Efficient Nutrition Screening in an Inpatient Substance Abuse/Stress Recovery Program

Abstract

LEARNING OUTCOME: To describe an efficient nutrition screening tool for use by the admitting practitioner on a substance abuse/stress recovery unit.The 1996 Joint Commission on Accreditation of Hospitals (JCAHO) requires that nutrition screening be completed within 24 hours of admission. At the medical center, the routine nutrition screening was completed by a dietetic technician within 48 hours of admission on all inpatients, requiring 15minutes per patient. Nutrition screening covered 7 criteria (subjective parameters, diagnosis, weight, % Ideal Body Weight, weight change, albumin, total lymphocyte count) with 20 parameters. Data was gathered through a patient interview and medical record review; the form was then completed.To meet JCAHO standards, a new screening tool was developed by the interdisciplinary team. Criteria were reduced to five. A 60 day pilot program was initiated to test the new parameters for reliability and validity. Thirty seven patients were screened using the new tool. It was administered by the admitting practitioner during the admission history and physical, in the first 24 hours of admission. Subsequently, the same patients were rescreened by a Registered Dietitian using the existing screening tool. Results showed that the new tool agreed with the traditional tool 94% of the time. Other results were: 1. JCAHO nutrition screening requirements were met; 2. Diet technician time was reduced from 15minutes per patient to none, and the technician was reassigned; 3. Interdisciplinary team awareness of nutrition screening criteria was increased; 4. Duplicate questions were not asked of patient by nursing and dietetics.