Investing in patients’ nutrition: nutrition risk screening in hospital

Abstract

Objective: This paper explores the current state of knowledge and evidence for investing in the nutrition screening of patients in hospital.

Setting: Hospitals.

Subjects: Hospital patients; nursing care. 

Primary argument: Nutrition screening of hospital patients is widely supported in evidence‑based guidelines because poor nutritional status has a negative impact, increasing patients’ morbidity, mortality and length of hospital stay. Screening is often undertaken by nurses as part of the patient admission process and in conjunction with other health risk screening tools, although the extent of routine nutrition screening in Australian hospitals is unclear. Once a patient is screened and subsequently assessed and diagnosed with malnutrition and treatment is commenced, there is a lack of high quality evidence about the effect of this treatment on longer term patient outcomes. This has most likely restrained nursing decisions about investing nursing resources in routine nutrition screening of all targeted patients.

Conclusion: Routine screening of hospital patients for nutrition risk early in their admission is obligatory according to best evidence, though not universal in Australian hospitals. Further high quality research (eg., randomised trial) is warranted to determine the consequences of screening which appear to include positive impact of nutritional interventions upon undernourished/malnourished patients. If this data were available, administrators may recognise both economic and patient‑centred benefits of investing in systematic nutrition screening.