Meal Intakes on MAR

southernbeegirl, BSN, RN · Oct 2, 2008

we just went thru this CCM. we took the BMs and the meals off the mar. we now have a "CNA book" where they keep the documentation in. We only keep 7 days worth at a time. The nurses check this book daily for their documentation. I dont know the specific reg for it, but it is not a reg to keep that stuff unless it is careplanned to monitor. if you need the specific reg, i can find out tomorrow.

Thornbird · Oct 2, 2008

assuming CapeCod Mermaid means you live in Mass, this is the way it is. There is no specific "law" or regulation. But, some surveyors like to see ( as "good nursing practice") percentages on therapeutic diets recorded. If this is done on the CNA flow sheet that is adequate. Nevertheless, some facilities, particularly some of the corporate owned ones, want them on the MAR. There is never a particluar need for documentation on MAR's of regular diets or just special prep, like ground. Hope this helps.

noc4senuf · Oct 3, 2008

Unless it is a reg in your state, it is not a federal reg. I have never seen the meal intakes in the MAR, we have always kept them on a clipboard in the dining room.

CoffeeRTC, BSN, RN · Oct 3, 2008

I've never seen the this on a MAR before in PA. Wow...we have enough to chart already.

Havin' A Party!, ASN, RN · Nov 6, 2008

Both are kept in the CNA book at our facility.

CNAs are mostly involved with these tasks firsthand.

4x4country · Nov 7, 2008

we keep them in the mar at my current job. HATE IT!! last job the cna's had a kiosk so they charted it in there. that was a lot easier. wish we had a BM Book.

SuesquatchRN, BSN, RN · Nov 7, 2008

I never thought I'd find a court decision relating to a constipated LTC resident to be fascinating.

http://www.lacoa2.org/Opinions%20PDF/37550ca.pdf

mandykal, ADN, RN · Nov 7, 2008

i am having a discussion with some of the nurses at my new job. i've already taken the bm charting off the mar and left in in the bm book where it belongs. they are telling me it's a regulation to chart meal percentages in the mar. i'm telling them that as long as the cna's document on a form that we keep, that is sufficient.
does anyone know the regs? i don't mean what you've always done but what the regulations really are?

if they tell you it's regulations, ask them how can you see it in black and white. bm's i can understand having it in two places, the cna flowsheet and the mar. both eyes better than one. the worst part is the end of shift i have to review to update the mar.

as for meals % in mar that is just to crazy! that's why they have flowsheets the cna's fill out and in connecticut most facilities the nurse has to initial that it was done. not by law, but by facility practice. cna sheets is a legal document aswell. there is no need to document more. we just added to our mar sp02 saturations making sure we are documenting pre and post nebs sp02.

to me, medication record should be kept clean with some safety added such as fluid consistency, asp precautions, may crush appropriate meds. too much information written is a set up for potential med error.

debRN0417 · Nov 16, 2008

There is no federal regulation which states that meal intake should be kept on the MAR. There is however a federal regulation regarding nutrition and "ensuring that residents maintain acceptable parameters of nutritional status..." (F325 483.25 (i) )

There is new guidance under this regulation. If you do not keep up with meal intake somewhere, you cannot accurately assess a residents nutritional status, or discern why there is weight loss/gain...ect...but put it where you choose, as long as it is complete, and accesable. Also it needs to be individualized to each resident....in other words each resident should have their own separate charting so that it can be placed in the clinical record. I have seen pages with lots of residents names and information on one page, but that just makes extra work for someone to transcribe them elsewhere because of course, you can't put a sheet in a chart with all those other names on it.

achot chavi · Nov 17, 2008

We keep a CNA book with pages for meal intake. BM's, showers, ambulation by CNA's, Bathroom assistance, weights, hygiene care (nails, teeth, etc), T&P, Assistance of 2 to transfer . We keep these for a year.