geriatrics malnutrition prevention in nursing homes
DESCRIPTION
Geriatrics Malnutrition prevention in nursing homes. Sarah Hallaj November 16 th , 2009. The goal of the proposal. - PowerPoint PPT PresentationTRANSCRIPT
SARAH HALLAJ NOVEMBER 16 T H , 2009
Geriatrics Malnutrition prevention in nursing homes
The goal of the proposal
The goal of this project is to prevent malnutrition in long term care facilities by hiring dietitians and retraining health care providers to detect early signs and symptoms of malnutrition and promote adequate nutrient intake
Project timeline
The implementation of the project will start in March 2010 to allow time for nursing home managers to hire dietitians
Evaluation will be conducted after 6 months, September 2010
Some statistics:
There are 1.5 million nursing homes residents nationwide
As part of Oregon Health Care Association, there are 620 nursing homes represented in Oregon. This is the largest private non-profit association in Oregon; its facility members serve 40,000 Oregonians each day
Objective and activity #1:
Objective: Dietitians will identify macronutrient and micronutrient deficiencies and promote adequate nutrient intake
Activity: Dietitians will look at monthly biochemical laboratory results and interpret values indicating deficiencies that lead to malnutrition.
The dietitian will then dedicate counseling time with each resident to address the problem, find the constraints and try to solve them
Objective and activity #2
Objective: Monitor and prevent resident’s weight loss of 5% or more during a month period
Activity: Each dietitian and nurse will have certain number of residents to measure and record their weights on the charts.
Reminders will be installed in patient’s charts to remind the staff to record those weights
Objective and activity #3
Objective: Each full time dietitian will spend at least 20 hours per month with residents at meal time
Activity: Every working day, the dietitian and nurse will spend lunch hour with residents
Retraining kitchen staff
Create a dining areaRetrain the server the difference between
“serve” versus “offer” “Serving” food is when a resident doesn’t
choose what they would like to eat but rather are expected to eat what is on the tray
“Offering” is when a resident has the freedom to choose what they would like to eat and how much
This activity will:
Increase resident’s freedom of choice and intake
Increase communication between residents, nurse and dietitian
Create a social time that supports de Castro’s social facilitation theory which is defined as: “the enhancement of a behavior owing to the sheer presence of others.”
Objective and activity #4
Objective: Highlight and reinforce the critical importance of the nutrition care process to nursing home managers and nurses in Oregon
Activity: Different dietitians serving nursing homes in Oregon will offer seminars/webinars 4 times a year
Evaluation
Evaluations will be conducted after 6 months except for resident’s weights will be monitored weekly and monthly
Evaluations will include nursing home managers, dietitians, and residents
Funding and conclusion
Each nursing home will partner with a nearby hospital in the area to offer funding, hire a dietitian and provide resources to implement the program (such as: weight scale, dining table…)
After two years of executing, testing and evaluating the program, other states can follow and install the program adjusting it as required. With implementing this program in Oregon, the state can be the lead and champion in improving the nutritional status and quality of service to the 1.5 nursing home residents nationwide
References:
"The National Nursing Home Survey: 2004 Overview." Centers for Disease Control and Prevention. U.S. Department of Health and Human Services, June 2009. Web. 25 Oct. 2009. <http://www.cdc.gov/nchs/data/series/sr_13/sr13_167.pdf>.
"About OHCA." Oregon Health Care Association. 2004. Web. 1 Nov. 2009. <http://www.ohca.com/aboutus.htm>.
Nijs, Kristel, Cees Graaf, Wija A. Staveren, and Lisette Groot. "Malnutrition and Mealtime Ambiance in Nursing Homes." Journal of the American Medical Directors Association 10.4 (May 2009): 226-29. Science Direct. Web. 07 Oct. 2009. <http://www.sciencedirect.com.liboff.ohsu.edu/science?_>.