AHRQ's Safety Program for Nursing Homes: On-Time Pressure Ulcer Prevention

Facilitator Training—Additional Exercises (continued)

Weight Summary Report Information Exercises

Objective: Facilitators will understand criteria and rules that determine information that displays on the Weight Summary Report.

Exercise #1: Risk Criteria and Rules

Please choose the best answer to the questions about report rules.

  1. The Weight Summary Report displays 4 weeks of trended weight information for each resident.
    1. True
    2. False
  2. If a resident was not weighed during the report week, what would you expect to see in the Weight Change in lb cell?
    1. Blank cell
    2. Dash (‐)
    3. 0
    4. NA
    5. None of the above
  3. If a resident was not weighed weekly, what weight values would you expect to see on the report?
    1. Four consecutive monthly weights instead of weekly weights
    2. Weight values in weeks when weights were recorded and blank cells when weights were not recorded
    3. The resident would not display on the report if weekly weight values were not recorded
    4. None of the above
  4. If multiple weights are recorded during the report week, the highest weekly weight is used for report calculations.
    1. True
    2. False
  5. Weight changes for the past 30, 90, and 180 days are calculated.
    1. True
    2. False
  6. Weights that are entered into the system incorrectly will be included in weight calculations unless the weight is flagged as an incorrect entry.
    1. True
    2. False

Answers:

  1. a
  2. a
  3. b
  4. b
  5. b
  6. a

Return to Additional Exercises Contents

Exercise #2: Report Information

Using the table below, answer the following questions:

  1. How many residents have any weight loss in the current week?
  2. How many residents have weight loss within the last 30 days?
  3. How many times has Resident 2 experienced weight loss in the last 30 days? Resident 4?
  4. How many residents experienced ≥10% weight loss in the last 6 months?
  5. Do any weights stand out as potential inaccuracies? What would be your followup questions to the team?
Name Res ID Wt 180 Days Prior Wt 90 Days Prior Wt 30 Days Prior Wt for Week 05/08/14 Week4 Wt for Week 05/15/14 Week3 Wt for Week 05/22/14 Week2 Wt for Week 05/29/14 Week1 Weight Change in lb ≥5% Wt Loss in Prior 30 Days (Any) ≥7.5% Wt Loss in Prior 90 Days ≥10% Wt Loss in Prior 180 Days
Res1 001 285.3 275 254.5 252.4 256.1 251.7 253.8 2.1   7.7% 11%
Res2 002 172.1 175.3 180 180 170 181 171 -10 5.6% :  5/12/14; 5% :  5/24/14    
Res3 002 146.8 132 126.2 124 122.2   116.8 -5.4 5.8% : 5/23/14 11.5% 20.4%
Res4 004 151 148.2 145       142.2 -2.8      
Res5 005 112 110.2 108 94.8 99.8 98 100.8 2.8   8.5% 10%
Res6 006 114 119 118.2       115 -3.2      
Res7 007 165.3 155 144.5 132.4 136.1 131.7 123.8 -7.9 6.5% :  5/27/14; 9% :  5/27/14; 6% :  5/27/14 20% 25.1%
Res8 008 182.1 175.3 180 180 164 161          
Res9 009 158.8 166.2 148.2 146.6 142.6 140.6 136.8 -3.8 6.7% : 5/23/14 17.7% 13.9%
Res10 010 169.3 159.3 136 132.2 146.4 134 128.2 -5.8 6% : 5/19/14; 6% : 5/23/14 19.5% 24.3%

Answers:

  1. 7
  2. 10
  3. Resident 2 twice; Resident 4 once
  4. 6
  5. Resident 7 has weights for 30 days prior and 4 weeks ago that are quite different. Is that possible? Same with Resident 5. Ask the team when those two weights were obtained (4 weeks ago and 30 days prior). How many days between those two weights? Was there something going on with the resident to explain the large difference in the two values?

    Resident 8 either had no weight loss or had no weight recorded during the report week.

    Weights for Resident 10 seem to fluctuate significantly. The weight for Week 3 seems particularly high and not in line with the other weekly weights. That one should be double-checked.

    Followup questions could focus on their weight recording procedures. If weights identified as possibly inaccurate were done by the same nursing assistant, there could be a need for retraining in this area.

Return to Additional Exercises Contents

Exercise #3: Prioritize Residents for Followup

Using the table below, prioritize residents for followup.

