This customizable document, Nutritional Assessment, is taken from MCN Healthcare’s Hospice Policy and Procedure Manual. For more than 20 years, MCN has been the health care industry’s leading provider of policy and procedure templates, forms, competencies and other compliance tools.

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Here is some sample content from Nutritional Assessment:

	PURPOSE: To provide guidelines for the appropriate assessment of patients who may require a nutritional assessment. POLICY: When the initial assessment indicates an alteration in nutritional status, the Hospice RN or designee will make a referral to the hospital's registered dietitian or nutritional educator. PROCEDURE: The nutritional assessment should include the following information as part of baseline data: Diet/appetite Height/weight estimated Digestive disorders Dysphagia swallowing difficulties Factors affecting nutritional status including, but not limited to: Nausea/vomiting ...
Second excerpt:
	...care Environment for meals Hydration/fluid intake Based on the above, the RN or nutritional educator will assess the patient for: Nutrition, altered, less than body requirements Nutrition, more than body requirements Documentation in the clinical record should reflect that the physician was contacted and include results of the nutritional assessment. The nutritional educator documents plans, discussions and interventions related to the nutritional assessment in the clinical...