Nutritional Status Classification in the Department of Veterans Affairs

Hiller, Lynn D.; Lowery, Julie C.; Davis, Jennifer; Shore, Carole J.; Striplin, Dana

doi:10.1016/s0002-8223(01)00196-1

Cited by 13 publications

(6 citation statements)

References 44 publications

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“…They can also incorporate risk factors that predict the likelihood of malnutrition in their respective patient population (e.g. aged more than 60 years, presence of specific diseases, longer length of hospital stay) 13,14 . Such information helps institutions to produce valid and reliable nutritional screening tools.…”

Section: Introductionmentioning

confidence: 99%

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Malnutrition screening in hospitalised patients and its implication on reimbursement

Raja

Lim

et al. 2004

Internal Medicine Journal

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Section: Introductionmentioning

confidence: 99%

“…aged more than 60 years, presence of specific diseases, longer length of hospital stay). 13,14 Such information helps institutions to produce valid and reliable nutritional screening tools.…”

Section: Introductionmentioning

confidence: 99%

Malnutrition screening in hospitalised patients and its implication on reimbursement

Raja

Lim

et al. 2004

Internal Medicine Journal

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“…The VANSC was developed by the VA to identify patients who would benefit from a more comprehensive nutrition assessment and to prioritize patient care and has been found to have both good to very good interrater reliability and good content validity . VANSC scores traditional nutrition indicators such as intake history, unintended weight loss, percent ideal body weight, and physical appearance and also scores nontraditional indicators such as degree of metabolic stress and functional capacity.…”

Section: Discussionmentioning

confidence: 99%

“…As a Veterans Administration (VA) hospital, part of the nation's largest healthcare system, we currently use the Veterans Administration Nutrition Status Classification (VANSC) tool to evaluate new inpatient admissions and to identify which patients require full assessments . The VANSC tool was developed >15 years ago using evidence‐based criteria and was designed to be applicable across a wide variety of veteran inpatient settings.…”

Section: Introductionmentioning

confidence: 99%

Identifying Critically Ill Veterans Who Require Nutrition Intervention: A Quality Improvement Study Comparing Nutrition Risk Tools

Hiller

Metzger

2019

Nut in Clin Prac

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Background: Identification of intensive care unit (ICU) patients who require nutrition intervention is crucial to initiating nutrition therapy. This prospective quality improvement study evaluated the Nutritional Risk Screening (NRS) 2002, Malnutrition Universal Screening Tool (MUST), and Nutrition Risk in Critically Ill (NUTRIC) score in comparison with the Veterans Administration Nutrition Status Classification (VANSC) tool to determine which best identified the need for nutrition intervention. Methods: A convenience sample of 150 ICU patients was evaluated using the VANSC, NRS 2002, MUST, and the NUTRIC score. The resultant score, need for nutrition intervention, and presence of malnutrition were recorded for patients. Interventions were defined as need for enteral or parenteral nutrition, nutritional supplements, or diet change. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Matthews Correlation Coefficient (MCC), F1 score, and accuracy to predict need for nutrition intervention were calculated for each screening tool. Results: Of the 150 patients, 49 (33%) required 1 or more nutrition interventions. The NRS 2002 (0.878) and VANSC (0.816) had the highest sensitivity. The NUTRIC (0.921) and VANSC (0.911) had the highest specificity. The VANSC (0.816) and MUST (0.687) had the highest PPV. The VANSC (0.911) and NRS 2002 (0.872) had the highest NPV. The VANSC (0.727) and MUST (0.528) had the highest MCC. The VANSC (0.816) and MUST (0.680) had the highest F1 score. Conclusions: Trialing several tools to identify their efficacy and reliability individual setting may help determine the most appropriate tool to utilize for your patient population and specific goals. (Nutr Clin Pract. 2019;34:414-420)

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“…Hiller and coworkers evaluated a nutrition status classification system used in the Department of Veterans'Affairs for validity and reliability. 17 The system used 7 criteria, including nutrition history, unintentional weight loss, percent of ideal body weight, diet order, diagnosis, serum albumin level, and total lymphocyte count. The algorithm demonstrated good interrater reliability among dietitians and dietetic technicians.…”

Section: Discussionmentioning

confidence: 99%

Nutrition Risk Screening in Acute Care: A Survey of Practice

2008

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The Joint Commission-accredited acute care hospitals are required to screen patients for nutrition risk, but criteria and procedures in use have not been described. The purpose of this study was to survey managers of clinical nutrition services in acute care hospitals regarding procedures for screening for nutrition risk. Members of the Clinical Nutrition Management Dietetic Practice Group were surveyed using an e-mailed link to an electronic survey. Of 1668 members contacted, 522 usable surveys were completed (31%). Most respondents (84%) reported that nursing staff had primary responsibility for nutrition screening; 10% used nutrition services staff; 4% used a computerized system. Where nursing staff did nutrition screening (n=441), 57% (n=252) said that nutrition services staff do a secondary admission screen. Dietitians most often performed secondary screens (70%), followed by dietetic technicians (16%), 4-year-degreed staff (4%), and clerks (3%). Most nutrition services staff screens (61%) used different data than nursing staff screens; 12% collected the same data as nursing staff. Screening criteria most often used by nursing staff were a history of weight loss (95%), poor intake prior to admission (81%), nutrition support (79%), chewing/swallowing issues (75%), and skin breakdown (72%). Criteria most commonly used by nutrition services staff were diagnosis (90%), nutrition support (81%), nothing by mouth (NPO)/clear liquid diet order (78%), visceral proteins (71%), and specific diet orders (68%). Most respondents had not formally evaluated their screening systems for sensitivity or specificity. There is a need to further evaluate the nutrition screening systems used in acute care hospitals in the U.S.

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Nutritional Status Classification in the Department of Veterans Affairs

Cited by 13 publications

References 44 publications

Malnutrition screening in hospitalised patients and its implication on reimbursement

Malnutrition screening in hospitalised patients and its implication on reimbursement

Identifying Critically Ill Veterans Who Require Nutrition Intervention: A Quality Improvement Study Comparing Nutrition Risk Tools

Nutrition Risk Screening in Acute Care: A Survey of Practice

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