Accuracy of Minimum Data Set in Identifying Residents at Risk for Undernutrition: Oral Intake and Food Complaints
Objective
to evaluate the accuracy of nursing home (NH) staff in documenting two Minimum Data Set (MDS) items that are used to identify residents at risk for undernutrition, low oral intake and food complaints, using standardized observation and interview assessment protocols implemented by research staff.
Design and Methods
MDS information related to low oral intake (item K4c: <75% of most meals) and complaints about the taste of food (item K4a) was compared to independent evaluations of low oral intake and food complaints for a random sample of 75 residents in two proprietary NHs within the same month that a complete MDS assessment was due for each participant. Direct observations were conducted by research staff during nine mealtime periods for 3 consecutive days according to a standardized mealtime observational protocol to estimate low oral intake; and, two one-on-one interviews with residents were conducted on two consecutive days using standardized questions to assess the stability of food complaints.
Results
Research staff documentation based on direct observation and resident interviews showed a significantly larger number of residents being identified as potentially at risk for undernutrition due to low oral intake (73%) and/or stable complaints about the taste of food (32%) as compared with NH staff documentation of MDS items K4c (44%) and K4a (0%), respectively, within the same month. A total of 47% of the participants expressed stable complaints about some aspect of the NH food service (eg, variety, appearance, temperature).
Conclusion
The documentation of low oral intake and food complaints on the MDS was inaccurate and resulted in a significant underestimate of residents with either of these risk factors for undernutrition.
aUniversity of California, Los Angeles, School of Medicine, Department of Geriatrics, the Borun Center for Gerontological Research, Los Angeles, and the Jewish Home for the Aging, Reseda
bVeterans Administration Greater Los Angeles Healthcare System, Sepulveda Geriatric Research, Education, and Clinical Center, Sepulveda, California
cState University of New York at Buffalo, School of Medicine and Biomedical Sciences, Buffalo, New York
Address correspondence to: Sandra F. Simmons, PhD, Jewish Home for the Aging/UCLA Borun Center for Gerontological Research, 7150 Tampa Avenue, Reseda, CA 91335
This research was supported by the University of California, Los Angeles, Older Adults Independence Center, through a Career Development Award, and the Beverly Manor Corporation.
ABSTRACT