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

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CHAPTER 1: RAI-MDS 2.0 IntroductionCHAPTER 1: RAI-MDS 2.0 Introduction................................................ 1Glossary of Terms ................................................................................ 2RAI-MDS 2.0 Overview for Nutrition Team .......................................... 3Getting Started Checklist .................................................................. 14
Glossary of TermsADLAlgorithmAverage weight forht/sex/ageARDBody mass index (BMI)CHESSCIHICPSDARTDRSGoal weight (GBW)IDTISELTCH CAPMDSNutrition Care TeamQIRAIRAPsReliabilityRUGsSection VTriggersUsual body weight(UBW)ValidityActivities of daily livingA precise rule (or set of rules) that specifies how certain problems should be solved.RAI has built-in algorithms for RAPs, outcome measures and RUGs.Weight defined in reference tables, which outline the average weight of individualsaccording to age, sex and height (Master, Laser, Beckman 1960, NHANES). Thisterm is sometimes referred to as ‘ideal body weight’ range (IBW).Assessment Reference Date, the last day of the assessment observation periodCalculated by weight (kg)/height (m) ². For persons 65 years and older, the ‘normal’range may begin slightly above BMI 18.5 and extend into the ‘overweight’ range(Health Canada). Healthy range also varies among ethnic backgrounds.Changes in Health, End-stage disease and Signs and SymptomsCanadian Institute for Health InformationCognitive Performance ScaleData Accuracy Review TeamDepression Rating ScaleThe target weight based on individual’s usual body weight and clinical assessment ofnutrition riskInterdisciplinary TeamIndex of Social EngagementLong-Term Care Homes Common Assessment ProjectMinimum Data SetThe primary nutrition care team includes clinical dietitian, nutrition manager andnursing. They will consult other care providers for nutrition information, ifappropriate.Quality indicatorResident Assessment InstrumentResident Assessment ProtocolsDo you get the same answer regardless of who is doing the assessment?Resource Utilization GroupsResident assessment protocol (RAP) summary formThe RAI-MDS 2.0 assessment items that group to form the algorithm(s) to initiate theRAP(s)Weight that an individual has maintained for an extended period of time. UBW is themost important factor in assessing weight changes.Does the instrument measure what it purports to measure? Are the relevant conceptscovered?For Information: 416.327.7625 2ltchrai@ontario.ca2
Page 1 and 2: RAI-MDS 2.0 Nutritional Care Resour
Page 3: Table of Contents1. Chapter 1: RAI-
Page 7 and 8: RAI-MDS 2.0 Target population:Frail
Page 9 and 10: SECTION F: PSYCHOSOCIAL WELL-BEINGI
Page 11 and 12: SECTION P: SPECIAL TREATMENTS AND P
Page 13 and 14: SECTION V - RESIDENT ASSESSMENT PRO
Page 15 and 16: OUTCOME SCALES OR MEASURES• 10 ou
Page 17 and 18: Getting Started ChecklistCompletion
Page 19 and 20: Selected Coding Sections of RAI-MDS
Page 21 and 22: WEIGHT CHANGE CALCULATION EXAMPLE:C
Page 23 and 24: EXAMPLE:Step 1: Calculate Total Cal
Page 25 and 26: Examples include wheat-free diet to
Page 27 and 28: Overview of Assessment TimelinesOBS
Page 29 and 30: 2. QUARTERLY ASSESSMENT TIMELINEThe
Page 31 and 32: TIMELINE FOR SIGNIFICANT CHANGE IN
Page 33 and 34: RAI-MDS 2.0 Nutrition Assessment Pr
Page 35 and 36: Day 0 First Day of New Admission On
Page 37 and 38: RAI-MDS 2.0 Nutrition Quarterly, Si
Page 39 and 40: Preparing to Code ChecklistThe foll
Page 41 and 42: Recommended Tools (Optional)Admissi
Page 43 and 44: Sensory Deficit Affecting Nutrition
Page 45 and 46: Admission Nutrition Assessment Work
Page 47 and 48: Essential Nutritional Assessment Ar
Page 49 and 50: Nutrition/Hydration Risk Identifica
Page 51 and 52: Assessing Nutrition / Hydration Ris
Page 53 and 54: 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
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RAPS and Care Planning Software Ori
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The College of Dietitians of Ontari
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8 Documentation by the dietitian in
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17.10 Draws relevant conclusions fr
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RAPProcessLeaves25% ormore foodunea
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RAP Process Step 1Type of RAPLeaves
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Dietitian ReferralDietitian Referra
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13. Dental Care14. Pressure UlcersD
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New triggered RAPs affecting nutrit
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Criteria to Review4. Evidence of RA
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OverviewOVERVIEW• Getting started
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MoodWorsened mood - symptoms of dep
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15. Prevalence of depression withou
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• E1l - Sad, pained worried facia
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AGGRESSIVE BEHAVIOUR SCALE (ABS)•
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• Hemiplegia, pneumonia, septicem
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Preparing for RAI-MDS 2.0 Outputs a
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Application of RAI-MDS 2.0 Reports
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Case Study ApplicationThe Quality I
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Domain # Quality Indicators - Unit
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Domain # Quality Indicators - Unit
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4-35Domain # Quality Indicators - U
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InterRAI RAI-MDS 2.0 Quality Indica
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For Information: 416.327.7625 28ltc
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Strategies for Achieving RAI-MDS 2.
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RAI-MDS 2.0 Quality Improvement Too
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Comments:Part C: Use of Data for De
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Literature: Recommended Articles1.
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RAI-MDS 2.0 Nutritional Care Resource Guide April 2011 - CCIM

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