others" was originally based on the CMS’s Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024. Every effort will be made to update it to the most current version. The MDS 3.0 Manual is typically updated every October. If there are no changes to the Item Set, there will be no changes to this guide. This guidance is intended to assist healthcare professionals, particularly new nurses or MDS coordinators, in understanding and applying the correct coding procedures for this specific item within MDS 3.0. The guide is not a substitute for professional judgment or the facility’s policies. It is crucial to stay updated with any changes or updates in the MDS 3.0 manual or relevant CMS regulations. The guide does not cover all potential scenarios and should not be used as a sole resource for MDS 3.0 coding. Additionally, this guide refrains from handling personal patient data and does not provide medical or legal advice. Users are responsible for ensuring compliance with all applicable laws and regulations in their respective practices.