Computerized Nutrition Screening Report Provides Data for Performance Improvement

Nutrition screening for this facility is completed via computer search of the admission database completed by nursing. A screening report is generated which includes patient name/location, admission date and time and risk indicators. (% ideal body wt, wt. loss, pressure ulcer present, swallowing/aspiration, pressure ulcer risk scores, high risk diagnoses, albumin, oral intake and geriatric surgical status). The computer enters results under the appropriate risk indicator column and indicates "M" under that indicator if data was missing or incomplete at the time of the search. The missing data component of the report replaced time consuming manual review of records to validate the screening process and provide data for performance improvement. Nutrition Services was able to quickly summarize unit performance and give immediate feedback to nursing on compliance with admission heights and weights, accuracy of reporting actual pressure ulcers and pressure ulcer risk scores. Collaboration with nursing from June 1997 through December 1998 achieved the following improvements in compliance: heights and weights, 58% to 89%; assigning/completing accurate pressure ulcer risk scores, 50% to 85% and reduced reporting other types of skin conditions incorrectly as pressure ulcers, from 50% to 30%. The report is now available in the computer for each nursing unit to review daily. Nutrition Services also used the reports to identify indicator specific populations for monthly tracking. This decreased monthly data collection time by 20%, allowed more timely feedback to individual clinicians and increased time for improvement action and standardizing nutritional care for patients with pressure ulcers.