Our Partners in Nutrition Assessment: Shifting Nursing Paradigms

Abstract

LEARNING OUTCOME: To describe how one health care institution adapted to meet Joint Commission of Accreditation of Healthcare Organizations (JCAHO) nutritional assessment requirements. Standards of practice for nutritional screening and assessment would not meet the 1996 JCAHO standards. Our data from chart review indicated only 60% of patients at risk had a nutrition care plan by day five of admission partially due to difficulty of retrieving indicators of nutritional risk. The medical and nursing records contained nutritional risk parameters, but this information was not readily accessible to the clinical staff. We needed a new approach. The clinical nutrition staff was able to garner support from hospital administration by presenting 1) the new JCAHO standards that state the hospital is responsible for identifying patients at nutritional risk upon admission and 2) the average length of stay savings from early and frequent nutrition intervention. A multidisciplinary task force was officially formed by the hospital quality improvement team to design an efficient nutrition screening process. The team restructured our current process to one that gave the admissions nurse an active role in identifying patients that would benefit from nutrition intervention. Partnering among disciplines on the team led to designing a new admission form, changing procedures to collect data, encouraging compliance with an incentive program and implementing an educational campaign. The multidisciplinary task force activity changed the paradigm of nutrition's services from “nice to have” to “cost effective and necessary for healing” and improved availability of data which will result in more rapid nutrition intervention.