CLOUDCRUISE UNITED

EHR Conditional Form

Skin Assessment

Select all that apply.

No problems identified

Bruising

Rash:

Incision:

Skin tear:

Poor skin turgor

Edema

Other:

Comments

Pressure Ulcer

(M1306) Does this patient have at least one Unhealed Pressure Ulcer/Injury at Stage 2 or Higher or designated as Unstageable?

0 - No1 - Yes(-) No information available

Surgical Wound

(M1340) Does this patient have a Surgical Wound?

0 - No1 - Yes, patient has at least one observable surgical wound2 - Surgical wound known but not observable due to non-removable dressing/device

Wound Manager