April2016

Dear(Editor):

Malnutritionremainsanissueofconcerninhealthcare,evenwiththeadvanced
technologyandmedicalpracticeswehavetoday.Theprevalenceofmalnutritioncanbe
ashighas50%.Itisassociatedwithworseningofexistingmedicalconditions,
increasinginmedicalcomplications,andprolongedhospitalizations.Inorderto
determineapatientsriskformalnutrition,andforearlydetectionandintervention,
nutritionscreeningtoolsmustbeused.
TheefficiencyandaccuracyofthenutritionscreenisessentialforRegistered
Dietitiansinordertoprovideappropriateinterventionsandavoidlengthyhospitalstays.
ItisthejobresponsibilityofRegisteredDietitianstohelppatientsachieveand/or
maintainnutritionalwellbeing.Withoutanefficientandaccuratescreeningtool,
RegisteredDietitianswouldnotbeabletoprovideadequatecare.
TheMalnutritionScreeningTool(MST)isashortandeasytousescreeningtool
thatfocusesontwoquestions:whetherthepatienthadexperiencedrecentweightloss
(ifyes,howmanypounds)andwhetherthethepatientisexperiencinglossofappetite.
Ascorewillbegivenbasedontheanswersprovided.Ascoreof2orhigheris
consideredtobeatriskformalnutrition.
ThisstudyevaluatestheaccuracyofMSTbasedonthemalnutritiondiagnosis
guidelinesofTheAcademyofNutritionandDietetics.Inadditions,theaccuracyofMST
isalsocomparedwiththescreeningtoolsusedatthethreehospitalswherethestudy
tookplace.MSTisdemonstratedtohaveahigherpercentageofaccuracycomparedto
thescreeningtoolsofthehospitals.
ThisstudywasconductedinfulfillmentofrequirementsoftheAramarkDistance
LearningDieteticInternship.Thestudywasconductedunderthesupervisionofan
AramarkDieteticInternshipDirectorandRegisteredDietitiansatXHospital,YHospital,
andZMedicalCenter.Thestudywasconductedwiththepermissionfromthe
InstitutionalReviewBoardsofthethreehospitalsmentionedabove.Thankyouforyour
considerationofthismanuscript.

Sincerely,
MeganEvans
AramarkHealthcareDieteticIntern
LisaHomiak
AramarkHealthcareDieteticIntern
CrystalLim
AramarkHealthcareDieteticIntern
1

ResearchPracticeandInnovation

MalnutritionScreeningTool,MST,MalnutritionScreening,NutritionFocusedPhysicalExamination

WordCount:2,981

TheAccuracyofMalnutritionScreeningTool(MST)inscreeningadultpatientsfor
malnutritionincomparisonwiththeeachhospital'sapprovedscreeningmethod,using
theAcademyofNutritionandDieteticsGuidelinesformalnutritionasamethodof
comparison

MeganEvans

DieteticIntern

AramarkHealthcareDistanceLearningDieteticInternship
XHospital

LisaHomiak

DieteticIntern

AramarkHealthcareDistanceLearningDieteticInternship
YHospital

CrystalLim
DieteticIntern
AramarkHealthcareDistanceLearningDieteticInternship
ZMedicalCenter

ExaminingtheaccuracyofMalnutritionScreeningTool(MST)inscreeningadult
patientsformalnutritionincomparisonwiththeeachhospital'sapprovedscreening
method,usingtheAcademyofNutritionandDieteticsGuidelinesformalnutritionasa
methodofcomparison

ABSTRACT

Malnutritioncanworsenduringhospitalization,increasingpatientmedical
complications.2Prevalenceofmalnutritioninthehospitalsettingcanbeashighas50%.
Thepurposeofnutritionscreensistoidentifypatientsatriskandthoselikelytobecome
atnutritionalrisk.1Screeningmethodsusedareshort,quick,easytouse,and
costeffective.Additionally,theymustalsobevalidandreliable.Themalnutrition
screeningtool(MST)isfairlynewandcurrentlynotyetadoptedbyallhospitalsacross
theU.S.ThisstudyexaminedwhethertheMSTismoreaccurateatscreeningthanthe
involvedhospitalsapprovedscreeningmethod,basedontheAcademyofNutritionand
Dieteticsguidelinesformalnutrition.The44participantsinthisstudywerepatients
selectedfromXHospital,YHospital,andZMedicalCenter.Theparticipantswere
screenedtobeatmoderateorhighnutritionalrisk,andgivenapreMSTbytheinterns
orRDsbasedontheinformationavailabletothematthetimeofscreening.Following
thefullnutritionassessmentandexam,participantsweregivenapostMSTscore.Pre
andPostMSTscoreswerecomparedattheendthedatacollectionprocess.ThePre
MSTscoreexhibiteda56%accuracy,whilethepostMSTscoreexhibitedahigher
accuracyof79%.Fromthis,wecanconcludethattheMSTismoreefficientand
accuratethanthecurrenthospitalscreeningtoolsusedateachhospitalinvolvedinthis
study.

