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The minimum data set weight-loss quality indicator: does it reflect differences in care processes related to weight
Sandra F Simmons1, Emily T Garcia, Mary P Cadogan
1Department of Geriatrics, University of California at Los Angeles School of Medicine, Borun Center for Gerontological Research, Los Angeles, California 91335, USA. ssimmons@ucla.edu
Journal of the American Geriatrics Society
|September 27, 2003
Summary
Nursing homes (NHs) with lower weight loss prevalence offer better feeding assistance. Staff in these facilities provide more verbal prompting and social interaction during meals, though overall feeding care needs improvement.
Area of Science:
- Gerontology
- Healthcare Quality
- Clinical Nutrition
Background:
- Weight loss in nursing homes (NHs) is a significant concern affecting resident health and quality of life.
- The Minimum Data Set (MDS) weight-loss quality indicator is used to assess prevalence, but its relationship with care processes is not fully understood.
Purpose of the Study:
- To investigate if nursing homes (NHs) with varying scores on the MDS weight-loss quality indicator provide different care processes for managing weight loss.
- To compare care practices in high-prevalence versus low-prevalence weight-loss NHs.
Main Methods:
- A cross-sectional study involving 16 skilled nursing facilities, categorized into low (25th percentile) and high (75th percentile) quartiles based on the MDS weight-loss indicator.
- Data collected from 400 long-term residents through direct observation of care processes, resident interviews, and medical record abstraction over three consecutive days.
- Sixteen specific care processes related to weight loss were measured using standardized protocols.
Main Results:
- NHs with higher weight loss prevalence had more residents at risk, particularly those with low oral intake.
- Few significant differences in most care processes were found between high- and low-weight-loss NHs.
- Staff in low-weight-loss NHs provided more verbal prompting and social interaction during meals, especially to at-risk residents.
Conclusions:
- The MDS weight-loss quality indicator effectively differentiates NHs based on weight loss prevalence.
- Lower weight loss prevalence in NHs is associated with fewer at-risk residents and more mealtime social support.
- Feeding assistance and care quality require improvement across all nursing homes studied.