科研之友
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摘要
Aim:
To develop a process for malnutrition screening for adult multi-day inpatients in an acute public hospital with a large, elderly, multicultural population and streamline referrals to match current workforce resources.
Method:
Admitted patients were screened over five months in 2008 using the Malnutrition Screening Tool. For any patient who was unable to communicate because of their medical condition or where an English language barrier existed, an observational item was added and applied to identify 'frail' or 'underweight' appearance. Patients identified using the frail item were assessed for malnutrition by dietitians using Subjective Global Assessment.
Results:
Of 3033 patients (72% of admissions) screened using Malnutrition Screening Tool, 16.5% were at risk of malnutrition. A further 6.5% were deemed at risk using the frail item. The mean age of all at-risk patients was 71 +/- 23 years; 57% were females. Of patients screened, 10% experienced communication barriers. With systematic screening, referral of patients increased by 39%. Dietitians assessed 95 patients identified by the frail item using Subjective Global Assessment; and 58% were confirmed as malnourished.
Conclusion:
The study identified a proportion of acute hospital patients for whom nutrition screening using Malnutrition Screening Tool was difficult because of limited applicability if a patient was unable to communicate. Use of the Malnutrition Screening Tool modified by an additional frail/underweight observation was practical in a systematic nutrition screening process and assisted the containment of dietitians' workloads. Further research is warranted to develop or modify a subjective tool valid for the screening of all targeted hospital patients.
- 出版日期2010-6
