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

Facilitator Training—Additional Exercises (continued)

Intervention History for Nutrition Risk Report

Exercise #1: Report Information

Please choose the best answer to the questions.

  1. Intervention History is a companion report to (circle all that apply):
    1. Nutrition Risk Report: High Risk
    2. Nutrition Risk Report: Medium Risk
    3. Weight Summary Report
    4. Trigger Summary Report
    5. None of the above
    6. All of the above
  2. If there is no physician's order for Hospice, the cell shows:
    1. The word "NO"
    2. A dash (-)
    3. Blank
    4. None of the above
  3. Lab values are displayed.
    1. True
    2. False
  4. Average supplement intake is displayed.
    1. True
    2. False
  5. All residents for a single nursing unit display on the Intervention History for Nutrition Risk Report.
    1. True
    2. False
  6. If a resident has two orders for a PT consult in the last 30 days, then both order dates will display on the report.
    1. True
    2. False

Answers:

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

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Exercise #2: Using the Intervention History for Nutrition Risk Report

Use the Intervention History for Nutrition Risk Report and the companion Nutrition High-Risk Report to answer the following questions.

  1. Resident A was admitted after a stroke and has been at the facility for about 2 months receiving therapy. What questions would you want to ask the multidisciplinary team?
  2. Resident B was admitted from the hospital with advanced cancer. What would you want to discuss with the team?
  3. Resident C was admitted with dementia as a long-term patient several months ago. What questions would you want to ask?

Sample Intervention History for Nutrition Risk Report: High-Risk Residents

Nursing Unit: A
Report Date: 4/2/14

ID Name Room Diet Diet Changes Supple- ments PT OT Speech Social Services Psych Gastro- enterology Hospice Seen by: MD / PA or NP Chemistry Micro- biology Hema- tology
A Jones, M 301 Pureed 2/28/14   2/28/14 2/28/14 2/28/14         3/28 /14      
B North, D 310 Mech 1/22/14 3/14/14               2/13/13     11/13/13
C Kelly, D 304 Reg 1/22/13           1/25/14     3/16/14 3/18/14 3/18/14 3/18/14

Sample Nutrition Report: High Risk

Nursing Unit: A
Report Date: 4/2/14

Resident Room Number Decreased Intake: First Date Avg. Meal Intake %  3/1/14 Avg Meal Intake % 3/8/14 Avg Meal Intake % 3/15/14 Avg Meal Intake % 3/22/14 Diet TF Avg. Supple- ment Intake %* Weight Change in lb Most Recent Ulcer Access Date # of Pr Ulcers
A 301 03/22/2014 50 41 36 29 Pureed
2/28 /14
    -3.5    
B 310 03/22/2014 54 52 47 45 Mech
1/22 /14
  50% -2.3  3/31/14  1
C 304 03/21/2014 74 62 58 42 Reg
3/22 /14
    -5.5    

Answers:

Resident A. What did the speech therapist recommend on 2/28/14? Does ST plan to do a followup? If not, should another ST consult be considered? There are no lab dates. Can it be true that the resident has never had lab work? Is the dietitian aware of the steady decline in meal intake over the past 4 weeks? The pureed diet was ordered on admission, but could the diet be advanced at this stage? Who will speak with the speech therapist? Should a supplement be considered? Has the dietitian spoken to the resident about food preferences? How are the resident's spirits? Has the nursing assistant noticed any change in mood? Is this person depressed? Is a psych consult in order?

Resident B. Is the dietitian aware of the poor meal intake over the past 4 weeks? Has he or she spoken to the resident or family about food preferences? Has this resident or family been approached regarding hospice? It has been a while since any labs have been done. Has this been discussed with the physician or resident and family? Should PT evaluate the appropriateness of the support surfaces? How are the resident's spirits? Does the nursing assistant or social worker have any insight into this resident's frame of mind? Should a social services or psych consult be considered?

Resident C. Is the dietitian aware of the decline in meal intake over the past 4 weeks? Has he or she discussed food preferences with the resident and family? What is the nursing assistant seeing? Are there any problems swallowing? Any problems with the resident's teeth? Should a change in the diet order be considered or the addition of a supplement? Has this resident been evaluated by restorative nursing? Would he be a candidate for restorative dining?

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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/addexercises6.html