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There are two versions of the new food intake method-one for

By Janet Peters,2014-04-20 19:40
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There are two versions of the new food intake method-one for

    OVERVIEW AND INSTRUCTIONS

    FOR TRACKING FLUID BETWEEN MEALS

Overview

     This method for tracking fluid between meals, using the BEVERAGE

    ESTIMATION VISUAL (BEV), was designed for use with residents at high risk for malnutrition and/or dehydration who have been designated to be on ”Intake

    Watch.” It was also designed for use with residents on fluid restriction, I&Os and „calorie counts.‟

    Although technically possible, it would be cumbersome to use the BEV to record and tally between-meal fluid intake for all residents on a routine basis.

BEVERAGE ESTIMATION VISUAL (BEV)

    1. The BEV need to be labeled weekly with the resident‟s name, room #,

    floor/unit, date and thickness of fluid (if relevant).

    a. Option: a computer-printed label with this information can be affixed to

    top of the 7-day BEV.

    2. A clipboard or binder will hold the BEV (one-two sided sheet per resident) for

    all residents on “Intake Watch” on a given unit.

    a. Each week a completed BEV will be replaced with a fresh BEV.

Estimation of Fluid Intake.

    3. The between-meal fluid estimation method requires that the pre-printed BEV

    be accessible to those staff members who are providing fluid to residents

    between meals:

    a. BEVs should stay at the nurses station or other designated spot on

    each unit so they can be marked when residents on “Intake Watch” are

    offered between-meal fluids, including:

    i. fluid offerings per medical orders, usually pre-labeled with

    resident‟s name;

    ii. spontaneous offering of between-meal fluids;

    b. Fluid offerings/intake from a hydration or snack cart between meals

    should also be recorded staff who are pushing the cart.

    i. The BEV can be carried on the cart during the fluid pass and

    then returned to the nurses‟ station.

    c. It may also be prudent to record fluid offerings/intake during “med

    pass” for those residents at risk for dehydration.

    i. Med pass can contribute significantly to fluid intake if substantial

    portions of fluid (4-8 oz) are offered each time there are

    “medication rounds.”

    ii. The BEV can be carried on the medication cart during the med

    pass and then returned to the nurses‟ station.

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    4. Depending on the layout and activities of the facility, it may be necessary to

    place additional copies of the BEV for residents on “Intake Watch” in areas of

    the facility where residents regularly consume fluids and full-time staff are

    available to record intake:

    a. Physical Therapy

    b. Activities Area

    5. After the resident has completed his/her beverage, the responsible staff

    member marks the BEV with the beverage provided and the % consumed.

    a. Choose from options 0, 25, 50, 75 and 100% consumed.

    b. Staff should initial each time they record a drink on the BEV.

    c. The staff members who record on the BEV will vary and include:

    CNAs, nurses, food and hydration aides, and therapists.

Tallying and Trending of Between-Meal Fluid Intake.

    6. Between-meal fluid intakes need to be totaled sometime during the

    subsequent day.

    a. This is best accomplished when the BEV would be least likely to be

    utilized by a staff member, e.g. before breakfast or right before lunch.

    b. Additional BEVs must also be temporarily retrieved from the physical

    therapy room, activities room or other area where fluid intake is being

    recorded.

     CONVERSION SHEET FOR TALLYING BETWEEN-MEAL FLUID INTAKE 7. Using the CC

    (below), write the cc value in the box where “% Drank” has been marked.

    8. Use the calculator to add the cc values of all marked fluid items.

    1. Don‟t forget BEVs collected from other areas, like PT or activities.

    9. This value should be graphed in the section entitled “CC of Fluid Consumed

    Between Meals” on the respective resident‟s FOOD AND FLUID INTAKE TRACKING

    form.

    a. Mark a ; (dot) on the graph corresponding with total fluid consumed

    (100cc, 400cc, etc.) on that day.

Calorie Counts.

    10. The DTR, RD or Diet Clerk responsible for physician-ordered “Calorie

    Counts” may also gather data from the between meal fluid estimation sheets

    when completing calorie calculations.

Discard Between-Meal Fluid Intake Estimation Sheets.

    11. After the week‟s BEVs have been tallied and recorded, they may be

    discarded.

    a. Completed BEVs will be replaced with fresh BEVs at the end of each

    week.

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    CC CONVERSION SHEET FOR TALLYING BETWEEN-MEAL FLUID INTAKE

    PERCENT DRANK

    BEVERAGE 0 % 25% 50% 75% 100% JUICE / WATER (4 oz) 0 cc 30 cc 60 cc 90 cc 120 cc JUICE / WATER (6 oz) 0 cc 45 cc 90 cc 135 cc 180 cc JUICE / WATER (8 oz) 0 cc 60 cc 120 cc 180 cc 240 cc JUICE / WATER (10 oz) 0 cc 70 cc 140 cc 210 cc 280 cc JUICE / WATER (12 oz) 0 cc 80 cc 160 cc 240 cc 320 cc MILK (8 oz) 0 cc 60 cc 120 cc 180 cc 240 cc MIGHTY SHAKE (6 oz) 0 cc 45 cc 90 cc 135 cc 180 cc SUPPLEMENT (6 oz ) 0 cc 45 cc 90 cc 135 cc 180 cc SODA (8 oz) 0 cc 60 cc 120 cc 180 cc 240 cc SODA (12 oz) 0 cc 90 cc 180 cc 270 cc 360 cc ICE CREAM (4 oz) 0 cc 30 cc 60 cc 90 cc 120 cc COFFEE (8 oz) 0 cc 60 cc 120 cc 180 cc 240 cc SOUP (6 oz) 0 cc 45 cc 90 cc 135 cc 180 cc

     ( oz) cc cc cc cc cc

     ( oz) cc cc cc cc cc

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