For some home health patients, monitoring nutrition, food and fluid intake will be a critical part of their individualized plan of care. Therefore, the Outcome Assessment and Information Set (OASIS) includes questions related to these topics in Section K. It’s important for clinicians to understand these items and ensure they are answered correctly to demonstrate a patient’s progress.
Home health providers must use OASIS-E beginning January 1, 2023. Providers need to be aware of changes to the OASIS instrument with this updated version. This is the seventh blog in the Axxess series reviewing each section.
Importance of Section K
There is only one additional item added to the nutritional assessment in OASIS-E Section K: K0520 on nutritional approaches. However, it is important that clinicians refer to items in other areas of Section K to make accurate assessments.
For example, measuring the actual height and weight of every patient is essential to determining if the nutritional approaches being used in the care plan are effective. If the patient is receiving IV therapy for hydration, the admitting clinician will monitor patient weights to determine the success of the treatment. Overhydration or underhydration could cause significant clinical risk to the patient.
In previous versions of the OASIS, clinicians addressed whether IV therapy was being used at the time of the assessment. In OASIS-E, clinicians will assess what type of nutritional or hydrating fluids were administered at the time of the start of care, seven days prior to admission and at discharge.
The therapeutic diet is also addressed in this section. Clinicians should keep in mind that more than one answer here may be correct. For instance, the patient may have diabetes and need both a diabetic diet and soft mechanical diet.
Tips for Completing OASIS-E Section K
Clinicians should remember that getting an accurate on-site height and weight for the patient is important to establish a baseline for assessing the effectiveness of any treatment ordered. They should not accept a pre-written weight on a physician progress note or hospital discharge form.
Also, calling the physician’s office for verification of diet and parenteral, IV or enteral feeding is imperative. These orders need to be specific. Clinicians should also be aware that IV orders for issues other than nutrition or hydration are not included in this part of this assessment, such as IV antibiotics for an infection. While the use of a dash is allowed to answer questions in Section K, it’s best to focus on getting the information because it’s so important to the successful assessment and care planning for each patient.
In past OASIS assessments, clinicians have primarily depended on patient answers and input regarding diet. Clinicians will need to get specific information from the physician regarding dietary requirements to answer this item effectively. As mentioned in previous blogs, getting input from family members and caregivers will also be important relative to any compliance issues the patient may have. Diet restrictions and modifications are one of the most difficult “change challenges” patients encounter.
Clinicians have five full days to complete the OASIS assessment, so they can take the time necessary to get an accurate accounting of all the required information. Making those additional phone calls at admission will improve patient outcomes at discharge. Accurate information is vital to patient and organizational success.