Dehydration and/or Malnutrition

The incidence rate of dehydration and malnutrition are also quality indicators in the long-term care setting. Hydration and nutrition are often at the heart of many claims, as a resident who is dehydrated will be confused and lethargic, leading to greater immobility and thus a greater risk for the development of pressure ulcers. Further, a resident who has become nutritionally compromised does not have the same nutritional stores necessary to promote healing from injuries. Types of claims rooted in nutrition and hydration include poor wound healing, decreased immune function, increased risk for pressure ulcers, increased functional dependence, increased risk of infection, weakness (leading to falls), and Urinary Tract Infections (UTIs) or urosepsis. It is remarkably common to investigate a claim where a resident has a fall that results in a broken bone and have the hospital staff treating the emergent broken bone discover that the resident is also suffering from a UTI and dehydration. While weight loss is not always an indication of malnutrition, it is generally accepted that one who experiences a weight loss of 5% body weight within 30 days, 7.5% within 90 days, or 10% within 180 days needs to have the cause of the weight loss investigated, and appropriate nutritional interventions taken.