Acquisition and utilisation of anthropometric measurements on admission in a paediatric hospital before and after the introduction of a malnutrition screening tool

Abstract

Introduction of a screening tool improved the acquisition of anthropometric measurements by nursing staff, although its utilisation by medical staff remained poor.

Malnutrition risk in hospitalized children: use of 3 screening tools in a large European population

“…The PYMS and STAMP are based on anthropometric measures and, thus, detect the large majority of children with abnormal anthropometric measures (26,27). However, the use of these tools may come at the expense of too many children being categorized as high risk.…”

“…Moreover, screening tools are also aiming to identify children at risk of deterioration of malnutrition risk because of an acute medical insult despite normal anthropometric measures at hospital admission. This identification encompasses a large proportion of children who are admitted in acute settings in developed countries, and the intervention and prevention of weight loss are probably as important as the correction of weight loss and growth catch-up in children who are already malnourished (26).…”

Nutritional assessment of acute medical admissions is still done badly despite 'nutrition screening'

“…Perhaps when this basic standard is not being met, it can be no surprise that nutrition screening (eg, STAMP) is also done badly or that risk assessment has been shown by others to have little impact 4. We suggest that standards will not improve until increased emphasis is given to this topic during medical and nursing training.…”

Visual inspection is not a substitute for anthropometry in screening for nutritional status and growth in sick children

“…It is important that sick children are screened for malnutrition and growth faltering to ensure that those in need of intervention receive optimal health care. Paediatric malnutrition screening tools and the acquisition and plotting of anthropometric measurements are not routinely used and this means that, at best, there is substantial reliance placed on visual inspection when it comes to screening for nutritional problems . The extent to which healthcare professionals can visually identify children whose physique deviates from norms, and how valid this approach would be for routine screening on hospital admission, has not been studied thoroughly, particularly in sick children.…”

“…The absence of an association between the level of experience of health professionals and physique predictions might indicate that the diagnostic accuracy of visual inspection does not improve with training. Alternatively, it might reflect the opportunistic acquisition of anthropometry and screening for malnutrition in routine clinical practice .…”