ExaminingtheaccuracyofMalnutritionScreeningTool(MST)inscreeningadult
patientsformalnutritionincomparisonwiththeeachhospital'sapprovedscreening
method,usingtheAcademyofNutritionandDieteticsGuidelinesformalnutritionasa
methodofcomparison

INTRODUCTION

Optimalnutritionisabalancebetweennutritionalintakeandrequirements.Intake
includesactualfoodintakeandabsorptionrequirementsareincreasesordecreasesin
one'sdailyneedsbasedonvariouscircumstancesandifbotharenotaccuratelymet,
thepatientcouldbeatnutritionalrisk,whichcouldleadtomalnutrition.Forinstance,an
illness,periodsofgrowth,orgeneralwellbeingwouldchangeapersonsnutritional
needs.1
Malnutritionissimplyanynutritionalimbalance.1Apoornutritionalstatusisa
concerninacute,chronic,andtransitionalcaresettings,becausemalnutritioncan
worsenduringhospitalizationandincreasetheirmedicalcomplications.2Prevalenceof
malnutritioninthehospitalsettingcanbeashighas50%,dependingonthepopulation,
location,andassessmentparameters.2Inordertodetermineaperson'srisk,nutrition
screeningtoolsareused.Thepurposeofnutritionscreensistoquicklyandaccurately
identifypatientsatriskandthoselikelytobecomeatnutritionalrisk.1Afteranindividual
isscreenedtobeatrisk,itmustbedeterminedwhetherafullnutritionassessmentis
necessary.Screeningmethodsusedvarybetweenhospitals.Itistypicallycompleted

duringeachpatient'sinitialscreening,whichisadministeredbyadiettechnician,
registerednurse,oraphysician.Screeningmethodsusedareshort,quick,easytouse,
andcosteffective.Additionally,theymustalsobevalidandreliable.Mostscreening
assessmentsinclude:historyofweightloss,decreaseinappetite,currentneedfor
nutritionsupport,skinbreakdown,andchronicuseofmodifieddiets.1
TheaccuracyofthenutritionscreenisessentialtotheRegisteredDietitiansjob.
Withoutthescreen,thedietitianwouldnotknowwhoisatanutritionalriskandwould
notbeabletoprovideadequatecaretothepatient.Everytimethescreeningtool
identifiessomeoneatrisk,itpopulatesanutritionconsultandtheRegisteredDietitian
furtherevaluatesthepatientduringafullnutritionassessment.Thisallowsthemto
assessthestatusofmalnutritionanddevelopanaccurateandeffectivemethodtotreat
eachindividualpatienttherefore,itisveryimportantforthescreeningtoolutilizedtobe
effective,reliable,andeasytouse.DietitianscanusetheAcademyofNutritionand
Dieteticsguidelinesformalnutrition.
Themalnutritionscreeningtool(MST)isfairlynewandcurrentlynotyetadopted
byallhospitalsacrosstheU.S.TheMSTisaconvenientandeasytousetoolusedto
screenpatientswhoareatriskformalnutrition.Itwascreatedbasedonastudy
conductedbyFergusonetal.in1999.3Thestudypopulationincluded408patients

