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

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CHAPTER 5: AppendicesCHAPTER 5: Appendices...................................................................... 1Strategies for Achieving RAI-MDS 2.0 Requirements in the Absence ofthe Services of a Dietitian ................................................................... 2RAI-MDS 2.0 Quality Improvement Tool for Nutrition Care ................. 4Literature: Recommended Articles ..................................................... 8
Strategies for Achieving RAI-MDS 2.0Requirements in the Absence of the Servicesof a DietitianFor homes that have been unsuccessful in their recruiting efforts of a dietitian, the following strategies are for theirnursing and nutrition manager to implement in the absence of a dietitian. During the absence of a dietitian, thenutrition manager and registered staff will need to collaborate to ensure the nutritional needs of the residents are met.These strategies may be modified and/or integrated into the home’s policy and practice. Homes in this situationshould continue their efforts in recruiting a dietitian.For Nutrition Manager:1. Set up regular meeting with the unit charge nurse or the RAI Coordinator to review residents’ nutrition carestatus and update priority residents and care plans.2. Provide a list of high-risk nutrition care residents to nursing, including residents with renal, swallowing andenteral feeding.3. Depending on home’s policy, maintain ongoing nutritional care, coding, RAP documentation and care planningfor medium to low risk residents.4. Depending on the home’s policy, review dietitian referral form with the unit charge nurse.5. Collaborate with registered staff to re-assign nutrition risk level as required.6. Participate in the interdisciplinary team care conference or RAPs and care planning review.7. Inform the RAI Coordinator of vacation or leave of absence so that RAI-MDS 2.0 assignment will be re-assignedto registered staff.8. Maintain record of all dietitian referral forms.For Nursing:1. Assign all high-risk nutrition care residents, including high priority residents (e.g. renal, swallowing, enteralfeeding etc.) to registered staff to complete coding, RAPs and care planning.2. Explore with management the availability of external dietitian resources including:• Dietitian agency services• Hospital Dietitian• Home Care Dietitian3. Assess and determine the home’s ability to meet residents’ nutritional needs prior to accepting placement.Advise CCAC and the Ministry of the home’s decision to decline a resident admission related to complex dietaryneeds and lack of on-site dietitian services.4. Residents with renal needs: contact the renal centre dietitian to ensure the necessary nutritionalrecommendations are sent back to the home to be implemented by the attending physician.5. Residents on enteral feeding: ensure prior to admission/re-admission that the resident is stable and implementformulary as recommended by the home care or hospital dietitian.6. Residents with swallowing difficulties: communicate to physician when a change in diet order is required andplace a referral to a Speech Language Pathologist for assessment and recommendations.For Information: 416.327.7625 2ltchrai@ontario.ca2
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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
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Assessing Nutrition / Hydration Ris
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CHAPTER 3: Resident Assessment Prot
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TRIGGERED RAPS IN THE RAI-MDS 2.0 R
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TRIGGERED RAP OR NON-TRIGGERED CLIN
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What have you read to support evide
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NO EXISTING RAP TRIGGEREDIf existin
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RAP IMPLEMENTATION STRATEGIES Compl
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NEW ADMISSION RAP AND CARE PLAN TIM
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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 and 102: Preparing for RAI-MDS 2.0 Outputs a
Page 103 and 104: Application of RAI-MDS 2.0 Reports
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 117 and 118: For Information: 416.327.7625 30ltc
Page 119: For Information: 416.327.7625 32ltc
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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