Relative to diabetes, over three million or 13% of all African Americans aged 20 Implement a diabetes prevention curriculum utilizing culturally competent …
Screening and Prioritizing Protocol rev 4/00
|Criteria |High Risk |Moderate Risk |Low Risk |No Risk |
|Age | | 85 years, 16 |All Other Age |All Other Age |
| | | |Groups |Groups |
|Ideal Wt| 80 IBW | |80-90 IBW | 90 IBW |
|Usual Wt | 80 UBW | 90 UBW |90-95 UBW |95 UBW |
|BMI |17 |17-19 |19 | |
|Albumin | 26 g/dl |27-30 g/dl |31-34 g/dl |35 g/dl |
| |except in term |except in term | | |
| |pregnancy |pregnancy | | |
| | 37 g/dl peds| | | |
| |to 18 years | | | |
|Prealbumi| 10 mg/dl |10-14 mg/dl |15-18 mg/dl | |
|n | | | | |
|Glucose | 300 mg/dl
|————- |200 mg/dl | |
|Diagnosis|AIDS-Acquired |ARF Acute Renal |ALOC |BPH- benign |
| |Immune Deficiency|Failure |CABG, MVR/AVR |prostatic |
| |Syndrome, |CVA Cerebrovascular|CAD |hypertrophy |
| |Pneumocystis |Accident, |CHF |MI |
| |Carinii |intracranial bleed |COPD/SOB |PTCI/PTCA |
| |Vent Respiratory|Diabetes Newly |CRF |TURP |
| |Failure |Diagnosed, Out of |GIB |Angina |
| |Crohns Disease \|Control, HHNKS- |TB |Appendicitis |
| | |hyperglycemic, |Acute Abdominal |Asthma |
| |Failure to Thrive|hyperosmolar, |Pain |Cardiac Cath |
| | |nonketotic syndrome,|Anemia |Cholecystectomy |
| |Gestational |ketoacidosis-DKA |Bowel Obstruction|Cholelithiasis |
| |Diabetes |Diverticulitis | |Cholecyctitis |
| |Hepatic
|Skin Ulcers- |Cancer/Oncology- |Femoral Bypass |
| |Encephalopathy |decubitus, pressure |Chemotherapy/ |Graft revision or|
| |Hyperemesis |ulcers, non-healing |Radiation |shunts |
| |Malnutrition |wounds, diabetic |Cellulitis |Hemorrhoids |
| |Sepsis |ulcers |Dehydration |Hip Replacement |
| |Pancreatitis | |Irritable Bowel |Prenatal |
| | | |Syndrome |Psychiatry |
| | | |Pneumonia |Removal of |
| | | |Dementia |Hardware |
| | | |Urosepsis/UTI |Sickle Cell |
| | | | |Crisis |
| | | | |Skeletal Fracture|
| | | | | |
| | | | |Spine/Orthopedics|
|
| | | | |
| | | | |Stent |
| | | | |Umbilical Hernia |
| | | | |Repair |
| | | | |ALOC/Syncope |
|Other |TPN/PPN |Dysphagia Diet |Diabetes as a | |
| |Tube Feeding |RD Discretion |secondary | |
| |Ventilator | |diagnosis | |
| |Dependent | |NPO x 5 days | |
| |Admission Data | |RD Discretion | |
| |Base: Change | | | |
| |in appetite, | | | |
| |Significant | | | |
| |Weight Loss | | |
|
| |RD Discretion | | | |
|Referrals|NCDI RN- |NCDI RN-Diabetes |NCDI RN- BG 200| |
| |Gestational |related diagnosis as|mg/dl | |
| |Diabetes, |above | | |
| |Physician | | | |
| |Referral- | | | |
| |Completed within| | | |
| |24 hours of | | | |
| |receipt | | | |
|Charting |SCIP on green |SCIP on green banded|Preprinted |Preprinted |
| |banded |nutritional |nutritional |nutritional |
| |nutritional |assessment sheet in |assessment |assessment |
| |assessment sheet |therapies section |sticker 1 or |sticker 2 |
| |in therapies | |cardiac
rehab | |
| |section | |education record | |
| | | |for post CABG | |
| | | |patients | |
|Screening|Within 24 hours |Within 24 hours of |Within 24 hours |Within 24 hours |
| |of admit |admit |of admit |of admit |
|Assessmen|Within 48 hours |Within 72 hours |Within 5days |Re-screen within |
|t | | | |5 days |
|Follow - |RD discretion up |RD discretion up to |RD discretion up |Re-screen within |
|up |to 5 days of |5 days of initial |to5-7 days of |5-7 days |
| |initial |assessment |initial | |
| |assessment | |assessment | |
|SNF |Screen 24 hours; Assessment 7 days; MDS 5 days, 14 days, 30 days, 60 |
| |days; RAPS/ Care Plan 14 days; Significant weight change follow up |
| |monthly ; Follow up per RD
discretion |
References:
1 Rita Jackson PhD, RD Editor Computerize Nutrition Screening Health
Care Food and Nutrition Focus 1999; 15:5-7
2 ADAs definitions for nutrition screening and assessment J Am Diet
Assoc 1994; 94:838-839
3 American Society for Parenteral and Enteral Nutrition ASPEN Board
of Directors Clinical Pathways and Algorithms for Delivery of
Parenteral and Enteral Nutrition Support in Adults Silver Springs, MD
ASPEN; 1998
Source:kids-kount.org
