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

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