Assessing nutritional risk of long-term care residents

The validity was determined for Minimum Data Set (MDS) 2.0 oral/nutrition status (Section K) items, used to identify long-term care residents at nutritional risk. A registered dietitian assessed 128 long-term care residents using standardized procedures, and used clinical judgment to provide a nutritional risk rating. Registered nursing staff completed the MDS assessments. Bivariate tests of association were used to assess the relationship between the dietitian rating and each Section K item. The sensitivity (Se) and specificity (Sp) of specific and combinations of variables were also determined. The MDS variables of dietary prescription (diet rx), supplement use, and swallowing problems were significantly associated with nutritional risk rating. Body mass index (BMI), calculated from MDS data, also was significantly associated with nutritional risk rating. The MDS trigger system, however, had poor Se and Sp. The best combination of variables included the presence of one or more of diet rx, supplement use, swallowing problem, or BMI <24 kg/m2 (Se=0.81, Sp=0.50). Although Section K items are associated with nutritional risk, Se and Sp analyses suggest that these items and this section require further refinement and validation before use as part of a referral mechanism.