Nutritional risk screening: development of a standardized protocol using dietetic technicians

The development of a standardized screening mechanism for identifying patients in compromised nutritional status is beneficial for prompt initiation of nutrition care. A pilot screening study was conducted at St. Luke's Episcopal Hospital over a 3-month period to determine the prevalence of patients meeting defined nutritional risk criteria. Dietetic technicians screened each nursing unit once, in random order, until the entire hospital had been screened. Results indicated that one-third of the 225 patients screened were at nutritional risk. From those results, a standardized screening protocol and charting form were developed. The current screening procedure includes the original pilot study parameters of height, weight, albumin, diagnosis, and type of nutritional support, as well as additional parameters. Dietetic technicians also collect data on weight changes, appetite status, number of surgical procedures, and length of hospital stay. Criteria are listed under a severe risk or a moderate risk category. Patients meeting one severe or two moderate risk criteria are considered at nutritional risk. Recent data verify that more than one-third of patients screened are at nutritional risk. Through the utilization of technical support personnel, the standardized protocol has helped to identify patients who meet nutritional risk criteria.