Screening and Diagnosis of Malnutrition in a Hospital Care Setting Prior and After Multidisciplinary Educational Intervention

Abstract Objectives To compare initial malnutrition screening performed by nursing staff to that of the dietitians’, pre and post educational intervention To determine the knowledge and practice, of nurses regarding malnutrition Methods The study is a quasi-experimental design which included pre and post interventional malnutrition screening and diagnosis, and three multidisciplinary educational interventions, accompanied with pre and post knowledge assessments, for nurses, physicians and pharmacists. Admitted patients were screened for malnutrition using the NRS-2002 or MNA. Patients at risk of malnutrition or malnourished at screening were diagnosis for the latter using ASPEN, ESPEN and GLIM malnutrition diagnostic tools. Nutrition focused physicals examination, functional status and body composition analysis were also conducted. The nurses’ initial screenings of malnutrition (NRS-2002) was recorded for comparison with the dietitians’ screenings. Results A total of 269 patients were screened prior to the intervention out of which 37 (13.75%) were either at risk of malnutrition or malnourished. Post intervention, 311 patients were screened and 84 (27.01%) were either at risk or malnourished. Hundred and one registered nurses attended the educational session, and a repeated measure ANOVA showed that the nurses’ knowledge significantly improved (P < 0.001) but not practice. A significant difference within (pre and post intervention) and between groups (dietitians versus nurses), was detected in the sections related to BMI and weight loss in the NRS initial screening (P < 0.001). Also a significant difference (P < 0.001) in the reported food intake was revealed between the dietitians and nurses. Reporting severity of illness showed a significant difference (P < 0.001) pre but not post intervention. Conclusions The knowledge of the nurses regarding malnutrition screening improved right after the educational intervention. Despite a significant difference between the dietitians’ screening and that of the nurses’ in some parts of the NRS-2002, the latter didn't change post educational intervention except for the “severity of illness” assessment. Funding Sources None.