Notify the provider per the patient-specific parameters and agency policy, and document the closed loop — contact, content, response, and follow-through.
State the specific parameter that was met (the value or finding that triggered notification).
Record the date and time of contact, who was notified, exactly what was reported, the response or orders received, and the follow-through.
If a response is pending, document the scheduled follow-up time so the loop is not left open.
Common notification triggers for this system: significant unintentional weight loss or a sustained decline in intake; intolerance of the therapeutic diet or enteral feeding; an elevated residual or a dislodged or clogged enteral tube; signs of dehydration accompanying poor intake; or new dysphagia limiting safe intake.
Closed-loop example
“Provider notified at 11:20 of a 7-lb unintentional weight loss over 30 days with reduced intake and early satiety, no acute GI symptoms. Order received to start an oral nutritional supplement twice daily, obtain laboratory studies, and refer to a dietitian. The patient was taught fortification and small frequent meals; reassessment of weight and intake arranged.”
