Accuracy of Patient Care Staff in Estimating and Documenting Meal Intake of Nursing Home Residents

Pokrywka, Helene S.; Koffler, Karen; Remsburg, Robin E.; Bennett, Richard G.; Roth, Justine P.; Tayback, Matthew; Wright, Jonelle E.

doi:10.1111/j.1532-5415.1997.tb03774.x

Cited by 67 publications

(44 citation statements)

References 16 publications

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“…The results to this question about how much the residents ate from the offered meals in average can only approximately describe the amount of food the residents ate. However, it is known from previous studies that nurses often overestimate the actual food intake significantly among nursing home residents (Pokrywka et al, 1997;Simmons & Reuben, 2000;Suominen et al, 2004). Thus, our findings that nearly half of those suffering from malnutrition ate only half or less from the offered food portion is probably rather an underestimate than overestimate of the true situation.…”

Section: Discussionmentioning

confidence: 97%

Malnutrition and associated factors among aged residents in all nursing homes in Helsinki

Muurinen²,

et al. 2005

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Objective: To acquire information about nutritional problems and factors associated with them in all nursing homes in Helsinki, Finland. Design: Descriptive, cross-sectional study. The residents were assessed by the Mini Nutritional Assessment test (MNA) and information was gathered about residents' backgrounds, functional status, diseases and about daily routines in institutions providing nutritional care. Setting: All nursing homes in Helsinki community, the capital of Finland. Subjects: Of 2424 eligible subjects, 2114 (87%) aged residents, mean age 82 y, were examined. Results: One-third (29%) of the studied residents suffered from malnutrition (MNAo17), and 60% were at risk (MNA 17-23.5). Malnutrition was associated with the female gender, a longer stay in the nursing home, functional impairment, dementia, stroke, constipation and difficulties in swallowing. In addition, eating less than half of the offered food portion, not eating snacks and resident's weight control at long intervals were associated with malnutrition. In logistic regression analysis mainly patientrelated factors predicted malnutrition: impaired functioning (OR 3.71, 95% CI 2.76-4.99), swallowing difficulties (OR 3.03, 95% CI 2.10-4.37), dementia (OR 2.06, 95% CI 1.45-2.93), constipation (OR 1.84, 95% CI 1.38-2.47), but also eating less than half of the offered food portion (OR 3.03, 95% CI 2.21-4.15). Conclusions: Although internal factors explain most about the poor nutritional status of aged residents in nursing homes, the factors related to nutritional care need further investigation to clarify their role in maintaining the nutritional status of aged residents.

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Section: Discussionmentioning

confidence: 97%

Malnutrition and associated factors among aged residents in all nursing homes in Helsinki

Muurinen²,

et al. 2005

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“…It is not surprising that a relationship between staffing levels and nutritional status is also observed in the residential care setting. Apart from staff numbers, suitable training is also important, as it had been documented that approximately one-third of nutritionally at risk subjects was not identified by home staff, who also tended to overestimate meal intake by up to 20% (Pokrywka et al, 1997).…”

Section: Discussionmentioning

confidence: 99%

Low staffing level is associated with malnutrition in long-term residential care homes

et al. 2005

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Objective: To determine if staffing level is associated with poor nutrition in the long-term residential care setting, adjusting for other confounding factors. Design: Cross-sectional survey. Setting: In total, 14 residential care facilities in Hong Kong, stratified by nature (government subvention or for-profit) to reflect the overall proportion in Hong Kong. Subjects: A total of 1914 subjects were assessed, using the Resident Assessment Instrument (RAI) 2.0. The response rate was 95% (1820 subjects), of which 1699 subjects had complete nutritional information. Intervention: Body mass index (BMI) was calculated by weighing and height measurement, and arm span was used if the subject could not stand. Subjects who were receiving parenteral or enteral nutrition via nasogastric of enterostomy tubes were excluded. A history of weight loss of 5% in the past month or 10% in the past 6 months, leaving 25% of food uneaten, and BMI o18.5 kg/m 2 were examined as nutritional indicators. Association with age, gender, functional disability, oral problems, taste problems, presence of physical diseases and psychological well-being was examined using w 2 -test, and multiple logistic regression. Results: In all, 26% of residents had a BMI o18.5 kg/m 2 , with a higher prevalence in the for-profit homes. History of weight loss and the record that 25% of food was left uneaten were poor indicators of low BMI. Multivariate analysis showed that having chronic obstructive airways disease, requiring help with feeding, being female, older age, were factors associated with an increased risk of poor nutrition, while being independent in activities of daily living and higher staff levels were associated with a reduced risk. Conclusion: Poor nutrition is a persistent problem in the long-term care setting, and inadequate staffing levels may be a reversible cause. However, resource limitations may render efforts at improvement difficult. Sponsorship: SK Yee Memorial Fund.

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“…Several studies have reported inaccuracies of such charts, especially in residential homes (1,9,10). In one study, onethird of residents whose fluid intake placed them at risk of dehydration were not identified (1).…”

Section: Introductionmentioning

confidence: 99%

Assessment of a self-reported drinks diary for the estimation of drinks intake by care home residents: Fluid intake study in the elderly (FISE)

Jimoh

Bunn

Hooper

2015

The Journal of nutrition, health and aging

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Objectives:We evaluated the accuracy of a newly developed self-completed Drinks Diary in care home residents and compared it with direct observation and fluid intake charts. Design: Observational study. Setting: Residential care homes in Norfolk, UK. Participants: 22 elderly people (18 women, mean age 86.6 years SD 8.6, 12 with MMSE scores <27). Measurements: Participants recorded their own drinks intake over 24 hours using the Drinks Diary while care staff used the homes' usual fluid intake chart to record drinks intake. These records were compared with drinks intake assessed by researcher direct observation (reference method), during waking hours (6am to 10pm), while drinks taken from 10pm to 6am were self-reported and checked with staff. Results: Drinks intake assessed by the Drinks Diary was highly correlated with researcher direct observation (Pearson correlation coefficient r=0.93, p<0.001, mean difference -163ml/day) while few staff-completed fluid charts were returned and correlation was low (r=0.122, p=0.818, mean difference 702ml/day).

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Accuracy of Patient Care Staff in Estimating and Documenting Meal Intake of Nursing Home Residents

Abstract: Study findings indicate that the present system used to document nursing home residents' intake is inadequate and that a more accurate mechanism or an entirely different process for identifying residents at risk for nutritional problems should be developed and implemented.

Cited by 67 publications

References 16 publications

Malnutrition and associated factors among aged residents in all nursing homes in Helsinki

Malnutrition and associated factors among aged residents in all nursing homes in Helsinki

Low staffing level is associated with malnutrition in long-term residential care homes

Assessment of a self-reported drinks diary for the estimation of drinks intake by care home residents: Fluid intake study in the elderly (FISE)

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