admittedtothehospital.Pediatric,maternity,andpsychiatricpatientswereexcluded.
ThepatientswereassessedformalnutritionbasedontheSubjectiveGlobal
Assessment(SGA)and20nutritionscreeningquestionsthatinquiredaboutweightloss,
appetite,recentsurgeries,foodallergiesorintolerances,specialdiets,andother
pertinentinformation.CriterionssuchasBMI,handgripstrength,andbiochemical
parameterswereusedtotestforvalidityofthequestionsselected.Questionswiththe
highestsensitivityandspecificityatpredictingthesubjectiveglobalassessment(SGA)
resultswerenarroweddownandlabeledastheMalnutritionScreeningTool(MST).3
TheMSTconsistsoftwoquestionsregardingrecentunintentionalweightlossandloss
ofappetite.Theanswerstothequestionsarescored.IftheMSTscoreis0or1,the
individualisnotatriskformalnutritionhowever,iftheindividualisscoredwitha2or
more,theyarescreenedtobeatriskformalnutrition.Theauthorsrecommendedusing
theMSTwithin24hoursofadmission.3WhenputtingMSTtopractice,aconsulttoa
registereddietitianwouldbepopulatedwhenapatientisscreenedtobeatriskfor
malnutrition.
TheAcademyofNutritionandDietetics(A.N.D.)andtheAmericanSocietyfor
ParenteralandEnteralNutritions(A.S.P.E.N.)guidelinesformalnutritionisa
standardizedsetofdiagnosticcharacteristicsusedtoidentifyanddocument

malnutrition.Thisguidelineusedforadultsinclinicalpracticerecognizesetiologies,
suchasenvironmentalcircumstances,chronicillness,andacuteillness,andalso
differentiatesbetweenmoderateandseveremalnutrition.4Theclinicalcharacteristics
thatareexaminedbasedontheguidelineinclude:inadequatefoodandnutrientintake,
severityofweightloss,lossofsubcutaneousbodyfat,lossofmusclemass,generalized
orlocalizedfluidaccumulation,andreducedhandgripstrength.Thereisnosingle
criterionthatisconclusiveintermsofidentifyingmalnutritiontherefore,twoofthesix
clinicalcharacteristicsisrecommendedforthediagnosisofmalnutrition.4
Theregistereddietitianshouldsharepatientsnutritionstatuseswithallmembers
ofthehealthcareteam.Dataobtainedshouldbedocumentedandusedbythephysician
whenconsideringadiagnosisofmalnutrition.Collaborativelywithdoctors,nurses,and
othersonthehealthcareteam,registereddietitianscanimprovepatientoutcomes
throughnutritioninterventionsandpreventfurtherprogressionofpatientscondition.5
Malnourishedpatientswhoareidentifiedandaddressedarefoundtohaveshorter
lengthofhospitalstay,lowerratesofreadmission,andbetteroutcomesoverall.6
Personalizednutritioncareisevolvingandgainingimportanceinthefieldofdietetics.5
Aswehoneinonwhatbestdetectsmalnutritionandareabletodiagnoseandtreat
accordingly,registereddietitianswillbevaluabletothehealthsystembypreventing

longerhospitalstaysandcreatingreimbursementforservices.Beingabletoidentify
highriskgroupsearlyinadditiontobeingabletocollectdataforoutcomesresearch
coulddramaticallyalterthewaythehealthcaresystemworks.5Thismayleadtothe
usageoflessinvasiveandunnecessaryprocedures,andfewercomplicationsfrom
inappropriatemedications.5

ThepurposeofthisstudyistodeterminetheeffectivenessoftheMSTand
compareittoeachhospitalscurrentscreeningtools,thencomparebothtothe
AcademyofNutritionandDieteticsguidelinesformalnutrition.Theefficiencyand
accuracyoftheMalnutritionScreeningToolwillbeevaluatedbycomparingittoall
patientsassessedbytheRDwithamoderatetoseverenutritionalrisk.Thecomparison
willbebasedontheAcademysguideforassessingnutritionalrisk.Eachhospitals
currentnutritionscreeningpolicywillbecomparedtotheMSTandtheguidelines.The
validityoftheMSTwillalsobeinvestigatedagainsteachofthehospitalsnutrition
screeningprocesses.Asaresultwehopetoanswerthefollowingquestion:Canthe
MalnutritionScreeningTool(MST)accuratelyscreenadultpatientsadmittedtoX
Hospital,YHospital,andZMedicalCenteratriskformalnutritionincomparisonwiththe
eachhospital'sapprovedscreeningmethod,usingtheAcademyofNutritionand
DieteticsGuidelinesformalnutritionasamethodofcomparison?

