Nutritional Screening & Assessment

Nutritional screening is a rapid, standardized process completed within 24 hours of admission to identify clients at nutritional risk. It is NOT a full assessment — it triages who needs one. Validated screening tools include the Malnutrition Screening Tool (MST), which asks about recent unintentional weight loss and appetite changes, and the Nutrition Risk Screening (NRS-2002) for hospitalized adults. A positive screen triggers a comprehensive nutritional assessment performed by or in collaboration with a registered dietitian. The full assessment includes anthropometric data (BMI, mid-arm circumference, waist-to-hip ratio), biochemical markers (albumin, prealbumin, transferrin), clinical exam (skin turgor, hair quality, wound healing, oral mucosa), and dietary history (24-hour recall, food frequency, intake adequacy). Prealbumin (normal 15–36 mg/dL, half-life ~2 days) reflects recent protein status far better than albumin (normal 3.5–5.0 g/dL, half-life ~20 days), which lags behind actual changes. The nurse's role is to perform the initial screen, collect accurate intake and output, obtain daily weights on the same scale at the same time in similar clothing, and communicate findings to the interdisciplinary team.