Improvement of the Screening And Assessment of Obstetric Patients

Abstract

The nutrition screening and assessment process of obstetric patients was studied to improve patient care and timeliness of nutritional intervention. The nutrition clinic and obstetric clinic staff collaborated in identifying two additional opportunities to initiate periodic nutrition screens. Following the initial screen, patients nutritional status was reassessed on two occasions. Using the American Dietetic Association's Medical Nutrition Therapy Across the Continuum of Care Obstetric Screening and Assessment Tool, obstetric patients were given the initial nutrition screen at Obstetric Orientation. Three additional questions were added to the initial nutrition screen that addressed the following: over the counter medication or herbal supplement use, anemia with prior pregnancy and breast feeding. A condensed version of the initial questionnaire was utilized during the second and third nutritional reassessments. Baseline data revealed most patients were screened at risk due to poor eating habits which supports the findings of NHANES II. Subsequent interviews of patients screened at risk revealed most women have adopted healthier eating habits after the OB orientation nutrition lecture. Data also revealed timely interventions made by telephone follow-ups reduced potential dietitian time spent with patients by 50%. To improve efficiency the nutrition screen was included in the physician's checklist of items to cover during the 16-20 and 28-30 week visits. The checklist serves as a reminder, especially for the rotating residents, to screen for nutritional risk thereby optimizing care. The screening tools facilitate continuity of care, enforce timely nutritional interventions and allows for accurate collection of nutritional status information.