METHODOLOGY

ProjectDesign
Acrosssectionalstudywasconducted.Acrosssectionalresearchdesign
surveysagroupofparticipantsthatmatchourresearchcriteriaatasinglepointintime.
Participantsincludedinthisstudywereidentifiedasbeingatnutritionalriskatthe
timetheywereadmittedtothehospitals.Theywereidentifiedusingeachhospitals
approvednutritionscreeningparametersconductedbytheRNorRD.Thepatientsthat
wereidentifiedasbeingatnutritionalrisk,weregivenapreMSTbytheinternsorRDs
basedontheinformationavailableatthetimeofscreening.Followingthenutrition
assessmentandnutritionalinterview,apostMSTscorewouldbegiven.TheAND
guidelinesformalnutritionwillbeusedasameasuringtooltodeterminetheaccuracyof
eachscreen.Inorderforittobeanaccuratescreen,theguidelinesmustapplytothe
patient.
DataCollection
Alldatawascollectedbythedieteticinternswiththehelpofsomepreceptors
whoareRegisteredDietitians.(SeeAppendix1fortheDataChartusedinthisresearch
project)

MethodsandMaterials
1.

Patients

PatientsincludedinthestudywerethoseidentifiedatnutritionalriskatYHospital
inCO,ZMedicalCenterinNYandXHospitalinPAbetweenDecember2015and
February2016.
2.Anthropometricandbiochemicalanalysis
Patientinformationwasobtainedfromthepatientortheirelectronicmedical
recordsincludinggender,age,currentweight,weightchanges,UBW,andpointake.
3.Assessmentquestions
MST
TheMSTconsistsoftwostepsscreeningquestionsandscoring.Question1:
Haveyourecentlylostweightwithouttrying?Ifyes,howmuchweighthaveyoulost?
Question2:Haveyoubeeneatingpoorlybecauseofadecreasedappetite?Ascoreof
0or1isnotatriskformalnutrition,ascoreof2ormoreisatriskformalnutrition.
AcademyofNutritionandDieteticsGuidelinesforMalnutrition
Thenutritionscreeningprocessesusedatthehospitalscoveravarietyofcriteria
toidentifypatientsatnutritionalrisktoallowtheregistereddietitianstoperformamore
indepthassessment.Theacademysassessmentcriteriaincludeenergyintake,

10

interpretationofweightloss,physicalfindingsandreducedhandgripstrength(thelatter
twobeingcomponentsoftheNFPE).TheNutritionFocusedPhysicalExamination
(NFPE)isavisualand/orphysicalexaminationofthepatientperformedtoidentifysigns
ofmalnutrition.TheNFPEhelpstovalidatethemalnutritiondiagnosis.Eachhospital
hastheirownapprovedscreeningparameterandaversionoftheAcademys
guidelines.Thefollowingisamorecomprehensivelistofcriteria:energyintake,
interpretationofweightloss,dietorder,BMI,diagnosis.
SubjectRecruitment
Foraparticipanttobeincludedintothisstudy,theymustmeetthefollowing
inclusioncriteria:
1. >18yearoldadultpatientsadmittedtoXHospital,YHospital,orZMedical
Center
2. AreidentifiedasbeingatanutritionalriskbasedontheRNadmission
assessmentthatincludesahospitalapprovednutritionscreen

ResourcesNeeded
1. Patientswerescreenedusingeachhospitalsapprovedscreeningparameters,
andassessedAcademysmalnutritionguidelines
2. MSTwasusedtogiveeachidentifiedpatientwhoisatnutritionalriskascore
3. Alldatawerecollectedwithinthehospitals
4. Printer,computer
5. Microsoftexcelwasusedtoorganizeandevaluatethedatacollected
6. Datacollectionchart
7. 8monthswasusedforthisprojectfromstarttofinish(SeptApril)
8. Permissionletters,GANTTchart,articles,nutritionscreeningtools

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Funding
Nofundingwasusedforthisproject.

StatisticalEval
DescriptiveevaluationofdatainMicrosoftExcel.

RESULTS

Atotalof44patientswereusedfordatacollection.Ofthese,20camefromX
hospital,10fromYhospital,and14fromZMedicalCenter.Datafromeachhospital
wascombinedandthenanalyzedasawhole.Altogether,therewere23malesand21
femalesbetween28and91yearsold.
Atthetimeofdatacollection,noneofthehospitalsinvolvedinthedatacollection
processwereusingthemalnutritionscreeningtool.Itshouldbeknownthateachofthe
currentscreeningtoolsdidnotfullyanswereachquestionfromtheMST.Thus,
preMSTscoreswerebasedoninformationobtainedfromthehospitalscreeningtool
andthedietitiansorinternsusedtheirbestjudgementtocompletequestions.Then,
oncethepatientwasassessedbytheRDordieteticintern,thepostMSTscorewas
determinedfrompatientintervieworpatientmedicalrecord.Thepostscoreisbasedon
theactualquestionsfromtheMST,andeachscorewasassignedbyanswersprovided
directlyfromthepatient.Inordertoevaluatetheaccuracyofnutritionscreening,thepre
andpostMSTscoreswerecomparedtothenumberofpatientsthatwereactually
malnourishedbasedontheANDguidelines.Also,preandpostscoreswerecompared

12

toeachothertodetermineiftheMSTwasamoreaccuratescreeningtool,overother
hospitalapprovednutritionscreeningtools.

