Patient selection: hospital inpatient
Outcome: nutritional assessment
High risk for malnutrition:
(1) unplanned weight loss > 7 pounds (3.2 kg) within the last 30 days
(2) eaten less than 50% of normal intake for > 5 days
(3) received enteral or parenteral nutrition within the last 30 days
(4) mechanical ventilation for respiratory failure
(5) cachexia
(6) PEG or J-tube placement
(7) short bowel syndrome
(8) malabsorption
(9) major GI surgery
(10) liver disease
(11) renal failure with renal replacement therapy
(12) dysphagia
(13) non-healing wound or Stage II-IV wound
(14) hip fracture
(15) medical oncology admission
(16) body mass index < 18.5 kg per square meter
Orders associated with high risk:
(1) stroke with NPO diet order
(2) order for TPN, tube feed or calorie count
(3) pureed and/or thickened liquid diet order
(4) protein/calorie supplement ordered
(5) renal diet
(6) low-protein or high-protein diet
(7) nutrition consult
Moderate risk for malnutrition:
(1) small bowel obstruction
(2) pancreatitis
(3) diabetic ketoacidosis
(4) amputation
(5) inflammatory bowel disease
(6) celiac disease
(7) dementia or altered mental status
where:
• The first 3 questions under high risk are answered by the nurse and the rest by the dietician.
The patient is screened every 5-7 days.