Name Res ID Wt 180 Days Prior Wt 90 Days Prior Wt 30 Days Prior Wt for Week 05/08/14 Week4 Wt for Week 05/15/14 Week3 Wt for Week 05/22/14 Week2 Wt for Week 05/29/14 Week1 Weight Change in lb ≥5% Wt Loss in Prior 30 Days (Any) ≥7.5% Wt Loss in Prior 90 Days ≥10% Wt Loss in Prior 180 Days
Res1 001 185.3 175 154.5 152.4 156.1 151.7 153.8 2.1   12.1% -17%
Res2 002 192.1 185.3 180 170 174 171 168 -3   9.3% -12.5%
Res3 002 188.8 176.2 168.2 166.4 162.4 158.6 156 -2.6 6.3% : 5/29/14 11.5% -17.4%
Res4 004 159.3 139.3 135 136.2 155.4 144 126.2 -17.8 7.3% : 5/24/14; 7.3% : 5/16/14;18.8% : 5/24/14; 12.4% : 5/24/14 9.4% -20.8%
Res5 006 164 159.2 145.9 148.2 144.2 136.8 135 -1.8 7.7% : 5/18/14; 8.9% : 5/26/14;5.1% : 5/18/14; 6.4% : 5/26/14 15.2% -17.7%
Res6 007 126 133.2 130.3       129 -1.3      
Res7 008 184 169.2 155.5 148.2 136.2 130.8 130 -0.8 8.1% :  5/9/14; 11.7% :  5/18/14; 12.3% :  5/24/14 23.2% -29.3%
Res8 010 156 133.2 130.3       129 -1.3     -17.3%

Answers:

Residents 3, 4, 5 and 7

Return to Additional Exercises Contents

Weight Summary Report Implementation Exercises

Objective: Facilitators will understand how to coach teams on implementation of report use. Facilitators will be prepared to respond to a variety of questions from clinical teams implementing the Weight Summary Report for the first time.

Exercise #4: Report Calculations

Choose the best answer to the questions about report calculations.

  1. How is Weight 180 Days Prior determined? (Circle all that apply)
    1. Identify all weights that occur in the range of 170-190 days from the most recent weight date; select the weight closest to 180 days
    2. Identify all weights that occur in the range of 175-180 days from the most recent weight date; select the weight closest to 180 days
    3. If two weights are the same distance from 180 days, select the highest weight
    4. If two weights are the same distance from 180 days, select the lowest weight
    5. None of the above
  2. When determining Weight 30 Days Prior, first identify all weights that occur in the range of 28-32 days from the most recent weight date.
    1. True
    2. False
  3. When determining a Point-to-Point weight loss within a 30-day period, you may identify multiple weight losses.
    1. True
    2. False
  4. How is >5% Wt Loss ≤30 Days calculated using Any weight loss calculation? (Circle all that apply.)
    1. Week 4 Weight is subtracted from Week 3 Weight, then Week 2 Weight, then Week 1 Weight; negative values are divided by Week 4 Weight
    2. Week 3 Weight is subtracted from Week 2 Weight, then Week 1 Weight; negative values are divided by Week 3 Weight
    3. Week 2 Weight is subtracted from Week 1 Weight; negative values are divided by Week 2 Weight
    4. None of the above

Answers:

  1. a and d
  2. b
  3. a
  4. a, b, c

Return to Additional Exercises Contents

Exercise #5: Implementation: Key Points

Choose the best answer to the questions.

  1. Dietitians are generally more likely to adopt and use the Weight Summary Report if weight loss calculations are explained prior to report use.
    1. True
    2. False
  2. Weight Summary Reports typically replace facility reports currently in use by dietitians once dietitians become familiar with report data and calculations.
    1. True
    2. False
  3. Initial use of the Weight Summary Report often highlights opportunities for facilities to improve existing processes to capture and record resident weights in their health IT system.
    1. True
    2. False
  4. Weight Summary Reports are often used in the following forums (circle all that apply):
    1. Weight Management Meeting
    2. Interdisciplinary Team Meeting
    3. Risk Management Meeting
    4. Weekly Nursing Assistant Nutrition Risk Huddle
    5. MDS Assessment Prep/Review
    6. All of the above
    7. None of the above
  5. Using the Weight Summary Report (circle all that apply):
    1. Highlights the importance of accurate and timely documentation of resident weights
    2. Motivates the team to document weights in a more accurate and timely manner
    3. Helps CNAs understand the link between weight loss and nutritional status
    4. Highlights the value of having a formal process to validate resident weights prior to entry into the  health IT system
    5. All of the above
    6. None of the above

Answers:

  1. a
  2. a
  3. a
  4. f
  5. e

Return to Additional Exercises Contents
Proceed to Next Section
Return to Pressure Ulcer Prevention

Page last reviewed April 2016
Page originally created March 2013
Internet Citation: AHRQ's Safety Program for Nursing Homes: On-Time Pressure Ulcer Prevention. Content last reviewed April 2016. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/long-term-care/resources/ontime/pruprev/addexercises4.html