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

More documents

Recommendations

Info

STEP 5: CARE PLANNING DECISIONState whether you will be care planning this problem or not.If yes..• What is the goal of the plan of care?If not to care plan..• State the reason whyRemember…Do not write the plan of care interventions in this step.Save these for the plan of care.EXAMPLES:Current plan of care will be updated with the goal of increasing caloric intake and preventing further skinbreakdown.No plan of care is required because resident has no evidence of dehydration.EXAMPLE OF COMBINED RAPSCombined RAPs: Nutritional Status & Dental CareNutritional Status Triggers:• K5c = Checked (Mechanically altered diet)• K4a = checked (Complains about taste of many foods)• K4c = Checked (Leaves 25% or more food uneaten at most meals)Dehydration Trigger:• J1d = Checked (Insufficient fluid/did not consume all liquids provided)Dental Care Triggers:• K1c = checked (mouth pain)• L1e = checked (oral abscess)COMBINED NEW RAPS: NUTRITIONAL STATUS, DEHYDRATION AND DENTAL CARE1New RAPs. 2Mr. Wiley has a tooth abscess and is experiencing pain when eating or drinking.He has been limiting fluid intake, eating less than 50% of the food at his meals and complainingthat everything tastes bad when eating. 3The mouth pain is impacting his ADL functioning andlimiting his participation in activities. The mechanically altered diet to reduce chewing pain is nolonger effective. 4Referral will be made to MD to discuss antibiotic therapy, and pain medicationand the dentist for possible tooth extraction. 5This RAP will be care planned with the goal ofeliminating the resident’s mouth pain and avoiding dehydration resulting from a reduction in fluidintake.For Information: 416.327.7625 8ltchrai@ontario.ca8
NO EXISTING RAP TRIGGEREDIf existing RAP is not triggered in the next quarter, nutrition care team is responsible for evaluating theeffectiveness of the care plan interventions outlined from the previous quarter.They can then decide whether to maintain, adjust or discontinue the existing RAP problem and the planof care.e.g. Nutritional RAP (triggered by weight loss K3a=1) was triggered in previous quarter, but not in thecurrent quarter due to medication change to improve his behavioral problemThis existing RAP is not triggered in this quarter. Resident gains 1.5 kg this quarter, is able to sitthrough the entire meal and tolerates the high calorie supplements. He is responding well to thebehavioral medication change - less agitation, more cooperative and alert. Care plan will be maintainedfor monitoring no further weight loss fluctuation.PLAN OF CAREWHAT IS A RESIDENT PLAN OF CARE?A communication tool for care team members in all shifts on how to care for the resident.CHARACTERISTICS OF A GOOD CARE PLAN• Current• Accurate• Clear• Useful/practical• Individualized - meets the needs and wishes of the resident• Interdisciplinary - reflects team contributions• Comprehensive - addresses physical, psychosocial, spiritual and medical• Accessible by all staffPLAN OF CARE: PROCESS AND COMPONENTSFor Information: 416.327.7625 9ltchrai@ontario.ca9
Page 1 and 2:
RAI-MDS 2.0 Nutritional Care Resour
Page 3 and 4:
Table of Contents1. Chapter 1: RAI-
Page 5 and 6:
Glossary of TermsADLAlgorithmAverag
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
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: What have you read to support evide
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 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:
Page 119 and 120:
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.
show all

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

Create successful ePaper yourself

Delete template?

Save as template?