Why Are Screening and Assessment Important?

Benefits of Nutritional Risk Screening and Assessment

Early diagnosis of hospital malnutrition is the first step in effective management of this prevalent health care problem. In a comprehensive study, it was found that only 50 percent of malnourished patients were recognized in regular clinical practice.1 Severe malnutrition can be identified rather easily, whereas less severe states of malnutrition, particularly in patients with complex conditions, tend to become evident only in later stages of treatment.2 For this reason, mandatory screening using a validated nutritional risk screening tool is recommended for early identification and treatment of malnutrition.3,4

Patient Benefits of Nutritional Risk Screenings

When nutritional risk screening is performed, the deleterious effects of hospital malnutrition can be reduced or prevented. The benefits include:

Early Detection is Critical to Enabling Good Clinical Nutrition

To counteract hospital malnutrition and its consequences, timely identification of impaired nutritional status and quick response to start treatment are crucial for patients in nutritional risk groups. Today, only 50 percent of hospital malnutrition cases worldwide were recognized in regular clinical practice.1,10

Good nutritional care is a vital part of patient management and includes11:

Recommended Patient Screening Tools

Various screening tools have been designed to detect protein and energy undernutrition in patients. These tools are also effective for predicting whether undernutrition is likely to develop and/or worsen. The European Society for Clinical Nutrition and Metabolism (ESPEN) has set guidelines for nutritional risk screening of hospitalized patients12suggesting the following tools to avoid unnecessary depletion:

Each screening method has been recommended for different patient populations, care settings and age groups. Criteria for the selection of the appropriate tool also include validity and reliability of the method, predictive power, and simplicity of use.4

These tools consider weight loss, body mass index, physical signs of malnutrition, age, and disease severity among the signs of hospital malnutrition.14

Assessment is the second step of efficient nutritional management. It is a detailed, more specific and in-depth evaluation of the causes of malnutrition and the risk factors for nutrition and fluid deficiency.14

The assessment should be performed by a nutritional expert (e.g. a dietitian, a clinician interested in nutrition, or a nutrition nurse specialist) or by a nutritional support team. Clinical judgment is indispensable for the decision on the appropriate follow up. The completion of the assessment allows interventions which can lead to better outcomes.

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