RE: [MARKETING] [EXTERNAL] Malnutrition criteria
A BMI less than 19 does not automatically equal malnutrition. Note that
while currently a BMI less than 19 is a "CC", it still requires a
diagnosis to support the clinical significance of the finding. Our
facility does generate an automatic dietary consult for any patient with
a BMI less than 18, but there are some small framed people around who
are not malnourished.
I look at our nutrition consults and have seen patients with BMI's far
above 19 with "positive signs of protein calorie malnutrition and muscle
wasting" based on the clinical dieticians assessment. I have reviewed
the joint statement on the definitions of severity of adult malnutrition
with our dieticians and providers and they agree with those.
When I see a dietician note indicating signs of malnutrition then I
query the provider as to the clinical significance of that finding. I
rarely query simply because of a low BMI.
Robert
Robert S. Hodges MSN, BSN, RN, CCDS
Clinical Documentation Improvement Specialist
Secretary, Nursing Professional Standards Board
Aleda E. Lutz VA Medical Center
1500 Weiss Street, ATTN PAS-136
Saginaw MI 48602
989-497-2500 x13101
Robert.Hodges2@va.gov
VA Core Values: Integrity, Commitment, Advocacy, Respect, Excellence
("I CARE")
VA Core Characteristics: Trustworthy, Accessible, Quality, Innovative,
Agile, Integrated
"The difference between the right word and the almost right word is the
difference between lightning and the lightning bug." Samuel "Mark Twain"
Clemens
while currently a BMI less than 19 is a "CC", it still requires a
diagnosis to support the clinical significance of the finding. Our
facility does generate an automatic dietary consult for any patient with
a BMI less than 18, but there are some small framed people around who
are not malnourished.
I look at our nutrition consults and have seen patients with BMI's far
above 19 with "positive signs of protein calorie malnutrition and muscle
wasting" based on the clinical dieticians assessment. I have reviewed
the joint statement on the definitions of severity of adult malnutrition
with our dieticians and providers and they agree with those.
When I see a dietician note indicating signs of malnutrition then I
query the provider as to the clinical significance of that finding. I
rarely query simply because of a low BMI.
Robert
Robert S. Hodges MSN, BSN, RN, CCDS
Clinical Documentation Improvement Specialist
Secretary, Nursing Professional Standards Board
Aleda E. Lutz VA Medical Center
1500 Weiss Street, ATTN PAS-136
Saginaw MI 48602
989-497-2500 x13101
Robert.Hodges2@va.gov
VA Core Values: Integrity, Commitment, Advocacy, Respect, Excellence
("I CARE")
VA Core Characteristics: Trustworthy, Accessible, Quality, Innovative,
Agile, Integrated
"The difference between the right word and the almost right word is the
difference between lightning and the lightning bug." Samuel "Mark Twain"
Clemens