Abstract
Field, B., L. (2015). Differentiating malnutrition screening and assessment: A nutrition care process perspective. Journal of the Academy of Nutrition and Dietetics, 115(5), 824-828.
Introduction: The World Health Organization acknowledges the dual burden of malnutrition in the U.S., where the country not only faces a problem with obesity but food insecurity as well. Bowers, Francis, and Kraschnewski (2018) inform that in 2016, 12% of American households had food insecurity 2016. Worse is the fact that malnutrition affects 30-50% of adult hospital patients in the U.S. (Field, 2015). Given the dual nature of malnutrition in the U.S., Bowers, Francis, and Kraschnewski (2018) suggest the implementation of nutrition policies, capitalization on donations, secure partnerships, nutrition education, and malnutrition screening as some of the measures viable in battling malnutrition. In the article “Differentiating Malnutrition screening and assessment: A nutrition care process perspective,” Field (2015) suggests that the first step in combating malnutrition among patients is screening patients for malnutrition as the first step in the identification of the patient’s malnutrition risk. Subsequently, such patients can then benefit from seeing a registered dietitian nutritionist.
Purpose: The article additionally sets out to differentiate between malnutrition screening and assessment, where screening entails identification of patients that require visits to a registered dietitian nutritionist (Field, 2015). On the other hand, the article identifies nutrition assessment as a process in which a trained nutritional professional obtains, verifies and interprets data necessary for the identification of nutrition-related problems, the causes of the problems and their significance (Field, 2015).
Results: The article does not have a hypothesis, given its nature as a comparative article of the two processes rather than a study. The study delves into malnutrition screening and the prevalence of screening among patients, suggesting that while malnutrition affects up to 50% of adult hospital patients in the country, only a meagre 3.2% leave the hospital with a malnutrition diagnosis (Field, 2015). Further, the article lists nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring and evaluation as the approved nutrition care process as adopted by the Academy of Nutrition and Dietetics through the Nutrition Care Process and Model (NCP) in 2003 and updated in 2008 (Field, 2015). The four steps mark the standardized process for nutrition and dietetics practitioners in their daily work of addressing nutrition-related problems and providing quality care. Available tools screening tools include Subjective Global Assessment (SGA) and Malnutrition Clinical Characteristics (MCC). Given the need for tools in nutrition screening and assessment, validity of the tools used in the processes need assessment. Sensitivity, specificity, positive predictive value, and negative predictive value make up the tools’ validity (Field, 2015). Even with the validity, problems occur in the screening process, particularly confusing assessment tools for screening tools.
Conclusion: There exists many screening methods and tools. It is important, however, to use tools validated for screening. Validated tools improve resource utilization in addition to increasing interprofessional confidence and avoiding double screening. Screening for patients is not a one-time process, but continues throughout the patient’s stay in the hospital, given the possibility of changes in patient risk levels. To improve patient care and outcomes, facilities must identify at-risk patients, even as RDNs school patients, families, administrators, and health professionals on the goals and processes of valid nutrition screening.
Practical application: the article edifies on the need for nutritional screening and assessment, especially for patients. The fact that only 3.2% of patients get nutritional screening despite the high levels of malnutrition makes for a practical application of nutritional screening not only for patients in hospitals but the general public as well.
References
Bowers, K., S., Francis, E., & Kraschbewski, J., L. (2018). The dual burden of malnutrition in the United States and the role of non-profit organizations. Prev Med Rep., 12, 294-297.
Field, B., L. (2015). Differentiating malnutrition screening and assessment: A nutrition care process perspective. Journal of the Academy of Nutrition and Dietetics, 115(5), 824-828.