Screening Protocols: Taking an Accurate Patient History on Admission— A Vital Part of Screening

Potential warning signs for the risk of malnutrition include:

• Recent weight loss
• Loss of appetite
• Gastrointestinal problems
• Long-term chronic illness

An initial nutritional screen should be conducted with patients within 8 hours of admission. The Nutritional Screen Form, provided here, is an example of the questions that may be asked and the laboratory tests that may be ordered.

Source: Brugler L, DiPrinzio MJ, Bernstein L. The five-year evolution of a malnutrition treatment program in a community hospital. JCAHO Journal of Quality Improvement. 1999;25 (4):194. Used with permission.

Defining a Comprehensive Screening Strategy A. Michael Spiekerman, PhD Chief, Chemistry Scott and White Clinic Full Professor of Pathology and Laboratory Medicine College of Medicine Texas A&M University, Temple, TX

Anthropometrics

The most basic tool for nutritional assessment is weight monitoring. Malnutrition is functionally defined as an inappropriate reduction in lean body mass based on the patient's age, gender, height, genetic background and level of activity. Monitoring patient weight over time can provide important clues as to overall nutritional health; however, weight monitoring in a hospital setting can be difficult, particularly for patients who are very sick and/or obese.

The Lab: Key to Identifying Malnutrition Frank N. Konstantinides, MT, MS Clinical Associate Professor College of Pharmacy University of Minnesota St. Paul, Minnesota