We’ve made a lot of changes in our dining program. To enhance the meal experience, we have moved to an open breakfast from 7:00-9:30 and we are now serving meals in the dining room as well as 2 of our 4 neighborhood dining rooms. We’ve also increased satisfaction with meals on our TCU unit by offering more meal options.
Our team is hoping these changes will help decrease unintended weight loss, but we also wanted to see if there is anything else we could do. I talked with another nursing director and she shared how their scales were causing part of the problem with inaccurately recording weight. So, we had our scales recalibrated by our maintenance department director. Maintenance staff will calibrate the scales each quarter.
At our staff meeting we discussed the process of weighing residents. Monthly and weekly weights are being done before bathing. The weights are entered into our electronic health record. We were able to set up some alerts in the system to monitor if there is a 3-lb change from the last weight. This triggers a reweigh alert to the nursing assistant. The nurse manager and dietician are sent an alert also.
The dietician also is meeting with the neighborhood staff on a weekly basis to review everyone whose weight is being monitored, whose meal intake is less, and those with pressure ulcers, infections, and any other concerns that might be related to weight loss or gain. This huddle meeting is about 10 minutes on each neighborhood. The dietician told me she loves those meetings as she gets to ask questions of the staff, talk with the nursing assistants, and do any follow up she feels is needed. For example, she recently asked for therapy to re-evaluate a resident to see if some adaptive eating equipment might help them remain independent. They recommended a non-tipping cup and built up utensils. The resident agreed to try these. The dietician then talked with the nursing assistants and dietary aides to assure the resident would get this equipment each meal. She’ll follow up with the resident and staff. I love it when the different departments work together with the resident to meet changing needs.
Is there a way I can promote this more? I shared the example at our staff meeting and asked staff to be aware of other residents who could benefit from reassessments.