Diep-Pham Huyen-Tran, Donald Natasha, Wall Catherine L
Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
Department of Medicine, University of Otago, Christchurch, New Zealand.
Nutr Diet. 2023 Nov;80(5):530-537. doi: 10.1111/1747-0080.12838. Epub 2023 Aug 23.
This research aimed to assess the rate and reliability of routine nurse-completed malnutrition screening and report the prevalence of malnutrition risk on admission to Christchurch Hospital.
Student dietitians administered the Malnutrition Screening Tool to patients in three speciality wards within 48 h of admission. Student dietitians' Malnutrition Screening Tool scores were compared against documented nurse-completed Malnutrition Screening Tool scores. Data were analysed using descriptive statistics, Fisher's exact test, and Cohen's kappa tests (interrater reliability ⱪ). A p-value <0.05 was considered statistically significant.
Student dietitians, using the Malnutrition Screening Tool, screened 360 (96%) of 377 eligible patients while nurses screened 332 (88%) patients. Student dietitians and nurses screened 119 patients (33%) and 63 patients (18%) respectively at risk of malnutrition. There was fair agreement (ⱪ = 0.311) in Malnutrition Screening Tool total scores between nurses and student dietitians. There was a significant difference in the proportion of patients screened at risk of malnutrition between nurses and student dietitians (p < 0.0001).
Malnutrition risk remains high in acute care settings. Nurses were less likely to screen patients as at risk of malnutrition than student dietitians. Regular support and training in using Malnutrition Screening Tool may help improve the rate and reliability of routine malnutrition screening.
本研究旨在评估护士常规完成的营养不良筛查的比率和可靠性，并报告克赖斯特彻奇医院入院时营养不良风险的患病率。
学生营养师在患者入院48小时内对三个专科病房的患者使用营养不良筛查工具进行筛查。将学生营养师的营养不良筛查工具评分与记录的护士完成的营养不良筛查工具评分进行比较。使用描述性统计、费舍尔精确检验和科恩卡方检验（评分者间信度ⱪ）对数据进行分析。p值<0.05被认为具有统计学意义。
使用营养不良筛查工具，学生营养师对377名 eligible 患者中的360名（96%）进行了筛查，而护士对332名（88%）患者进行了筛查。学生营养师和护士分别筛查出119名（33%）和63名（18%）有营养不良风险的患者。护士和学生营养师在营养不良筛查工具总分上的一致性一般（ⱪ = 0.311）。护士和学生营养师筛查出有营养不良风险的患者比例存在显著差异（p < 0.0001）。
急性护理环境中营养不良风险仍然很高。与学生营养师相比，护士筛查出有营养不良风险患者的可能性较小。定期提供使用营养不良筛查工具的支持和培训可能有助于提高常规营养不良筛查的比率和可靠性。
