Critical Evaluation of a Pediatric Hospital Nutrition Screen

Abstract

LEARNING OUTCOME: To evaluate the effectiveness of a pediatric nutrition screen, risk criteria, interventions and outcomes. Early identification of nutrition compromise and risk status is a priority for the health care team. A nutrition screen for pediatric patients was developed utilizing subjective (patient interview & caregiver's reports) and objective (diagnostic, clinical, anthropometric, & biochemical) data. Periodically, the nutrition screen and point system for ranking risk criteria have been evaluated and revised to meet the changing demands of the hospital environment and current standards. Three methods used to evaluate the screen are listed. 1) A one month comparison of the results from routine nutrition screening and concurrent assessments by the pediatric nutrition support team was evaluated with patient care outcomes in the intensive care unit. The levels of care provided to 23 out of 27 (85%) patients were consistant with the results of the initial nutrition screens. 2) 25 pediatric patients identified at nutrition risk were monitored for implementation of dietitian recommendations for nutrition care strategies. Six (100%) high risk care plans were initiated and 11 out of 19 moderate risk patients' feedings were altered as suggested. 3) A four month review of screening accuracy (n=208) and timeliness identified areas that the resulted in improvements implemented by the technicians. Screens reviewed revealed 98% of the risk level assignments were correct and the nutrition plans were appropriate for the level of care. The pediatric nutrition screen contributes to patient care with identification of patients in need of intervention to optimize treatment response, recognition of the signs of malnutrition by all staff, promoting consistency in care levels and facilitating the evaluation of effectiveness and appropriateness of care plans.