Clinical Indicators Associated with Unintentional Weight loss and Pressure Ulcers in Elderly Residents of Nursing Facilities
Section snippets
Methods
The CD-HCF and DNS Quality Management Committee developed a plan for a geographically distributed, multicenter study of nursing-facility residents and home-care clients to field-test indicators related to unintentional weight loss and pressure ulcers. Unintentional weight loss and pressure ulcers were selected because of the severity of their effect on clients’ health. The study monitored two target populations. One population comprised adults older than 65 years living in nursing facilities
Unintentional Weight Loss
Two hundred ninety medical records met the criteria for unintentional weight loss, and these records were reviewed by the 45 auditors. The numbers and percentages of residents’ medical records in which the indicators were present, missing, or not applicable to the problem are shown in Table 1. For these residents (n=290), the most frequently occurring indicators were reduced functional ability, intake of 50% or less of food served for the past 3 consecutive days, and chewing problems—the
Implications
This multicenter study was initiated to field-test indicators related to unintentional weight loss and pressure ulcers in the elderly population. Our results indicate that dietitians who work with this population must assess nutrient intake and acceptance and tolerance of supplements and monitor and recommend serum albumin and cholesterol levels. Dietitians’ assessment of residents’ chewing and swallowing abilities is also important, because this can lead to evaluation by a specialist in
Applications
This study identified the indicators associated with unintentional weight loss and pressure ulcers in the elderly living in nursing facilities. Reassessment by a dietitian is suggested when unintentional weight loss or pressure ulcers trigger a new minimum data set or a significant change.
Inappropriate dietary intake, disease, and disability place many residents in nursing facilities at risk for malnutrition. The prevalence of unintentional weight loss and pressure ulcers challenges dietitians
References (38)
- et al.
Anorexia in the elderly
Neurobiol Aging.
(1988) - et al.
Zinc nutriture in the elderly in relation to taste acuity, immune response, and wound healing
Am J Clin Nutr.
(1982) - et al.
Nutritional status survey of healthy non-institutionalized elderlyenergy and nutrient intakes from three-day diet records and nutrient supplements
Nutr Res.
(1986) - et al.
Vitamin C and human wound healing
Oral Surg Oral Med Oral Path.
(1982) Minimum Data Set Reference Manual
(1993)Nutrition Screening Manual for Professionals Caring for Older Americans
(1991)- et al.
The problem of pressure sores in a nursing home populationstatistical data
J Am Geriatr Soc.
(1976) - et al.
Incidence and prediction of pressure ulcers in five patient care settings
Decubitus.
(1991) Pressure ulcer prevalence and associated patient characteristics in one long-term care facility
Decubitus.
(1989)- Bordy J. Bedsores — a costly, aged-old malady that continues to take toll. SD Union. Aug 24,...
The nutritional aspect of pressure ulcer care
Ostomy Wound Manage.
Pressure Ulcers in AdultsPrediction and Prevention
Suggested Guidelines for Nutrition and Metabolic Management of Adult Patients Receiving Nutrition Support
A mortality risk for men in a Veterans Administration extended care facility
JPEN.
Prognostic significance of serum cholesterol in nursing home men
JPEN.
The prognostic significance of hypocholesterolemia in hospitalized patients
Klin Wochenschr.
Effects of three liquid diets on nutrition-sensitive plasma proteins of tube-fed elderly men
J Am Geriatr Soc.
Nutritional Management of the Pressure Ulcer Patient
SPSS User's Guide
Cited by (63)
Appetite Regulation in Healthy Aging
2017, Nutrition and Functional Foods for Healthy AgingSerum albumin level is a limited nutritional marker for predicting wound healing in patients with pressure ulcer: Two multicenter prospective cohort studies
2011, Clinical NutritionCitation Excerpt :ROC curves overlapped for both models. Serum albumin level has been traditionally considered as a nutritional marker, and also as a marker for PU healing.14 However, its usefulness in clinical PU management remains unclear.
An evaluation of serum albumin and the sub-scores of the Waterlow score in pressure ulcer risk assessment
2011, Journal of Tissue ViabilityCitation Excerpt :Logistic regression showed malnutrition at one week increased poor outcomes including pressure ulcers. The correlation between albumin and pressure ulcers is very well established in a series of cross sectional studies [12–28]. However the relationship is complex.
Quality of feeding assistance care in nursing homes
2008, Food for the Ageing Population: A volume in Woodhead Publishing Series in Food Science, Technology and NutritionQuality Improvement for Feeding Assistance Care in Nursing Homes
2007, Journal of the American Medical Directors Association