Graph1:IndividualHospitalScores

Table1:Pre&PostMSTScoresfromeachhospitalandthetotal#ofactual
malnourishedpatientsarecomparedtodetermineaccuracy
Hospital

PreMST

PreMST

PostMST

PostMST

Score>2

Score<2

Score>2

Score<2

19

13

11

Total:

25

19

29

15

13

#ofactual

14

12

23

10

56%

37%

79%

33%

malnourished
patients*
%Accuracy

*ANDguidelineswereusedtodetermineifpatientsweremalnourished

PostMSTscorescorrectlyidentifiedmalnutrition23outof29times(79%
accuracy).Thismeanssixoutof29subjectsscreenedasmalnourishedwhentheywere
actuallynot.ThepreMSTwasabletocorrectlyidentifymalnutrition56%ofthetime.It
alsooverestimatedmalnourishmentbyidentifying25peopleinthescreeningprocess,
whenonly14ofthosewereactuallymalnourishedaccordingtotheANDguidelines.

Graph2:AccuracyofthePreandPostMSTScores

14

ItcanbeconcludedthattheMSTis23%moreaccurateatidentifyingpatientsat
nutritionalriskthaneachhospitalapprovedscreeningtool.Also,itcanbeconcluded
thattheMSTis4%lessaccurateatidentifyingpatientsnotatnutritionalriskthanthe
hospitalsapprovedscreeningtool.

DISCUSSION
TheMalnutritionScreeningTool(MST)istheoffspringofastudyconductedin
1999.Thisstudylookedatthe20questionsintheSubjectGlobalAssessment(SGA)
andnarroweditdowntothequestionsthathadthehighestsensitivityandspecificityat
predictingnutritionrisksinpatients3.Thosequestionsarethetwothatnowmakeupthe
MST.Researchhascomealongwayinthepast17yearssincetheMSTwasfirst
created,thusindicatingresultsmaybedifferenttoday,Ourobjectivewastodetermine
howaccuratetheMSTisatidentifyingpatientsatnutritionalriskincomparisonwith
eachhospitalscurrentnutritionscreeningtool.
Acrosssectionalstudywasimplementedanddatawascollectedfromeach
hospitalovertwoandahalfmonths.Eachdieteticinterncollecteddataonpatientage,
gender,preMSTscore,postMSTscore,andfindingsthatcoincidewiththeAND
guidelinesformalnutrition.PreMSTscoreswerebasedoninformationobtainedfrom
thehospitalsscreeningtoolonlyandpostMSTscoreswerebasedoninformationfrom
thepatientsmedicalrecordorfromthepatientthemself.Theguidelineswereusedasa
measuringtoolforaccuracyofthescreen.Itwouldbeconsideredanaccuratescreenif
theguidelinesappliedtothepatient.

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Ourresultswereconcurrentwiththestudythatwasdonein1999becausewe
foundthattheMSTwas79%moreaccurateatidentifyingpatientsatnutritionalrisk.
However,thereisroomforimprovementbecausetheMSTwasshowntobe4%less
accuratethanthehospitalsapprovedscreeningtoolsatidentifyingthosenotatriskfor
malnutrition.
Thestrengthsofthisstudyincludeanincreasedunderstandingofthe
malnutritionscreeningtoolandthenutritionscreeningprocessaltogether,resultswere
consistentwiththestudyin1999,andourresultsansweredourresearchquestion.
Therewerealsoweaknessesinthisstudy.Oneofthoseweaknesseswasthatthe
researcherseachhadvaryinglevelsofexperienceandknowledgerelatedtoscreening
andassessment.Bythat,itmeanseachresearcherallcameintothisinternshipwith
differentexperiencesandwedidnotallstartintheclinicalrotation.Thismadeitdifficult
tocommunicateexactlywhateachneededtobelookingat.However,astimewenton
andthingscametogether,itbecameeasiertohaveopendiscussionsabouthowto
evaluatedataandimprovethestudy.Bytheend,everyonesunderstandingofthe
wholenutritioncareprocesswasenhancedandllwereabletofindananswertothe
researchquestion.
Witheverystudytherewillbeunavoidableerrors.Someerrorsthatcouldhave
affectedourresultsarehumanerrorwhencalculatingourresultsorhumanerrorbythe
nurseswhoadministeredandsubmittedthenutritionscreen.Therecouldalsobeerrors
intheinformationobtainedfrompatientsduetochangesinmentalstatusor
miscommunicationerrors.Also,theMSTitselfaskswhetherapersonhasbeeneating

16

poorlybecauseofadecreasedappetite.Thismeanstheymaynotscoreunderthis
sectiondespiterecentlyeatingpoorlyduetoanotherunderlyingcauseotherthan
decreasedappetite.

