RAI-MDS 2.0 Nutritional Care Resource Guide April 2011 - CCIM

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RAI-MDS 2.0 Outputs Software OrientationChecklistThis checklist will serve as a guide for dietitians and nutrition managers during their RAI-MDS 2.0 outputsand reports software orientation. Please feel free to add other checklist items specific to your software. Atthe end of your software orientation, you should be competent in performing the following computer skills.Skills Checklist Notes/Comments Check1.2.3.4.5.6.Module 4 - Output ReportsLog in and open the RAI-MDS 2.0 outputs and reportssoftware folderObtain password for RAI-MDS 2.0 output reports if applicableOpen and close RAI-MDS 2.0 output reportsAccess and view different RAI-MDS 2.0 output reports (readonly) in the software:• Cognitive Performance Scale• Depression Rating Scale• Changes in Health End Stage Disease and Signs andSymptoms (CHESS)• Pain Scale• Index of Social Engagement• ADL - Short, Long and Hierarchy scale• Aggressive Behaviour Scale• interRAI Pressure Ulcer Risk• Quality Indicators• Resource Utilization GroupsAccess and view previous RAI-MDS 2.0 output reportsPrint RAI-MDS 2.0 Output Reports by:• Resident• Unit/program• Entire facility• QuarterlyFor Information: 416.327.7625 15ltchrai@ontario.ca15
Application of RAI-MDS 2.0 Reports to QualityImprovement PlanThe quality indicator (QI) reports for Unit 1 and Unit 2 are compared. Unit 2 has more residents with weight loss thanUnit 1. In the last quarter, there were 21% of residents on Unit 2 with weight loss compared to no weight loss on Unit1 for the past two quarters.Before addressing the weight loss issue on Unit 2, it is important to validate the problem by conducting a thoroughreview of the root cause related to weight loss. Below, you will find sample questions that can be asked during theinvestigation:Step 1: Data accuracy review (records review and staff interview)• Are there any RAI-MDS 2.0 coding errors on both units?• Are supporting documentation records accurate and current? For example, the weight loss record, food andfluid intake records progress notes etc.• Are care plans up to date addressing nutrition care issues• Are there regular coding accuracy checks? When was the last coding accuracy check conducted? Whatwas the result?Step 2: Other related quality indicators (to weight loss) review• A review of other QIs related to weight loss, for example:- Prevalence of symptoms of depression- Prevalence of symptoms of depression without antidepressant therapy- Prevalence of the use of nine or more different medications- Incidence of cognitive impairment- Prevalence of fecal impaction- Prevalence of tube feeding- Prevalence of dehydration- Incidence of decline in ROM- Prevalence of antipsychotic drug use in the absence of psychotic and related conditions- Prevalence of anti-anxiety/hypnotic drug use- Prevalence of hypnotic drug use more than two days in past week- Prevalence of Stage 1-4 pressure ulcers- Prevalence of little or no activityStep 3: Resident profile review (between the 2 units)• A review of RAPs related to weight loss, for example:- Nutritional Status- Feeding Tubes- Dehydration/Fluid Maintenance Status- Dental CareFor Information: 416.327.7625 16ltchrai@ontario.ca16
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RAI-MDS 2.0 Nutritional Care Resour
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Table of Contents1. Chapter 1: RAI-
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Glossary of TermsADLAlgorithmAverag
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RAI-MDS 2.0 Target population:Frail
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SECTION F: PSYCHOSOCIAL WELL-BEINGI
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SECTION P: SPECIAL TREATMENTS AND P
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SECTION V - RESIDENT ASSESSMENT PRO
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OUTCOME SCALES OR MEASURES• 10 ou
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Getting Started ChecklistCompletion
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Selected Coding Sections of RAI-MDS
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WEIGHT CHANGE CALCULATION EXAMPLE:C
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EXAMPLE:Step 1: Calculate Total Cal
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Examples include wheat-free diet to
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Overview of Assessment TimelinesOBS
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2. QUARTERLY ASSESSMENT TIMELINEThe
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TIMELINE FOR SIGNIFICANT CHANGE IN
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RAI-MDS 2.0 Nutrition Assessment Pr
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Day 0 First Day of New Admission On
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RAI-MDS 2.0 Nutrition Quarterly, Si
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Preparing to Code ChecklistThe foll
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Recommended Tools (Optional)Admissi
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Sensory Deficit Affecting Nutrition
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Admission Nutrition Assessment Work
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Essential Nutritional Assessment Ar
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Nutrition/Hydration Risk Identifica
Page 51 and 52: Assessing Nutrition / Hydration Ris
Page 53 and 54: CHAPTER 3: Resident Assessment Prot
Page 55 and 56: TRIGGERED RAPS IN THE RAI-MDS 2.0 R
Page 57 and 58: TRIGGERED RAP OR NON-TRIGGERED CLIN
Page 59 and 60: What have you read to support evide
Page 61 and 62: NO EXISTING RAP TRIGGEREDIf existin
Page 63 and 64: RAP IMPLEMENTATION STRATEGIES Compl
Page 65 and 66: NEW ADMISSION RAP AND CARE PLAN TIM
Page 67 and 68: M axim um 7 days M aximum 7 days Ma
Page 69 and 70: RAPS and Care Planning Software Ori
Page 71 and 72: The College of Dietitians of Ontari
Page 73 and 74: 8 Documentation by the dietitian in
Page 75 and 76: 17.10 Draws relevant conclusions fr
Page 77 and 78: RAPProcessLeaves25% ormore foodunea
Page 79 and 80: RAP Process Step 1Type of RAPLeaves
Page 81 and 82: Dietitian ReferralDietitian Referra
Page 83 and 84: 13. Dental Care14. Pressure UlcersD
Page 85 and 86: New triggered RAPs affecting nutrit
Page 87 and 88: Criteria to Review4. Evidence of RA
Page 89 and 90: OverviewOVERVIEW• Getting started
Page 91 and 92: MoodWorsened mood - symptoms of dep
Page 93 and 94: 15. Prevalence of depression withou
Page 95 and 96: • E1l - Sad, pained worried facia
Page 97 and 98: AGGRESSIVE BEHAVIOUR SCALE (ABS)•
Page 99 and 100: • Hemiplegia, pneumonia, septicem
Page 101: Preparing for RAI-MDS 2.0 Outputs a
Page 105 and 106: Case Study ApplicationThe Quality I
Page 107 and 108: Domain # Quality Indicators - Unit
Page 109 and 110: Domain # Quality Indicators - Unit
Page 111 and 112: 4-35Domain # Quality Indicators - U
Page 113 and 114: InterRAI RAI-MDS 2.0 Quality Indica
Page 115 and 116: For Information: 416.327.7625 28ltc
Page 121 and 122: Strategies for Achieving RAI-MDS 2.
Page 123 and 124: RAI-MDS 2.0 Quality Improvement Too
Page 125 and 126: Comments:Part C: Use of Data for De
Page 127: Literature: Recommended Articles1.
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RAI-MDS 2.0 Nutritional Care Resource Guide April 2011 - CCIM

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