– Good morning team, come
on in and have a seat. We’d like to give you an overview of a new weekly meeting called the On-Time five minute standup meeting. Now the purpose of this meeting is to discuss residents at nutritional risk, and decide how we, as a team, work together to improve meal intake and prevent weight loss, and ultimately, prevent
development of pressure ulcers. For this meeting, we’ll be
using the nutritional report, that summarizes and trends
nutrition information such as resident’s eating
patterns over four weeks. CNAs, you spend a great deal
of time with the residents, and you know them very
well, their eating patterns, their likes, dislikes, and how
they’re feeling in general. Your observations and
input in team discussion along with report information are an important part of this new process. Rose, our dietician,
will be leading the team. As CNAs, you will attend the meetings and participate in team discussions, Rose? – Okay, I’ll get right to the process. I’ll bring the nutritional
report to each meeting and highlight residents
to discuss as a team. Using the report at the standup meeting will focus our discussion
and give you an opportunity to share dietary information
you feel I should know about. – Don’t we already talk about our resident’s eating habits when we see you on the floor everyday? – Yes, but instead of meeting one on one, we can discuss residents
at nutritional risk as a team each week and brainstorm ways to improve resident meal
intake or resident weight loss. – So the nutrition reports summarizes our computer notes about
meals and can show us if a resident is eating less each week? – That’s right, Lucy. That’s why your charting is so important. – Sometimes looking at
trending information overtime helps us notice subtle
changes in eating habits that we might not pick
up on from day to day. It gives us the bigger picture. Of course, you don’t have to
wait for our weekly meeting if you have immediate concerns
about your resident’s eating. – We often tell you that CNAs
are important team members, but now you can see in
action how everyone benefits from your daily documentation
and the insights you provide about your residents. – Let’s look at the nutritional report for your nursing unit. You see the residents listed and the four numbers next to each name? Each value represents an average of what the residents
took in for all meals for one full week. What do you think about
Mrs. Smith’s meal intake? – Well, four weeks ago,
Mrs. Smith took in 74%, then 72%, then 68%, and for
the most recent week, 54%. – It looks like Ms. Smith is
eating less and less each week. – That’s right, does
anyone know this resident, could this be true? – Yes, this is my resident,
and she’s been eating less than usual, Mrs.
Smith just told me today that her tooth has been bothering her for a couple weeks now. Can someone take a look at her tooth? – Sure, this is a great
example of getting on top of a problem before it gets worse. We want to make sure we have
a good care plan in place for residents at potential
risk for nutritional decline. – I think these numbers are correct for my residents who are
listed on this report. – Mine too. – Good, now you’ll have some idea of what to expect and how we’ll
use the report information. Okay, so what’s a good day
of the week and time of day to schedule the standup meeting
for all CNAs on this floor? – Okay, team, Gayle and I have identified two residents on the nutrition
report to review with you. Who’s caring for Mrs. Jones? The report information
shows that her meal intake has steadily declined
for the past four weeks. – I am, she hasn’t been eating her lunch, and then the evening CNA
told me that she’s been refusing some of her dinners, too. Mrs. Jones like to eats breakfast foods. I think she might eat more if she could have breakfast
foods like cereal and eggs for lunch, too. Is that possible? – That’s a good idea,
let’s try changing her diet to breakfast choices for lunch, and then see if we can get
her to eat her usual dinner. Can you give me an update
on her progress on Thursday? – Sure, I’ll inform the evening
CNA about the menu change, and I’ll get back to you Thursday about Mrs. Jones’ meal intake. – Good, now let’s talk about Mr. Walker. He eats bout 55% on average each week, which is usual for him,
but as of last week, he has lost 2.2 pounds. – I’m taking care of Mr. Walker. He doesn’t eat much for
lunch, and sometimes only 25% of breakfast. I think he might have trouble
chewing but I’m not sure. – Interesting, I know he was
given pain medicine yesterday for a headache. I’ll talk with his nurse, we may need to get a dental consult. – I can change his diet to
puree and see if that helps. Priscilla, can you get him
to take an afternoon snack? – I’ll try, he sleeps
a lot in the afternoon. – Okay Priscilla, let’s get
another weight tomorrow morning. Are there any other residents
you’d like to discuss today? – No. – Very good, we’ll be following up with Mrs. Jones and Mr. Walker. We learned a lot from your
feedback this morning. Thank you all. – [All] Great, thank you. – Hi Rose, you asked me
to give you an update on Mrs. Jones today. She’s been eating better, since getting breakfast
foods for lunch too, and she seems really happy. The evening CNA said she’s taking more of her dinner tray, too. – Lucy, that’s terrific, you were right about the breakfast food. She didn’t realize she had
a choice and is excited about the change to her menu. Thank you for bringing it to my attention before it turned into a serious problem. – That was a good meeting, everyone. Let’s talk about our
performance as a team. What did we do well? – I think it’s great that the CNAs are so open and communicative. They have a lot of good ideas about getting the residents to eat. – Well this is a great time
for us to share with you about our residents. I feel like we have more of a voice now. – I think it’s great that we
can see our meal documentation on this report, and it
helps us see what’s going on with our residents and we
learn a lot from each other when all the CNAs are together. – And using the report helps
to keep the discussion focused. So what is not going well? Are there areas for improvement? – The schedule, the directors
of rehab and social services would like to attend,
but Tuesdays conflict with other meetings. – It would be great to have
the other disciplines attend. What do you think about
switching to care plan meeting days when everyone will
already be on the unit? – Will meeting 20 minutes
prior to care plan meetings work for each nursing unit? – I think so. – Great, let’s make the change and plan to meet Thursdays
at 9:45 a.m. then. – Before we leave, I
would like to thank Lucy for following up with me last week. She monitored Mrs. Jones
after her menu change, and got back to me with
detailed feedback as requested. – That’s a great example of
following the plan of care and communicating back to
the dietician, good teamwork. We’ll see you next week. – Great. – Thank you.

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Methew Wade

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