{"title":"农村地区医疗中心临床护理人员对患者体重的记录","authors":"Helen Ballew, Robin Jean Maroulakis, P. B. Moore","doi":"10.1097/TIN.0000000000000303","DOIUrl":null,"url":null,"abstract":"Weight loss over a specific time period is an important indicator for recognizing malnutrition in hospitalized patients. Documenting accurate weights in the electronic medical record is crucial to identify and treat malnutrition. The purpose of this project was to evaluate clinical care staff compliance with documenting patient weight. A medical record review was performed on 7 randomly selected days (n = 122) over a 5-week period. Documented weight and method of obtaining weight were recorded. Weight information was documented 91.2% of the time. Objective methods of obtaining patient weight were used 77.9% of the time, while subjective methods were used 13.9% of the time. Results support the need to educate the clinical care staff on the importance of documenting patient weights as an indicator of nutritional status in order to improve outcomes in malnourished and at-risk patients.","PeriodicalId":48681,"journal":{"name":"Topics in Clinical Nutrition","volume":"38 1","pages":"59 - 65"},"PeriodicalIF":0.4000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Documentation of Patient Weights by Clinical Care Staff in a Rural, Regional Medical Center\",\"authors\":\"Helen Ballew, Robin Jean Maroulakis, P. B. Moore\",\"doi\":\"10.1097/TIN.0000000000000303\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Weight loss over a specific time period is an important indicator for recognizing malnutrition in hospitalized patients. Documenting accurate weights in the electronic medical record is crucial to identify and treat malnutrition. The purpose of this project was to evaluate clinical care staff compliance with documenting patient weight. A medical record review was performed on 7 randomly selected days (n = 122) over a 5-week period. Documented weight and method of obtaining weight were recorded. Weight information was documented 91.2% of the time. Objective methods of obtaining patient weight were used 77.9% of the time, while subjective methods were used 13.9% of the time. Results support the need to educate the clinical care staff on the importance of documenting patient weights as an indicator of nutritional status in order to improve outcomes in malnourished and at-risk patients.\",\"PeriodicalId\":48681,\"journal\":{\"name\":\"Topics in Clinical Nutrition\",\"volume\":\"38 1\",\"pages\":\"59 - 65\"},\"PeriodicalIF\":0.4000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Topics in Clinical Nutrition\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/TIN.0000000000000303\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Topics in Clinical Nutrition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/TIN.0000000000000303","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
Documentation of Patient Weights by Clinical Care Staff in a Rural, Regional Medical Center
Weight loss over a specific time period is an important indicator for recognizing malnutrition in hospitalized patients. Documenting accurate weights in the electronic medical record is crucial to identify and treat malnutrition. The purpose of this project was to evaluate clinical care staff compliance with documenting patient weight. A medical record review was performed on 7 randomly selected days (n = 122) over a 5-week period. Documented weight and method of obtaining weight were recorded. Weight information was documented 91.2% of the time. Objective methods of obtaining patient weight were used 77.9% of the time, while subjective methods were used 13.9% of the time. Results support the need to educate the clinical care staff on the importance of documenting patient weights as an indicator of nutritional status in order to improve outcomes in malnourished and at-risk patients.
期刊介绍:
Topics in Clinical Nutrition (TICN) is a peer-reviewed, quarterly journal designed as a resource for the continuing education and clinical practice of dietitians and nutritionists. Each issue addresses topics of interest primarily to dietitians and nutritionists, students and interns in professional training programs and other health care personnel involved in the nutritional care of patients. Articles include translational research reports (work that applies new knowledge to practical effect), practice projects, evidence-based literature reviews, case studies and book reviews, and articles that highlight education theory and applied research which share the tools and techniques of nutrition and dietetics education.