Weight Loss Prevention
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Quality Assessment in Nursing Homes by Systematic Direct Observation: Feeding Assistance
Sandra F. Simmons, Sarah Babineau, Emily Garcia, and John F. Schnelle, 2002, in Journal of Gerontology: Medical Sciences; Vol. 57A, No. 10, M665-M671.
This study showed that a standardized protocol that calls for direct observations of care can be used to accurately measure the adequacy and quality of feeding assistance in nursing homes. The observational protocol, designed for routine use by licensed nursing home staff, is a practical alternative to reviewing medical chart information to monitor quality of care. Prior studies have shown that chart information is unreliable in that it consistently overestimates residents' food and fluid intake. The observational protocol assesses the ability of nurse aides to accomplish four tasks deemed critical to the delivery of adequate feeding assistance. These tasks include: 1) accurately identifying residents with clinically significant low oral food and fluid intake during mealtimes; 2) providing feeding assistance to at-risk residents during mealtimes; 3) providing feeding assistance to residents identified in the Minimum Data Set as requiring staff assistance to eat; and 4) providing a verbal prompt to residents who receive physical assistance at mealtimes. The study showed that the protocol is reliable, replicable, and feasible to implement. One staff person can use it to reliably observe 6 to 8 residents during one mealtime period.
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