CONCLUSION

Overall,thepostMSTscoresweremoreaccuratethanthepreMSTscores.
Fromthis,wecanconcludethattheMSTismoreefficientandaccuratethanthecurrent
hospitalscreeningtoolsusedateachhospitalinvolvedinthisstudy.Theresultsfrom
thisstudy,alongwithfuturestudies,canhelpRegisteredDietitianstremendously.
InorderforRegisteredDietitianstoprovideadequatecare,theyneedavalidand
reliablenutritionscreeningtooltheycancounton.Malnutritionisassociatedwith
worseningofexistingmedicalconditions,increasinginmedicalcomplications,and
prolongedhospitalizations.Theefficiencyandaccuracyofthenutritionscreenallowsan
RDtoprovideappropriatenutritioninterventionsandavoidlengthyhospitalstays.Itis
theresponsibilityofRegisteredDietitianstohelppatientsachieveand/ormaintain
nutritionalwellbeing.Withoutanefficientandaccuratescreeningtool,Registered
Dietitianswouldnotbeabletoprioritizemostaccuratelywhoisatgreatestnutritional
riskandatgreatestneedfornutritionalcare.Thisisthefunctionofthescreeningtool.
FuturestudiescouldevaluatetheefficiencyandaccuracyofMSTwhenitis
usedforspecificpopulations.TheMSTcouldalsobeevaluatedfurtherbyconducting
thesamestudyinhospitalsthatactuallyutilizethemalnutritionscreeningtool.Itcould
alsobedoneathospitalsthatutilizeotherscreeningtoolslikethemininutrition

17

assessmentorthesubjectiveglobalassessment.Resultsfromthetwoproposed
studiesandtheresultsfromthisstudycouldbecombinedinametaanalysisto
determinethemostefficientandaccuratescreeningtool.

REFERENCES

1. Mahan,L,EscottStump,S,Raymond,J.KrausesFoodandtheNutritionCareProcess.
St.Louis,MO:W.B.Saunders2012
2. Kayashita,A,Yamato,H,Yoshida,I,Matsuzaki,K,Niki,H,Nagae,H,Miyamoto,K.
Evaluationof14questionsdetectingmalnutritioninnewlyhospitalizationpatients.The
JournalofMedicalInvestigation. 201360:138145.
3. Ferguson,M,Capra,S,Bauer,J,Banks,M,Developmentofavalidandreliable
malnutritionscreeningtoolforadultacutehospitalpatients.Nutrition.1999
12(6):458464.

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4. White,J,Guenter,P,Jensen,G,Malone,A,Schofield,M.ConsensusStatementofthe
AcademyofNutritionandDietetics/AmericanSocietyforParenteralandEnteral
Nutrition:CharacteristicsRecommendedfortheIdentificationandDocumentationof
AdultMalnutrition(Undernutrition).JournalOfTheAcademyOfNutrition&Dietetics.
2012112(5):730738.
5. RheaM,BettlesC.Futurechangesdrivingdieteticsworkforcesupplyanddemand:
futurescan20122022.AcademyofNutritionandDietetics. 2012112(3):1024.
6. Varela,V,Delgado,G.Riskofmalnutritionassociatedwithpoorfoodintakeprolonged
hospitalstayandreadmissioninhighcomplexityhospitalinColombia.Nutrition
Hospitalaria.201532(3):13081314.

APPENDIX

DataCollectionChart

Reason
For
Nutrition
AgeandGender
MSTScore
Consult
(ex:RN,
MD,orRD)

NFPE:Identifyany
indicatorsfor
NutritionalRisk

DidtheMST&/or
thehospital
approved
ClinicalCharacteristics: screeningtool
Identifyanyindicators correctlyidentify
forNutritionalRisk
malnutrition?
*pleasespecify
whichtoolifnot
both

19

MalnutritionScreeningTool

20

21