Abstract
Purpose:
To identify patients at nutritional risk early to prevent a state of nutritional depletion or excess, both of which will adversely affect medical or surgical interventions and increase risk of developing chronic, non-healing wounds. The nutritional screening and evaluation process should identify patients who may benefit from nutritional guidance, including referral to a registered dietician or healthcare professional for comprehensive nutritional assessment.
Policy:
All patients who are admitted for 24 hours or more should be screened for nutritional risk. At risk patients will receive in-depth nutrition assessment from a registered dietician or healthcare professional. Patients identified at pre-established levels of nutritional risk will receive appropriate nutrition intervention and recommendations for diet, nutritional supplements, enteral or parenteral nutrition if necessary, and education for patient, caregivers, family will be given.
Definitions: Nutrition screening is designed to rapidly and inexpensively identify apparently healthy individuals who may have, or be at higher risk for, a disease or condition than the general population. Screening identifies subclinical disease.
Nutritional assessment has been defined as ‘a comprehensive evaluation to define nutrition status, including medical history, dietary history, physical examination, anthropometric measurements, and laboratory data.’
Steps
Perform nutrition screening upon admission using the two validated nutritional screening options: Mini Nutritional Screening Form (MNA)1; Malnutrtion Screening Tool (MST).2
Malnutrition Screening Tool (MST) (age > 18 years)
Patients will be assigned a level of care based on the scoring of the MST form as follows:
- 0 – 1 point: Normal nutritional status. Not at risk. Rescreen weekly.
- 2 or more points: At risk of malnutrition.
Initiate nutritional interventions immediately. Refer for comprehensive nutritional assessment within 24-72 hours.
Patients will be assigned a level of care based on the scoring of the MST form as follows:
- Score totals = at risk for malnutrition or malnourished. Complete the comprehensive nutritional assessment.
- Score totals = not at risk. Re-screen within one week.
Patients will be assigned a level of care based on the scoring of the MNA form as follows (age > 65 years):
- 12–14 points: Normal nutritional status. Not at risk
- 8–11 points: At risk of malnutrition
- 0–7 points: Malnourished
Patients will be assigned a level of care based on the scoring of the MNA form as follows:
- Score totals = at risk for malnutrition or malnourished. Referral for comprehensive nutritional assessment.
- Score totals = not at risk Rescreen weekly.
