Weight Loss Prevention
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The Minimum Data Set Weight Loss Quality Indicator: Does it Reflect Differences in Care Processes Related to Weight Loss?
Sandra F. Simmons, Emily T. Garcia, Mary P. Cadogan, N.R. Al-Samarrai, L.F. Levy-Storms, Dan Osterweil, and John F. Schnelle, 2003, in Journal of the American Geriatrics Society; 51(10:1410-1418.
Federal regulations require nursing homes to complete resident assessments periodically using the Minimum Data Set (MDS) assessment protocol. Results are used to generate quality indicators (QI) for each facility as a means of identifying poor outcomes in a number of clinical areas. But the use of QIs as a measure of quality of care is controversial due in part to concerns about the accuracy of staff-generated MDS data. This study collected independent data that showed that the MDS-derived "prevalence of weight loss" QI does indeed discriminate between nursing homes with a high percentage of residents at risk for weight loss and those with a much lower percentage of at-risk residents. A desirable, low score on this QI, however, did not mean that the facility provided qualitatively better feeding assistance to its residents. In fact, results indicated that all the facilities needed to improve the adequacy and quality of their feeding assistance. The one consistent, between-group difference in care quality was that the nurse aides in low-weight loss prevalence homes were more likely to interact socially and verbally prompt residents to eat than the nurse aides in high-weight loss prevalence homes. Other studies have shown that verbal encouragement to eat and social interaction at mealtimes leads to increased food consumption among the elderly.
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