The Difference Between Nutritional Screening and Assessment
Nutritional screening is an initial process to identify individuals at risk of malnutrition, while a nutritional assessment is a more detailed evaluation performed by a dietitian. Effective screening helps prioritize patients for appropriate nutritional support.
Popular and Recommended Nutritional Screening Tools
Several validated tools exist, and the most suitable depends on the patient's age and clinical context.
Malnutrition Universal Screening Tool (MUST)
Developed by BAPEN, MUST is a five-step tool for identifying malnutrition risk in adults across all care settings.
Mini Nutritional Assessment (MNA)
Validated for geriatric patients (65 and over), the MNA is widely used in various settings. The MNA-Short Form (MNA-SF) is a quicker, 6-question version.
Nutritional Risk Screening 2002 (NRS-2002)
Recommended by ESPEN for hospital settings, the NRS-2002 identifies acutely ill patients who may benefit from nutritional support. It includes initial questions and severity scoring.
Subjective Global Assessment (SGA)
The SGA is a clinical method using patient history and physical examination to classify nutritional status and is often used in hospitals.
Comparison of Common Screening Tools
| Feature | MUST | MNA-SF | NRS-2002 |
|---|---|---|---|
| Target Population | Adults | Elderly (≥65 years) | Hospitalized Adults |
| Primary Setting | All care settings | Institutionalized and Community | Hospital |
| Key Criteria | BMI, Weight Loss, Acute Illness | Food Intake, Weight Loss, Mobility, Stress, Neuropsychology, BMI/CC | BMI, Weight Loss, Reduced Food Intake, Severe Illness, Age |
| Time to Complete | Quick | Very quick (<5 min for SF) | Quick (initial screen) |
| Scoring | Categorical risk score (low, medium, high) | Numerical score for risk (at risk, malnourished) | Numerical risk score (≥3 is high risk) |
| Key Strength | Universal applicability | High validity for older adults | Incorporates illness severity |
Which Tool is Recommended for Nutritional Screening?
The choice of tool depends on the setting and patient population. MUST is recommended for general adults, MNA for the elderly, and NRS-2002 for acutely ill hospitalized patients. SGA is a valid subjective tool for hospitals. Specialized tools may be used for specific conditions. Proper staff training is essential for any chosen tool.
The Screening Process
The process typically involves initial screening, scoring to identify risk, further assessment for moderate or high-risk individuals, and ongoing monitoring.
The Benefits of Effective Nutritional Screening
Early screening and intervention can improve patient outcomes, reduce complications, shorten hospital stays, and lower healthcare costs.
Conclusion
The most recommended nutritional screening tool aligns with the specific patient population and clinical context. MUST suits general adults, MNA is best for the elderly, and NRS-2002 is valuable in hospital settings. Implementing appropriate screening is crucial for identifying at-risk patients and providing necessary support.
