NutriScreen

MUST

Body mass index

Weight loss

Unplanned weight loss in past 3-6 months

Acute disease

If patient is acutely ill and there has been or is likely to be no nutritional intake for >5 days

Please fill out all questions

Evaluation

MUST

P.

MUST

Low Risk

Routine clinical care

Repeat screening: 

  • Hospital – weekly
  • Care Homes – monthly
  • Community – annually

for special groups e.g. those >75 yrs

Medium Risk

Observe

  • Document dietary intake for 3 days
  • If adequate – little concern and repeat screening
    – Hospital – weekly
    – Care Home – at least monthly
    – Community – at least every 2-3 months
  • If inadequate – clinical concern
  • follow local policy, set goals, improve, and increase overall nutritional intake, monitor and review care plan regularly

High Risk

Treat*

  • Refer to dietitian, Nutritional Support Team or implement local policy
  • Set goals, improve and increase overall nutritional intake
  • Monitor and review care plan

  • Hospital – weekly
  • Care Home – monthly
  • Community – monthly

* Unless detrimental or no benefit is expected from nutritional support e.g.imminent death.

An evidence-based therapeutic algorithm for management of malnutrition can be found "here.”

All risk categories:

  • Treat underlying condition and provide help and advice on food choices, eating and drinking when necessary.
  • Record malnutrition risk category.
  • Record need for special diets and follow local policy.

Obesity:

Record presence of obesity. For those with underlying conditions, these are generally controlled before the treatment of obesity.

Subjektive Einschätzung

Calculate nutritional goals

Information NutriScreen

Recognised/validated and commonly used screening tools to identify patients with manifest malnutrition or at increased risk of malnutrition

Nutrition therapy starts with the identification of patients with an increased risk of malnutrition. There are various "screening tools" recognised in medical practice for this purpose. The European Society for Clinical Nutrition and Metabolism (ESPEN) recommends the use of the Nutritional Risk Screening 2002 (NRS-2002). The treatment team should perform the screening within 24 h after hospital admission. With this application, the NRS-2002 can be easily calculated online 1.
The NRS-2002 quantifies the risk of malnutrition in adults based on nutritional status disorder (BMI, weight loss, food intake), severity of illness and age over 70 years on a scoring scale of 0-7:

  • NRS ≤2: Currently no risk of malnutrition requiring treatment.
  • NRS ≥3: Increased risk of malnutrition, initiate the following measures recommended:
  1. Detailed assessment and cause clarification of malnutrition.
  2. Nutritional counselling checks the indication for nutritional therapy in a multiprofessional setting.
  3. Record the diagnosis of malnutrition according to ICD ("International Classification of Diseases") and ensure coding.

References

  1. Kondrup J, et al. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr. 2003;22(3):321-36.

List of abbreviations

BMI Body Mass Index
ESPEN  European Society for Clinical Nutrition and Metabolism
ICD International Statistical Classification of Diseases and Related Health Problems
NRS Nutritional Risk Screening