A malnutrition screening tool is a rubric care providers can use to quickly assess a patient's risk of malnutrition. It standardizes patient assessments to reduce the risk of missing malnutrition or its complications in a patient, and also creates a score the doctor can enter in the patient's chart. The score makes it possible for other care providers in the future to track the patient, as it is an objective measure rather than a subjective comment like “patient looks thin.”
There are a number of malnutrition screening tools available, and medical facilities usually pick one and ask all their personnel to use it. The screening typically includes taking the patient's height and weight, asking the patient some questions, and noting the results. The doctor can follow a flowchart to assign a score. If a patient has unexpected weight loss, the doctor can determine whether it's associated with disease, malnutrition, or another issue, and will use this to determine the most appropriate score.
Rankings on a malnutrition screening tool can vary from a very low risk, indicating that a patient appears healthy and is getting appropriate nutrition, to active malnutrition that requires treatment. When a patient has a high score, the doctor may refer her to a nutritionist and perform a more thorough medical evaluation to learn more about why the patient is not getting enough nutrition. The doctor may also consider working with a social worker, as malnutrition may be the result of food insecurity rather than illness, and the patient could need help to access benefits programs that might pay for food.
Familiarity with a malnutrition screening tool can make the process go quickly. The doctor may be able to unobtrusively collect the necessary information, which can make the patient feel more comfortable. Patients may feel worried or singled out if they think their doctors are screening them for malnutrition, even though this is a routine part of patient intake that a facility usually requires for all new admissions.
Sometimes a malnutrition screening tool is not entirely accurate. Every patient is slightly different, and special circumstances may be difficult to account for. In this setting, the doctor may add a note to the numerical score to provide more context. Doctors must also consider how to handle the screening when a patient has an eating disorder. The doctor needs to use the malnutrition screening tool for patient safety, but asking questions about weight and eating habits might cause a relapse or emotional distress in the patient.