Weight Loss Prevention
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Accuracy of Minimum Data Set in Identifying Residents at Risk for Undernutrition: Oral Intake and Food Complaints
Sandra F. Simmons, Betty Lim, and John F. Schnelle, 2002, in American Medical Directors Association; May/June:140-145.
This study showed that nursing home staff inaccurately documented low oral intake and food complaints among residents, resulting in a significant underestimate of residents with either of these risk factors for undernutrition. The researchers found a significant discrepancy between nursing home staff estimates on Minimum Data Set (MDS) documentation and their own independent assessments based on direct observations of mealtrays and interviews with residents. Whereas the researchers identified 55 (73%) of the 75 residents who participated in the study as being at risk for undernutrition due to low food and fluid consumption, nursing home staff failed to identify 27 of these residents. In interviews with research staff, 32% of the residents complained about the facility's food. By comparison, nursing home staff reported no food complaints by residents. The authors suggest that staff-recorded inaccuracies may stem from nurse aides having too much to do during mealtimes, vague instructions in the MDS manual on how to assess intake and food complaints, and supervisors failing to periodically check nurse aide estimates for accuracy. Nursing home staff also may underestimate the number of residents, including those with cognitive impairments, who can reliably answer questions about the facility's quality of food and other aspects of their care.
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