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

• A review of the RUG III groups, for example:- What is the general resident profile on each unit?- Are there more residents in Unit 2 in the ‘special care’ or ‘clinically complex’ groups? (e.g. more diabeticand tube feeding residents on Unit 2)• A review of the RAI-MDS 2.0 outcome measures, for example:- What is the CHESS Scale score for both units? Higher CHESS score means higher frailty and instabilityof health- What are the Cognitive Performance Scale (CPS) scores? Are there more cognitively impairedresidents on Unit 2?- What are the Depression Rating Scale (CPS) scores for both units?- For the Pain and Index of Social Engagement Scale scores, are there any differences between the twounits?Step 4: Other potential contributing factors reviewCare Practice (staff interview, observation, care team conference)• Are residents receiving nourishments and other supplements as ordered on both units?• Are the weight scales properly calibrated on both units?• Are residents being weighed according to home protocols on both units?• Are staff following the dietitian referral protocol and making referrals when appropriate?Other (management reporting)• What is the staff turnover or staffing on both units? (Is Unit 2 having more staff turnover and staff shortage?This may impact coding accuracy or continuing of care)• Are staff members familiar with RAI-MDS 2.0 coding and RAPs documentation?Step 5: Data analysis: identification of potential contributing factors to weight loss• Review data collected from above and identify possible contributing factors to weight loss on Unit 2Step 6: Quality improvement plan development• Communicate results of the investigation to the care team• Collaborate with team members, including PSWs, to establish short and long term goals and developstrategies addressing weight loss on Unit 2• Identify if training is required• Document interventions and responsible person(s) for implementation in care plans and CQI plan• Determine how to monitor the interventions to ensure that they are implemented• Set a target date for team review and evaluate its effectiveness• Communicate the plan to all shifts and the entire care team• Adjust interventions as appropriate during the implementation of the planFor Information: 416.327.7625 17ltchrai@ontario.ca17