malnutrition
Our nutrition dept has repeatedly expressed concern about our malnutrition query process. I think there is confusion about the function of the query. They use an almost identical form (established before my time)which they place on the chart when they make a nutrition dx. The hope is that the Dr sees it, reads their note and signs is for inclusion in the medical record. Therefore, i think their imprssion is that everytime we place a query, we are making a diagnosis. several months ago, the director of nutrition approached me because she was concerned that we were using lab data on our query form. Our form has spots for us (CDS) to imput Protein, PreAlbumin, Albumin, BMI, if dietary was consulted and any other info-like weight loss). It then asks for dx clarification with several options including different types of malnutrition, underweight, other, none, etc. She went into depth about there being extensive criteria that nutrition uses to establish a dx of malnutrition.
I have explained that WE are not making a diagnosis. we are pointing out a few indicators that MAY indicate a diagnosis but it is expected that the Dr delve deeper into the medical record and the patient to determine if a dx is appropriate. I also took the issue to our physician liason and my director and they told me to continue as I have been. I explained this to the nutrition director and also explained that we do not base queries soley off lab data. We are aware that abnormal labs alone do not necessarily indicate malnutrition. I generally do not query unless we have several days of altered labs (or very low PreA) along with other indicators (cancer, cachexia, weight loss, etc). I have looked at the other examplies of malnutrition queries on the "tools and forms" link and ours are pretty much the same as everyone elses.
Now they have asked to set up a meeting between CDI and nutrition to discuss the matnutrition queries again!I do not know for sure that their concerns are exactly the same, but I am assuming they are.
Any advice to get them to understand the query process? Have any of you experienced issues like this? I get the impression they think CDI is "stepping on their toes". Our CDI program was basically missing for a couple years and only has been re-established in the last 6 mo.
Thank you!
I have explained that WE are not making a diagnosis. we are pointing out a few indicators that MAY indicate a diagnosis but it is expected that the Dr delve deeper into the medical record and the patient to determine if a dx is appropriate. I also took the issue to our physician liason and my director and they told me to continue as I have been. I explained this to the nutrition director and also explained that we do not base queries soley off lab data. We are aware that abnormal labs alone do not necessarily indicate malnutrition. I generally do not query unless we have several days of altered labs (or very low PreA) along with other indicators (cancer, cachexia, weight loss, etc). I have looked at the other examplies of malnutrition queries on the "tools and forms" link and ours are pretty much the same as everyone elses.
Now they have asked to set up a meeting between CDI and nutrition to discuss the matnutrition queries again!I do not know for sure that their concerns are exactly the same, but I am assuming they are.
Any advice to get them to understand the query process? Have any of you experienced issues like this? I get the impression they think CDI is "stepping on their toes". Our CDI program was basically missing for a couple years and only has been re-established in the last 6 mo.
Thank you!