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Nutrition:

7 OASIS Questions Shed Light On Nutrition Status

Published on Sun Jun 05, 2005

Hint: They don't all involve food.

To improve patient outcomes, use OASIS to uncover nutrition problems.
 
 Eighty-five percent of the elderly can benefit from nutritional intervention, Dr. Jody Vogelzang told listeners at a June 9 teleconference sponsored by the QIO Texas Medical Foundation.

Improved nutrition can enhance the patient's quality of life, prevent adverse events and add to your agency's outcome success, experts say. And you can use the OASIS tool indirectly to trigger further assessment.

Where to begin: To use OASIS to become more aware of nutritional issues, look at these M0 items that assess abilities that directly affect a patient's nutritional status:
 

  • M0490 (Dyspnea). A patient who is short of breath may find herself having to choose breathing over eating, Vogelzang suggested. Make every bite count in a patient who scores a "3" or "4" on this M0 item.
     
  • M0490 (Bowel incontinence frequency). If your patient is having an increase in fecal incontinence, check for self-feeding issues. The ability to feed oneself often begins to disappear at the same time fecal incontinence increases, Vogelzang said.
     
  • M0570 (Confusion). A confused patient may not remember to eat or may not be able to report nutritional intake accurately, Vogelzang said. So consider nutritional status when M0570 indicates some level of confusion.
     
  • M0590 (Depressive feelings reported or observed). Depression can contribute to anorexia, Vogelzang noted. And depression can isolate a patient, leading to poor nutritional intake. Studies show that older adults eat 23 percent more when they eat with family or friends, she reported.
     
  • M0710 (Feeding or eating). A patient who loses the ability to feed herself is at higher risk for malnutrition, Vogelzang said.
     
    Caregivers often are unaware that a patient is having difficulty swallowing certain foods, says registered dietician Kara Mitchell with the Duke Center for Living in Durham, NC.

    For example, they may believe the patient just doesn't like meat anymore, when the real problem is they can only swallow ground or pureed meat, she explains. A dietician would know the right questions to ask to determine the specific problem and can then suggest alternate sources of protein the patient can tolerate, she tells Eli.
     
  • M0720 (Planning and preparing light meals). As you assess this item, be sure the patient doesn't think this means tea and toast, Vogelzang warned.
     
    Encouraging something like scrambled eggs can increase protein without involving complex cooking, Mitchell suggests. Adding nutrition-packed commercial beverages can also turn a simple meal into a more nutritious one, she adds.
     
  • M0760 (Shopping). When assessing M0760, consider how difficult it may be for the patient or family member to procure enough food for the patient to be adequately nourished, Vogelzang reminds clinicians.

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