Photo Source: http://www.publichealthnotes.com/malnutrition-causes-types/ Hi, fellow interns! My name is Rachael Erickson, a distance intern in Ohio. I am almost done with my clinical rotation at Summa Health in Akron, Ohio. I am thankful for the opportunity to shadow several talented dietitians at two hospital campuses. Each has shown me different charting approaches, interviewing techniques and education styles. They all have helped me acquire the concise vernacular used in the acute care setting and develop my “nutrition filter.”
In my clinical rotation, I have been fascinated by the topic of malnutrition. The World Health Organization established an International Classification of Diseases, 10th edition (ICD-10) to assist hospitals with reimbursement rates. I was surprised to see how much the reimbursement for malnutrition is. A complexity is that patients who are malnourished are at greater risk of readmitting to the hospital; however, Medicare doesn’t reimburse hospitals for readmissions within 30 days. Improving patients’ nutritional status during their stay helps their prognosis, and that’s how we as RDs-to-be can provide care for patients! While doctors write the medical diagnosis for malnutrition, RDs play an integral role in identifying it, proving to be a “valuable member of the healthcare team.” RDs at Summa include malnutrition screening in their chart notes. They send emails with information on any patient identified with malnutrition to the coordinator. The RDs also internally track patients who are diagnosed by the MD, RD or both MD/RD. Summa uses the AND/ASPEN criteria for identifying malnutrition. There is a sense of accomplishment when identifying malnutrition during my nutritional assessments and interviews, even though not desired for patients at all. I love practicing the nutrition focused physical examination techniques we learned at Orientation Week to determine muscle and/or fat loss or edema. I also feel like I’m caring for patients through appropriate nutrition and supplement recommendations. This has been a valuable rotation with much learning. I’m looking forward to the next!
In my clinical rotation, I have been fascinated by the topic of malnutrition. The World Health Organization established an International Classification of Diseases, 10th edition (ICD-10) to assist hospitals with reimbursement rates. I was surprised to see how much the reimbursement for malnutrition is. A complexity is that patients who are malnourished are at greater risk of readmitting to the hospital; however, Medicare doesn’t reimburse hospitals for readmissions within 30 days. Improving patients’ nutritional status during their stay helps their prognosis, and that’s how we as RDs-to-be can provide care for patients! While doctors write the medical diagnosis for malnutrition, RDs play an integral role in identifying it, proving to be a “valuable member of the healthcare team.” RDs at Summa include malnutrition screening in their chart notes. They send emails with information on any patient identified with malnutrition to the coordinator. The RDs also internally track patients who are diagnosed by the MD, RD or both MD/RD. Summa uses the AND/ASPEN criteria for identifying malnutrition. There is a sense of accomplishment when identifying malnutrition during my nutritional assessments and interviews, even though not desired for patients at all. I love practicing the nutrition focused physical examination techniques we learned at Orientation Week to determine muscle and/or fat loss or edema. I also feel like I’m caring for patients through appropriate nutrition and supplement recommendations. This has been a valuable rotation with much learning. I’m looking forward to the next!
