A Quality Improvement System to Manage Feeding Assistance Care in Assisted-Living

Dyadic interactions and physical and social environment in dementia mealtime care: a systematic review of instruments

“…Among the 17 instruments identified to assess mealtime dyadic interactions, 16 were used in people with a specified dementia diagnosis, and one was developed and tested in long‐term care residents with and without dementia (Mealtime Social Interaction Measure for Long‐Term Care (MSILTC) 31 ). Among the 16 instruments that were used in the dementia population, 13 were originally developed in persons with dementia and their caregivers or partners, and three were not developed for but later used in persons with dementia and their caregivers (modified Nursing Child Assessment Scale (NCAS), 32,33 Feeding Assistance Observational Protocol (FAOP), 34–38 and Marital Interaction Coding System‐IV (MICS‐IV) 39,40 ). Among the 13 instruments that were originally developed in the dementia population and their caregivers or partners, eight were originally developed for mealtime care activities (Feeding Traceline Technique (FTT), 41–43 Trouble Source Repair (TSR), 44–46 Priefer and Robbins’ observation tool, 47 Altus et al .’s observation checklist, 48 Feeding Cycle Recording (FCR), 49 Levy‐Storms et al .’s observation tool, 50 the refined CUED mealtime video‐coding scheme, 11–13,16,17,51 and Gilmore‐Bykovskyi's coding scheme 52,53 ).…”

The Case for Malnutrition Quality Measures and Nutrition-Focused Quality Improvement Programs (QIPs) in US Skilled Nursing Facilities

“…Among our findings were that Elia et al [ 21 ] undertook a prospective, incremental cost-effectiveness analysis in older nursing home residents (≥80 years) randomized to receive either ONS or dietary advice for 12 weeks; their results showed that use of ONS was cost-effective relative to dietary advice. Simmons et al [ 45 ] sought to enhance mealtime feeding assistance and between-meal snack delivery for residents with dementia and associated risk of low oral intake and unintentional weight loss; QIP strategies resulted in sustained improvements in eating and snacking.…”

A System for Managing Staff and Quality of Dementia Care in Assisted Living Facilities

“…Elements of quality of care important for resident‐centered care and quality of life cannot be easily measured through staff self‐report. Observational data can also be used to provide immediate feedback regarding quality of care and areas in need of improvement to the observed staff member . Accurate data from any source has limited utility if it cannot be organized into a usable, interpretable format, and observational data are conducive to efficient summary using simple data management programs.…”

“…Meal and snack periods are conducive to observations because both occur at scheduled, predictable times and often in a common area (dining room), which allows a supervisor to observe multiple residents simultaneously (hence the large number of monthly resident-meal observations). 14,23,25,27 In addition to meal and between-meal snack reports, residents are weighed monthly, with the prevalence of weight loss monitored in a separate dashboard report (not shown in Figure 2). Figure 2C shows a monthly summary of activity engagement for all residents.…”