Need advice for tracking weight changes in my residents

[dhsieversRN]

I am the RN at an assisted living facility in Washington. I am the only RN. I delegate tasks to the CNAs who are also med aids. I have very busy days with training and delegating, making sure delegations are current, resident assessments are current, doing incident report assessments (ie: falls), reviewing new orders and the MARs, managing the overall health care of the residents, as well as being the liaison between the resident and or their family, and their PCP.

I know weight changes are significant especially since diseases and medications can be the cause. I would like any advice anyone has as to better monitor weight changes. The med aids get weights monthly on every resident and this goes in the resident file. So if the resident isn't currently being monitored "regularly" due to doctor's orders I may not know if a resident has gained or lost a significant amount of weight (I figure 5lbs is significant) in a month's time. We are paper not electronic. Which if we were electronic this would be so much easier. I just don't want a resident to slip by for a month or two losing or gaining weight until it is noticed (prob by a family member - yikes) and I don't know about it.

Any advice?

Thanks,

Diane

[Lissa,RN]

I would have the aides chart weights in the resident charts, but also have them put weights on a flowsheet somewhere. I keep mine on a clipboard that I can quickly and easily pick up and just check over. That way it's easy to add a new list just right on top of the old one whenever I need. Does that make sense?

[loriangel14, RN]

Maybe they need to weigh them more often.

[dhsieversRN]

I would have the aides chart weights in the resident charts, but also have them put weights on a flowsheet somewhere. I keep mine on a clipboard that I can quickly and easily pick up and just check over. That way it's easy to add a new list just right on top of the old one whenever I need. Does that make sense?

Thank you Lissa. The RCC does a flow sheet for me of the "monitored" residents. But I could start a clipboard where monthly weights of all residents get listed. That is a good idea.

[dhsieversRN]

Maybe they need to weigh them more often.

The "monitored" residents (the ones with doctors orders, or ones I want monitored) are weighed weekly. I'm talking about the residents that are not being monitored weekly because they have not yet had weight issues identified.

[VivaLasViejas, ASN, RN]

In addition to the informal list of weights that you keep for your own records (trust me, you do not want to ever have an official flowsheet that surveyors can use to hang you with), you should designate one person whom you can trust to assist you with weight management in the facility. This person can be a resident-care coordinator or even a caregiver/med aide; what matters is their ability to promptly communicate any weight changes.

In my building, all of the residents are weighed at least monthly during the first five days of the month and the weights recorded in the charts. However, we do have the "unofficial" list, which is merely a copy of the roster with a given month's resident weights that's kept on my personal clipboard in my office when not in use, and I review and compare with previous months once they're all done.

I'll reweigh anyone whose weight varies by more than 4 lbs in a given period, and if they are actually gaining or losing, I start investigating. Someone who's trending down will go on weekly weights; if it's someone with a CHF history I'll even start daily weights to make sure they aren't gaining weight because of increased edema. I also notify the resident's doctor and family and give them a heads-up as well.

Dunno how it's going in WA, but in Oregon I'm seeing more and more facilities cited big time for weight loss, as well as for failing to have a weight monitoring system in place. You are wise to get, and stay, on top of weight issues!

[dhsieversRN]

In addition to the informal list of weights that you keep for your own records (trust me, you do not want to ever have an official flowsheet that surveyors can use to hang you with), you should designate one person whom you can trust to assist you with weight management in the facility. This person can be a resident-care coordinator or even a caregiver/med aide; what matters is their ability to promptly communicate any weight changes.

Dunno how it's going in WA, but in Oregon I'm seeing more and more facilities cited big time for weight loss, as well as for failing to have a weight monitoring system in place. You are wise to get, and stay, on top of weight issues!

Thank you so much! Wow that's a bit scary. I will make sure that what ever I do it is "unofficial" and for me to monitor. I think may make an unofficial flow sheet for weight day to only be used and seen by the med aids getting the weights and make sure it is turned into me promptly.